Two deaths and about 300 positive cases of swine flu appear to have failed to bring the health department mandarins out of their stupor.

Sample this: Pinki Devi, a 30-year-old woman suffering from swine flu, died as an apparatus, which could have revived chances of her survival, was not available at the Infectious Disease Hospital (IDH), Patna, where she had been admitted on March 18 and breathed her last on March 20.

"Pinki had severe lungs infection and she needed to be put on biphasic positive airway pressure (BiPAP), which is a non-invasive ventilator. As the IDH did not have the machine, we tried to get it from Patna Medical College and Hospital or Nalanda Medical College and Hospital. But none of these hospitals has the machine. Hence we could do nothing much in the case," an IDH source said on Sunday.

Even health department principal secretary Brajesh Mehrotra was candid enough to accept the lack of BiPAP facility in the IDH as well as in premier health hubs like Patna Medical College and Hospital and Nalanda Medical College and Hospital.

"I find no reason as to why a machine, which patients need in emergency cases, has not been procured so far. I have issued directive for early procurement of the BiPAP," he said.

In the state till Sunday, at least 293 cases of swine flu have been detected so far with two casualties.

Interestingly, the IDH does not have the services of anaesthetist as well even though their services are required to handle ventilators and cardiac monitor machines, which are put in use in case of serious swine flu patients.

Mehrotra accepted this deficiency as well but claimed that department had made alternative arrangement for handling emergency situations. "We have asked Nalanda Medical College and Hospital to send their anaesthetist whenever there is some requirement at the IDH. Nalanda Medical College and Hospital is closer to the IDH. So, there will not be any problem as such," he said.

IDH and Nalanda Medical College and Hospital are hardly 100 yards away from each other and both these institutions are located on Agamkuan Road.

Biphasic Positive Airway Pressure (BiPAP) can be described as pressure-controlled ventilation in a system allowing unrestricted spontaneous breathing at any moment of the ventilatory cycle. It can also be described as a Continuous Positive Airway Pressure (CPAP) system with a time-cycled change of the applied CPAP level.

This device has been found to be especially useful for patients who have congestive heart failure or lung disorders, especially conditions that result in above-normal levels of carbon dioxide.

A WHO report suggests patients who are mechanically ventilated or receiving respiratory therapy treatment can be managed using standard and droplet precautions.

Such precautions include non-invasive ventilation (BiPAP, CPAP):12 standard and droplet precautions unless indicated otherwise by new evidence of increased transmission risk.