
Ventilator built from snorkel mask and 3D printed part - nireyal
https://www.isinnova.it/easy-covid19-eng/
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azernik
Original title is "Emergency mask for hospital ventilators". The title on the
post is misleading.

A ventilator is a machine with electronics, moving parts, and sensors that
pushes air into people's lungs and pulls it back out. This is an improvised
replacement for one of the less- or non-reusable accessories in short supply,
the mask that goes on the patient.

~~~
nireyal
Technically it is a "ventilation-assisted mask" but according to the sketches,
it does plug directly into the hospital's oxygen system. Scroll down to the
bottom to see sketches.

~~~
azernik
What you refer to as the "hospital's oxygen system" is the oxygen output port
on a ventilator. See also this note in the text:

"The prototype as a whole has been tested on one of our colleagues directly
inside the Chiari Hospital, _connected to the ventilator body_ , and has
proven to be correctly working."

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Kaibeezy
I’m having trouble seeing why this couldn’t be a widespread solution. It uses
the same supply lines; the mask is designed to maintain a seal and support
normal breathing.

What prevents this from being an option when the alternative is, I dunno,
death?

Is this actually a “ventilator”? Or is it just a mask and it’s the rest of the
air delivery system that’s in short supply? Can anyone point to a good basic
intro to the “design a ventilator” problem?

~~~
jcrubino
It is a ventilator in terms of displacing exhaled CO2 via the volume of air
moving through the circuit, mask and lungs. It also provides positive pressure
to aid in more effective oxygenation.

There is alot of selective focus and attention to "ventilators" currently. The
danger is people believe that a fuller featured ventilator will save them when
in reality (it will in some cases) public health focus should (arguably is) be
on everything that can be done to keep COVID patients from being intubated and
needing a full featured ventilators.

There is a risk that we run out of ventilators because they are dedicated to
long term life support of patients that become dependent on them when they
could be providing the short term ventilatory support of patients who will
recover enough not need one. This is another scenario given our medical
capabilities, well trained healthcare workers, and cultural outlook we are not
yet talking about.

~~~
iso1631
> This is another scenario given our medical capabilities, well trained
> healthcare workers, and cultural outlook we are not yet talking about.

In the UK the ethics boards are working on policies for triage

~~~
jcrubino
I saw the Italians intubation protocol has this in mind. A very public
discussion of these issues could create more panic than productive
conversations in the media, but it really it will need to be addressed openly
sooner or later before long-term ventilators start stacking.

~~~
iso1631
One person I speak to online is a reverend, who's been asked to be part of an
ethics committee which will be making those decisions when resources run out

What do you optimise for?

Number of lives saved? Number of Years saved (so better to save someone with a
life expectancy of 40 years than 2 people of LE of 5 years each)? Do you
remove ventilators from those who it's just delaying the inevitable? How to do
you factor in non-covid cases?

Do you take into account how "good" the patient was? Were they self isolating
or did they go to a pub lockin? Have they been hoarding toilet paper? Do you
save the person who caught it performing CPR? What about the Key Worker who
caught it while delivering food to the town? How about the dumbass politician
who's encouraging people to ignore the restrictions?

~~~
jcrubino
Generally (Used to be) in the united states the social worker will present the
general ethical frameworks to reason within and it is up to family to provide
the answer. Ethics boards develop recommendations as needed, when courts have
to step in.

I will say working in a Trauma and ICU rooms, families are generally well
aware of the decisions to be made when it is time.

~~~
iso1631
What do you mean "up to family"?

