On 4 April, Gujarat Chief Minister Vijay Rupani inaugurated locally-made ‘ventilators’ at Ahmedabad City hospital, the biggest COVID-19 facility in the state.
Despite 250 of these machines (called ‘Dhaman-1’) being supplied, the hospital superintendent JV Modi wrote to the Gujarat Medical Services Corporation Limited (GMSCL) regarding the need for 50 high-end ICU ventilators, because the former had not been delivering the ‘desired result’.
As per a PTI report, Modi wrote in the letter, "We have placed a demand for 50 high-end ICU ventilators each for COVID Hospital and Kidney Hospital. With rising coronavirus cases, we need more number of ventilators, as per the demand received by head of anesthesia department.”
Civil hospital head of anesthesia, Shailesh Shah said, "Luckily, until now, we used these ventilators on very few occasions, as high-end ventilators were available with us in enough numbers.”
Rajkot-based Jyoti CNC Automation had developed these ‘low cost’ devices in 10 days to meet the rising demand for the equipment in the treatment of COVID-19 patients. These were supplied free of cost to the government hospitals, reported Ahmedabad Mirror.
The state health principal secretary, Jayanti Ravi has said that the devices will be upgraded by the manufacturing company.
Ambu-Bags Being Passed off As Ventilators?
The report in Ahmedabad Mirror mentions that the machines were not exactly ventilators, but ambu-bags. Although sources close to the government have said the chief minister had never called them ‘ventilators’ in the first place, the pressnote shared in the article suggests otherwise.
The note also states, “Rajkot-based private company Jyoti CNC had developed the ventilator ‘Dhaman-1’ in a very short period of just 10 days. The manufacturing cost of DHman-1 is less than Rs 1 Lakh per piece. This great achievement would add a new feather to PM Narendra Modi’s dream campaign of Make in India.
The discrepancy came into light when the hospital raised the demand for good quality ventilators despite having been supplied 250 of these indigenous machines.
The Mirror report quotes a senior official who said that this is a mechanised Ambu-bag and not a ventilator. Sources at the hospital said that these are not ICU ventilators and doctors have been told to use them only in extreme conditions.
Parakraminh Jadeja also told the paper, “It is not a full-fledged ventilator and it was communicated to the government well in advance. There are several modes in the ventilator, this is to address emergencies. We are developing Shaman-3 which is a full-fledged ventilator. We have also promised the government to upgrade all the ventilators that we have supplied.”
Ventilators Verus Ambu-Bag; What’s the Difference?
In an earlier article, The Quint had explained the difference between ventilators, ambu-bags and other respiratory devices.
1. Ventilators (Price: Rs 2,00,000 to Rs 10,00,000)
Ventilators are most-effective in treating acute respiratory distress syndrome (ARDS) or severe breathing issues, which is one of the dangerous symptoms of COVID-19 infection. Patients who are badly infected cannot breathe on their own and this is where these ventilators are critical.
Patients using these types of ventilators are usually intubated, which means a tube is pushed down their throats to the lungs, directly pushing air in and out. The ventilator has different attachments that allow for oxygen supply at varied rates and provide constant monitoring of other vital signs such as heart rate, blood pressure, oxygen saturation levels etc.
2. Ambu-Bags (normally priced at Rs 1,500 - Rs 3,000)
Ambulatory bags or ambu bags are usually used in first-aid by first-responders. They are also used by anesthetists in operation theatres. These are temporary manually operated respiratory devices that consist of a bag that pumps air into a patient's mouth/nose with a mask.
The ambu bag has to be manually operated to keep a person breathing, forcing air into their lungs. Most of the innovations that have been proposed lately are mechanical ambu bags, where a machine does the pumping action instead of a human. An oxygen cylinder can be connected to an ambu bag to aid in oxygen supply to a patient.
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