
Low-Cost Arduino-Based Ventilator - guiambros
https://github.com/jcl5m1/ventilator
======
zackbloom
If you're interested we are working on various mechanical ventilator designs
which don't require actuators or electronics. There are actually devices like
that in the market, you can learn more in our collaboration docs:
[https://docs.google.com/document/d/1R25O2mKT3TfSjXTmheGEevIk...](https://docs.google.com/document/d/1R25O2mKT3TfSjXTmheGEevIk6rTJ49o-sGCJU3QqP3M/edit?ts=5e700663#heading=h.zd4mdan4zmci)

Edit: Another design we're considering based on an Army prototype:
[https://docs.google.com/document/d/1Hcuu-55q2a3_-LmBwg0uBdgM...](https://docs.google.com/document/d/1Hcuu-55q2a3_-LmBwg0uBdgMe-
ZNPQ9jSdtrimCYazs/edit#)

If you would like to help please join us at the #project-pneumatic-ventilator
room of the Helpful Engineering Slack:
[https://helpfulengineering.slack.com/join/shared_invite/zt-c...](https://helpfulengineering.slack.com/join/shared_invite/zt-
ct8p2gmd-2lmIbt6ee3uk1XXG4ywDWQ)

~~~
gentleman11
As a member of that group, I honestly wonder what use our work will be due to
regulations. Most hospitals cannot use uncertified equipment or software. I
think however that there might be a large policy shift where these projects
may become acceptable for use after some new or temporary legislation in 1-2
months. At that time, the projects may be extremely valuable

~~~
koheripbal
...also, if China and Italy are any example, you might be taking care of
mom/dad at home because the hospitals cannot accept any more patients.

...and at home, the FDA isn't there to tell you not to use your home-made
respirator.

------
hyperion2010
This probably should have gone on the thread about flattening the curve not
being enough. But.

Where is the core team of 12 people plus 108 collaborators that should have
been assembled a month and a half ago to figure out how to retune US
manufacturing to start producing stripped down ICU beds and the supplies
needed to keep them operational?

This game is easy. The parameters are well understood. You could assign the
basic problem to a middle schooler. Getting realistic numbers? Well it doesn't
matter, no matter what those number are, every single fully functional ICU bed
that can be brought online in the next 2 weeks is probably going to save 2
lives. According to some of the other economic analysis that has been posted
here today suggesting that we let people die, that is 18 million dollars in
human lives.

How many fully stocked ICU beds can you make for 18 million dollars? There's
your startup idea for the next 2 weeks.

Not ignoring the fact that you need a team to staff it and work it, but guess
what, you ALSO have two weeks to train as many people as you can to run these
things.

WHERE IS THIS TEAM?

~~~
TaylorAlexander
HI! I’m a robotics engineer with mechanical engineering, electrical
engineering, Linux and embedded programming skills, and I have 8 3D printers
at home including two Prusa printers, a high resolution resin printer, and a
large format printer.

I’d really like to help! But there’s no central organization for this. I think
we have to quickly organize ourselves!

If anyone has any ideas please add them here in these hacker news comments,
AND/OR I’ve just created a thread on my website which we can use for focused
discussion: [https://reboot.love/t/coronavirus-
thread/281](https://reboot.love/t/coronavirus-thread/281)

I’m working from home and have some freedom to delay my normal work and assist
with this. What should I do? Is it ventilators that are most obviously needed?

We could 3D print the air pumps, but where do we get a vast supply of cheap
motors? Or in another case hospitals just needed replacement parts for
existing ventilators. How do we get in touch with hospitals and determine
their needs? People have also suggested multiple people can be connected to
one ventilator with some success. Could we make an adapter to help with that?
How would we determine requirements?

~~~
koheripbal
The bottleneck with distributing new ventilators isn't physically producing
them - it is getting them tested and approved by the FDA.

So the use-case here is people putting their loved ones on these ventilators
at home because the hospitals are full (which is entirely possible).

Ideally, we should be working with existing ventilator manufacturers in the US
to have them increase their current output.

~~~
asdfasgasdgasdg
If that's the case we need a whole DIY course of treatment, not just the
machine itself. Playing doctor with only the tools and none of the rest is
going to be a losing game. :(

~~~
arcticbull
1\. There’s no treatment other than supportive care.

2\. Ventilators aren’t dumb iron lung machines. Current ventilators are large,
complex and very much specialized machines which require special training to
operate.