500 people outside need ICU beds, 6 patients have just died, so you have 6 new
beds open. Which of the 500 do you treat?

~~~
jcrubino
Family = Next of Kin

They are assigned a triage score and that score will be updated routinely. As
beds open, the people who fit the criteria get the bed. I believe that is
fairly standard in a public hospital type setting.

I have only ever worked in public and military icu, wards, er and trauma rooms
so I do not know too many details on how that works in practice.

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donquichotte
Just signed up as a local maker, it is nice that they are trying to connect
hospitals with manufacturing capabilities [1].

[1]
[https://docs.google.com/forms/d/e/1FAIpQLSdc0aa34YSqm6hPQWRL...](https://docs.google.com/forms/d/e/1FAIpQLSdc0aa34YSqm6hPQWRL9OT4bFaowXSlvObUVr9kZurn4MZnoQ/viewform)

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yamrzou
Relatedly, some engineering students from Tunisia created 3D printed
protective masks and started supplying hospitals as they have a shortage of
those. The prototype is open source : [https://github.com/FAB619/Protection-
Mask--COVID-19](https://github.com/FAB619/Protection-Mask--COVID-19)

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jylam
I'm not a ventilator specialist, but this is gaining some traction and I fail
to understand how it really helps. Is the ventilator shortage just a mask
shortage ? Isn't there a quite complicated machine plugged to the mask ? With
complex valves and a motor and pressure sensors and alarms and whatever ?

Again, I don't know what I'm talking about.

~~~
shoeffner
There has been some discussion on 3D printing medical ventilators on the local
hackerspace mailing list. One of the participants used to work at a company
which builds those and made similar points:

There are different systems, one are the C/VPAP which are only for ventilation
during sleep, avoiding a closure of the pharynx by increasing the pressure to
a certain maximum value. Some of those have parameters also taking care of the
patient's breathing pressure etc. but in general can only help for "better
sleep" – if they fail, then you have a bad sleep but won't die.

The systems they use in hospitals are the complex machines you describe: they
have battery power, measure the flow of breath, have alarms etc. Even here
they distinguish between "supported breathing" and "keeping alive", i.e. in
the former case the machine helps you to breathe while the second takes care
of breathing for you.

In Italy, a doctor asked for a replacement part of their ventilators which was
then 3D printed – the valves mentioned in the article. This seems to have led
to a surge in people now trying to build, design, etc. ventilators which can
essentially be build anywhere, to combat supply chain shortages.

Again: You are right, medical ventilators are a tricky business and difficult
to build. But in this case, the ventilators seem to be there, they just need
the valves, which can be printed. And they put up a huge disclaimer that
patients need to agree to use unapproved devices.

A German article covering this is [1].

[1] [https://www.deutschlandfunk.de/kreative-loesungen-in-
zeiten-...](https://www.deutschlandfunk.de/kreative-loesungen-in-zeiten-von-
corona-lebensretter-aus.676.de.html?dram:article_id=472978)

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Theodores
The panic of where we will get the ventilators from does not have to be the
sole focus. Not every patient will need a million dollar ventilator.

If someone is self isolated with the disease then they may need a lower
technology solution such as a dehumidifier. In that way they can avoid the
secondary bacterial infections that are the real killer. They can recover in a
room that won't be growing mould because it is damp from their breathing.

A humble dehumidifier could put someone on the road to recovery before it gets
to the ventilator stage in a northern climate where damp is a problem.

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nireyal
Article regarding inventors in the NYTimes:
[https://www.nytimes.com/2020/03/22/opinion/ventilators-
coron...](https://www.nytimes.com/2020/03/22/opinion/ventilators-coronavirus-
italy.html)

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growlist
Some interesting hacks appearing i.e. modifying a single ventilator to support
two or even more people.

~~~
mk89
It's amazing what people are coming up in the last weeks to make things work,
even though they don't follow the standards, the regulations, etc. etc. The
human brain under a certain amount of stress/motivation can come up with a sh
__load of ideas and solutions.

~~~
im3w1l
I think a lot of it is finally feeling safe to experiment. I'm sure ideas like
this were always around but people knew they'd be in prison if they tried it.

    
    
        The west gone wild
        Pioneering spirit
        A golden age for cowboys
        Warstories for grandchildren

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umut
Really hope that our societies can fund some research and development to bring
elasticity to health care capacity. This won't be the last time we as humans
will need it, and it will help if some smart people work on this instead of ad
click optimization..

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Tepix
The headline is misleading, this isn't a ventilator, this is an emergency
mask. Great project though!

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stuaxo
It doesnt help people who need intubation as many will with the virus.

~~~
laputan_machine
But could it help those who do not?

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numpad0
Are they(expected to be) in short supply?

