The COVID-19 pandemic has resulted in an increased need for ventilators. The potential to ventilate more than one patient with a single ventilator, a so-called split ventilator setup, provides an emergency solution. Our hypothesis is that ventilation can be individualized by adding a flow restrictor to limit tidal volumes, add PEEP, titrate FiO 2 and monitor ventilation. This way we could enhance optimization of patient safety and clinical applicability. We performed bench testing to test our hypothesis and identify limitations. We performed a bench testing in two test lungs: (1) determine lung compliance (2) determine volume, plateau pressure and PEEP, (3) illustrate individualization of airway pressures and tidal volume with a flow restrictor, (4a) illustrate that PEEP can be applied and individualized (4b) create and measure intrinsic PEEP (4c and d) determine PEEP as a function of flow restriction, (5) individualization of FiO 2. The lung compliance varied between 13 and 27 mL/cmH 2 O. Set ventilator settings could be applied and measured. Extrinsic PEEP can be applied except for settings with a large expiratory time. Volume and pressure regulation is possible between 70 and 39% flow restrictor valve closure. Flow restriction in the tested circuit had no effect on the other circuit or on intrinsic PEEP. FiO 2 could be modulated individually between 0.21 and 0.8 by gradually adjusting the additional flow, and minimal affecting FiO 2 in the other circuit. Tidal volumes, PEEP and FiO 2 can be individualized and monitored in a bench testing of a split ventilator. In vivo research is needed to further explore the clinical limitations and outcomes, making implementation possible as a last resort ventilation strategy.

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Objectives This cross‐sectional study examines first whether emergency physicians differ from a comparison group of surgeons, more specifically general surgeons and orthopedic surgeons, in terms of job and organizational characteristics and second to what extent these characteristics are determinants of professional well‐being outcomes in emergency physicians. Methods Belgian emergency physicians (n = 346) were invited to participate in this study. Forty‐three percent of the eligible participants completed a questionnaire. The survey instrument contained 48 questions on determinants (personal characteristics, job conditions [Job Demand Control Support], organizational and environmental work conditions) as well as 39 questions on outcomes (job satisfaction, turnover intention, subjective fatigue, psychological distress, work–home interference, work engagement) by means of the Leiden Quality of Work Questionnaire for Medical Doctors, the Checklist Individual Strength, the Brief Symptom Inventory, and the Utrecht Work Engagement Scale. Hierarchical multiple regression analyses were used to examine the association between the determinants and each of the outcomes. Results Emergency physicians reported higher job demands, lower job control, and less adequate work conditions compared with the group of surgeons. High job demands increased turnover intention, subjective fatigue, psychological distress, work–home interference in emergency physicians, but lack of job control, lack of social support from the supervisor, and inadequate communication also contributed in an unfavorable way to some of these outcomes. Conclusion Emergency medicine departments must reduce the constant exposure to high job demands by allowing emergency physicians to have enough time for both physical and mental recovery. Work motivation and work conditions might be improved by increasing job control over job demands by giving emergency physicians more decision latitude and autonomy, improving good communication and teamwork and adequate social support from the supervisor and providing good material resources. These interventions can improve professional well‐being outcomes in emergency physicians.

Background- The COVID-19 pandemic has resulted in an increased need for ventilators. The potential to ventilate more than one patient with a single ventilator, a so-called split ventilator setup, provides an emergency solution. Our hypothesis is that ventilation can be individualized by adding a flow restrictor to limit tidal volumes, add PEEP, titrate FiO 2 and monitor ventilation. This way we could ensure optimization of patient safety and clinical applicability. We performed bench testing to test our hypothesis and identify limitations. Methods- We performed a bench testing in two lungs: 1) determine lung compliance 2) determine volume, plateau pressure and PEEP, 3) illustrate individualization of airway pressures and tidal volume with a flow restrictor, 4a) illustrate that PEEP can be applied and individualized 4b) create and measure intrinsic PEEP 4c-d) determine PEEP as a function of flow restriction, 5) individualization of FiO 2 . Results- The lung compliance varied between 13 and 27 mL/cmH 2 O. Set ventilator settings could be applied and measured. Extrinsic PEEP can be applied except for settings with a large expiratory time. Volume and pressure regulation is possible between 70-39% flow restrictor valve closure. Flow restriction in the tested circuit had no effect on the other circuit or on intrinsic PEEP. FiO 2 could be modulated individually between 0.21 and 0.8 by gradually adjusting the additional flow, and minimal affecting FiO 2 in the other circuit. Conclusions- Tidal volumes, PEEP and FiO2 can be individualized and monitored in a bench testing of a split ventilator. In vivo research is needed to further explore the clinical limitations and outcomes, making implementation possible as a last resort ventilation strategy.