Once you get to the point you need a ventilator the ventilator is the least of
your problems.

~~~
asdfasgasdgasdg
"Supportive care" is not something I or most people know how to offer. That's
my point. What does supportive care consist of? For example, I know from
reading the news that pronating ventilated patients is considered preferable.
What else?

But really, I think this "home care in case the hospitals are full" thing is a
pipe dream. A uniquely American pipe dream. For one thing, how are you going
to hydrate and feed your loved one while they're on your homemade ventilator?
Do you know how to insert an IV? Do you have saline solution on-hand?
Ventilated patients in the hospital are being sedated, to my understanding. Do
you have an anesthetist on hand to manage that? Etc. The American impulse to
independence and prepping is so silly sometimes.

The only practical use for these ventilators is in a hospital context,
employed by real doctors and nurses. And then only if the number of available
ventilators ends up being the bottleneck (as opposed to the amount of
healthcare worker labor available or some other factor). Any other imagined
use is just a safety blanket, IMO.

~~~
jcrubino
You forgot the Respiratory Therapists.

As a former respiratory therapist I understand you concern about a project
like this. I doubt anything beyond a CPAP machine is helpful for home care
without risking a ventilator lung injury which is often characterized as the
same lung pathology that COVID-19 creates in the acute respiratory cases.

That said, at home you could help at home patients relieve some symptoms until
proper medical attention is available by doing positive breath holding
exercises and chest percussion therapy to recruit more alveolar activity.

Paging Dr. Scott Weingart

[https://emcrit.org/emcrit/some-additional-covid-airway-
manag...](https://emcrit.org/emcrit/some-additional-covid-airway-management-
thoughts/)

------
Mvandenbergh
What we really need is a simple ventilator, designed by manufacturers who
already know how to design and build these and produced at enormous scale
using a shadow factory system similar to that developed in world war 2. In
this model, the original manufacturer steps in to guide production, carry out
quality control and probably supply the control electronics and software. All
physical objects on which our civilisation depends are mass produced.

~~~
shiftpgdn
Devil's advocate: Why would a manufacturer consider damaging what is a
potential mega cash cow? I read earlier that ventilators generally sell for
$40-70,000USD to hospitals (who then go on to charge $20-40k for ventilator
based treatment.)

We're much better off right now with the government seizing the means of
production and figuring out how to make as many as possible.

~~~
dirtyid
Somewhat related:

[https://threadreaderapp.com/thread/1239675564199481347.html](https://threadreaderapp.com/thread/1239675564199481347.html)

>The President said today that governors should try to get things like
respirators and masks on their own. The problem with that approach is that
suppliers will have to emergently engage w 50 different state purchasers who
would in effect be competing for supply. 8/x

>Instead, the US fed gov should be central buyer and partner to this industry.
It brings substantial immediate resources, and clarity. And when manufacturers
make new ventilators in a mass effort, the fed gov would help organize their
distribution around the country. 9/x

>What we need is a massive fed gov program to buy ventilators on unprecedented
scale and with unprecedented speed. They don’t need to be the fanciest
ventilators on the market. They need to be able to keep ARDS pts alive through
course of COVID infection. 10/x

>This @forbes article gives snapshot of vent industry and a sense of what
might be possible. It quotes one US manufacturer from 2 days ago saying he
could ramp up production 5 fold but he hasn’t been asked to do it yet.

~~~
ashildr
The US fed gov just tried to buy an early vaccine candidate “on unprecedented
scale”. I’m not sure that they will do the same when shit hits the
ventilators.

~~~
jsight
The company that they supposedly tried to buy it from has said that was a lie
spread by others.

------
sub7
Cool but almost all covid patients who get to a stage where they need
ventilation need invasive, mechanical ventilation.

NIV does not allow the lungs to clear fluid and mucus. It also allows the
virus to spread via aerosol and infect anyone without full PPE in the
vicinity.

~~~
koheripbal
How can it be modified to provide lung drainage?

~~~
sub7
You can make a Philips cough assist type device which uses abrupt pressure
changes to expel fluid. Need to be super careful with these you can do real
damage if not used correctly.

Those are also nowhere near as effective as the real deal i.e. intubation
where you stick a tube down the lungs that sucks out fluid and pushes in air.

------
squidfish
Actually, Resmed and Philips can probably reflash firmware on almost all there
basic CPAP machines manufactured within past few years, thereby making them
into BiPAP type devices. BiPAPs are sort of "in between" a CPAP and a
ventilator.

This would actually be a good public service if they would do for free and
provide to hospitals, etc. for emergency use.

~~~
jdoss
I was just thinking the same thing. My 5yo son has a wimpy immune system and
asthma. We have spent some scary times in the ER/PICU when he gets a bad lung
based cold. I am thinking about how I can convert one of my old CPAPs into a
ventilator if I can't get him into a hospital to get the care he will need due
to the healthcare system being overwhelmed. It should be obvious, but I will
say it to be clear. This would be a last resort kind of thing on my end. The
last thing I want to do is "wing it" with any kind of medical care on my kids.

~~~
squidfish
Really, you don't need to "convert" anything much. Plain old CPAP is better
than nothing (especially if it has c-flex (or diff name depending on
manufacturer) to allow for decreased pressure during exhale). In fact it is
WAY better than nothing if a person is needing support and can't get them in
help as we may soon be encountering.

There are forums out there that teach you how to adjust the settings on your
CPAP/APAP/BiPAP machines, including how to get into the "clinician mode" to
make REAL adjustments (e.g., like pressing and holding two buttons down on
machine for couple seconds puts you into clinician menu settings). There is
also software out there that will let you download the data from the SD card
in most machines to your computer and analyze it. This isn't terribly
critical, but if you have motivation / need it is handy to know how to do
this. Makes titration much faster/easier and with less trial and error.

sleepyhead is the name of software (open source, no long maaintained
unfortunatly but entirely functional still). Just google for sleep apnea
forums.

Good luck with your son and rest of family!

------
threwr32424
For those of us outside the US/EU, can someone explain about the change in
tone here on HN ? There was a similar post a few weeks back and top-voted
comments were uniformly scornful about such DIY medical equipment, and about
how a ventilator was just one component in the ICU ecosystem.

Now, though, there is a complete 180 ? What gives ?

There is also the question of supply-side issues - uCs and IC boards are
overwhelmingly manufactured in East-SE Asia. These projects can't get around
these issues, right ? If only there were someway to hack the abundant numbers
of smartphones in order to do something useful.

~~~
pbourke
> For those of us outside the US/EU, can someone explain about the change in
> tone here on HN ?

HN is being HN, for better or worse. First skepticism, then shallow takes,
then acknowledgement and analysis, now frenzied problem solving.

> a ventilator was just one component in the ICU ecosystem.

Yes, the ventilator is a CPAP machine on steriods. The Respiratory Therapist,
Intensivist and Critical Care Nursing staff are what actually keeps someone
alive. It's not uncommon for one or more of these to have multiple touches per
hour for evaluation and adjustment of the parameters, management of other life
support, etc.

We need to buy a shit-ton of ventilators and PPE from existing manufacturers
and provide relief for the front-line staff who will be using them.

~~~
carlmr
>It's not uncommon for one or more of these to have multiple touches per hour
for evaluation and adjustment of the parameters

Maybe a stupid question, but why can't this be automated?

~~~
salawat
Everyone is different, and one size does not fit all; thereby causing
complications which require a trained eye to appreciate (read: carry in your
head the list of people/procedures to execute in case of problems, and list of
things to ignore) in order to accomodate that.

It's called the "practice of medicine" for a reason. You can do everything
"right" by the book and still have things go wrong. There is no substitute for
eyes on the patient. Ever.

------
taf2
I really like this as DIY - I also found this video
[https://www.youtube.com/watch?v=okg7uq_HrhQ](https://www.youtube.com/watch?v=okg7uq_HrhQ)
\- explaining how the virus eventually kills by causing failure of the lungs.
After explaining the functional parts he goes on to explain what seem like
some interesting things to consider when designing a ventilator with respect
to how they were used during the SARS outbreak. e.g. tidal forces causing
iteration and more inflammation, which then cuts off more air flow. So
thinking about how you maintain a constant air pressure instead of more
pushing force... at least the explanation made sense intuitively but I'm not a
doctor and don't know if this video or your Ventilator are safe - but I do
like the DIY aspect of it and figure thinking about or sharing ideas can't be
bad...

------
rootedbox
BEWARE: Even medical grade ventilator / CPAP is dangerous.

~~~
battery_cowboy
Understatement of the year, it's probably more dangerous to use these at home
than just using simple oxygen and someone to help you remember to breathe for
a few days. If you're to the point that you need a ventilator for covid-19,
you're also going to need a ton of meds and attention from trained medical
staff. I could see a CPAP machine being useful for lighter cases just to help
out, but even then I'm not a doctor.

Some things are good to DIY, but not this, we need HN to stop allowing these
dangerous posts.

~~~
squidfish
Yeah, I have news for you ... I'm slapping my CPAP on any family member in a
medical crisis where their O2 is bottoming out (I have o2 monitor too .. cheap
from amazon) that potentially may be coming. If they are unable to breathe and
we can't get them medical help/ventilated, it is no brainer.

Here is my experience: CPAP (actual APAP) for a several years now. Godsend for
me. Don't even nap without it. In addition to the sleep apnea and impact it
had on my life and long term health, there has been one other remarkable
benefit. I have had no lung issues (bronchitis, asthma, pneumonia or even just
wheezing), since not long after started using. For decades prior (I'm 50 now),
I had yearly bouts with bronchitis due to my mild asthma combined with allergy
seasons, etc. I also had couple which progressed to pneumonia. I have had NONE
of that since starting and we are on the 4th year now. The APAP helps expand
lungs and breath deeply, in addition to the intended benefit of keeping my
airway from collapsing / sleep apnea.

CPAPS aren't dangerous. I've already thought about scenario where I'd use it
on loved one over past couple weeks (prior to reading this article). Damn
believe I will if have to. Alternative is potentially death.

Yes, ventilator (to me implying being intubated) is of course totally
different.

~~~
gentleman11
I have a spare cpap actually and parents with lung issues. How do you use a
cpap to help someone if it came up?

------
beenBoutIT
The CPAP part of this project is by far the most expensive component required
and it's the part lots of people already own and don't use or have a use for.
Anybody with an unused CPAP can buy an Arduino for next to nothing and put
this together, you really need to put 'CPAP' somewhere in the title.

------
forkexec
Untested equals unsafe. Amateurism doesn't help anyone except the virtue-
signaler.

~~~
MockObject
This is only being considered as a device of last resort, if and after the
medical system has collapsed and there are no alternatives.

------
HumblyTossed
Scary. Wouldn't/isn't it easy to hurt your lungs with something like this?

------
eigenvalue
I think most people reading this who want to protect themselves at home should
instead focus on getting an oxygen concentrator and not a ventilator. These
devices enrich the oxygen level in air and connect to a person through a
cannula or face mask. They are pretty easy to use and safe, and can be
purchased from eBay or Ali for around $300 to $400 shipped. Only problem is
that shipping from China is slow now so it will likely take 2-3 weeks to
arrive. But this is what most people would get at a hospital unless they are
gravely ill and require intubation.

------
guiambros
Source: [http://procrastineering.blogspot.com/2020/03/low-cost-
ventil...](http://procrastineering.blogspot.com/2020/03/low-cost-
ventilators.html)

------
abakker
Can anyone explain why normal ventilators don't just use flow meters on
compressed air with a solenoid? A standard pilot valve pneumatic solenoid can
switch much faster than this. with regulated air pressure, and an air filter
on the air, it seems possible to make it work pretty easily just using
compressed air.

~~~
linuxftw
Compressed air contains lots of moister. You don't want this. It can also
contain oil or other contaminants.

~~~
chipsa
What about a scuba supply? That's breathing safe.

------
antimatter15
This appears to be by Johnny Chung Lee, who did all the experiments with head
tracking, and finger tracking with the Nintendo Wii controller many years ago
([http://johnnylee.net/projects/wii/](http://johnnylee.net/projects/wii/)).

------
Metallurgist
US Patent 3,419,029 Breathing Valve Assembly HH Straub Dec 31 1968

This appears to be simpler solution that can be AM'd quickly

Also, medical staff prefer not to use face masks because if the mask does not
fit well on to the patients face there is a potential to aspirate body fluids
and aerolise the virus.

------
jes
Possibly of interest, w/r/t improving availability of ventilators in a medical
crisis:

[https://www.youtube.com/watch?v=uClq978oohY](https://www.youtube.com/watch?v=uClq978oohY)

------
PaulHoule
All these things bug me because it is very easy to hurt your lungs with a
ventilator.

~~~
tw04
Death is also an easy way to hurt your lungs. I hope nobody is dumb enough to
use something like this in place of visiting a hospital, but if hospitals are
overrun this is better than nothing.

~~~
ploika
No, this is just something. This something is not necessarily better than
nothing.

It could be an awful lot worse than nothing, especially since it's coming from
GitHub and not somewhere like the Red Cross or MSF, with experience of medical
care in tough environments , that knows the difference between "actually
better than nothing" and "just something".

~~~
gentleman11
Can anybody comment? How could it be worse than nothing, and is there a way to
evaluate these designs? Imagine somebody had parents with lung issues and the
hospitals were turning away old people with such conditions in 1-2 months

~~~
serf
>Can anybody comment? How could it be worse than nothing

by giving those under-qualified to accurately diagnose a condition medical
equipment that requires expertise to use, you increase the chances of
incorrect use and non-indicated use.

------
anfractuosity
Would 'approved' ventilators use multiple MCUs/FPGAs/.. and a 'voting' system
so that if there are issues with one, others take over?

