
Open Source Ventilator Project - cklaus
https://opensourceventilator.ie/
======
cklaus
Welcome to Open Source Ventilator (OSV) Ireland. This project was initiated by
the COVID-19 global pandemic as a result of a community discussion within a
Facebook group called Open Source COVID-19 Medical Supplies (OSCMS). This
group rapidly grew and currently is targeting the development of a number of
different COVID-19 related medical supplies.

OSV Ireland was formed by Colin Keogh, Conall Laverty & David Pollard, with
the goal of building a focused team in Ireland to begin development of a Field
Emergency Ventilator (FEV) in partnership with the Irish Health Service. To
date we have formed a team of engineers, designers and medical practitioners
to develop new, low resource interventions, all working collaboratively
online. Bag Valve Masks (BVM), 3D printed and traditionally manufactured
components are being considered to maximise potential manufacturing
capabilities. We will also include other challenges and problems as they arise
from frontline healthcare workers, which we will encourage our volunteers to
tackle.

We have a core developer team publishing open source designs with ongoing
communication with medical professionals regarding needs requirements, testing
and validation processes. The developer team is led by OpenLung in Canada in
collaboration with an Irish based engineering and operations team. The
developer team is led by Trevor Smale, Dr. Andrew Finkle, and David O’Reilly
from OpenLung as well as Conall Laverty and Dr. Keith Kennedy from Ireland.
Work is well underway with hundreds of worldwide contributors.

~~~
niutech
Have you heard of Polish open source ventilator VentilAid?
[http://www.ventilaid.org](http://www.ventilaid.org)

------
vr46
What is the point of all these? Large scale manufacturers have already been
sent blueprints of ventilators and have the engineering ability and production
lines to make them. Then you need trained nurses and staff to operate them.

~~~
jka
Open source designs could help scale up production in times of need by
allowing manufacturers to self-assess whether they're capable of providing
additional capacity.

Yes, we assume blueprints have now been shared and that production is scaling
up - but it has required a lot of time, effort, communication and bargaining.

That said, open source alone is not a panacea. Questions should be asked of
open source designs:

\- Do the designs meet regulatory standards for the market(s) they are
intended for?

\- Is the quality assurance process equally open, so that manufacturers &
recipients can verify whether products are authentic and fit-for-purpose?

It looks like the OSV project are aware of these questions and provide their
working assumptions and information about work-in-progress on their homepage.

------
DoreenMichele
I made some remarks about ventilator alternatives here:

[https://news.ycombinator.com/item?id=22624959](https://news.ycombinator.com/item?id=22624959)

To pull out some pertinent details:

Ventilators for covid19 seem to be mostly for inflammation and fluid in the
lungs (aka pneumonia), not lung or chest paralysis.

If you need a ventilator due to inflammation or fluid build up, you can do
other things to address those issues.

If you are doing home care for serious lung issues, a downside of mechanical
intervention is that you probably don't know how to adequately sterilize your
equipment. This means nasty stuff grows on the equipment and then this nasty
stuff gets delivered directly into the lungs.

So I'm not thrilled to pieces to see the emphasis on "ooh, shiny!" homemade
technical solutions in place of non-invasive home care.

You can do lung clearance without mechanical intervention. This can make a
ventilator unnecessary.

You can do lung clearance easily on your own in the shower by standing with
your feet shoulder-width apart or a bit wider, bending over as far as you can
and coughing hard.

If you bring up a lot of fluid from the lungs, it looks and feels a whole lot
like vomiting. My sons and I call it "puking up a lung."

Inflammation can be combated with commonly available non drug remedies, like
caffeine, lettuce, avoiding pro inflammatory foods (avoid peanut oil like the
devil himself made it for you, limit or avoid bacon as it is hard on the
lungs).

Etc.

Please see my previous remarks about best sleeping positions, etc.

I am very concerned that homemade ventilators are going to become a source of
secondary infection and this secondary infection will be worse than covid19
because it will be bacterial or fungal and it will be antibiotic resistant.

If I had any idea how on Earth to start a counter movement, I would be all
over it. I have no idea how to do that, so I occasionally leave a comment on
HN giving some of my thoughts, which isn't likely to exactly catch fire. This
is today's comment in that vein.

~~~
AstralStorm
Please don't be silly. You cannot physically cough hard enough with dropped O2
sats like that, and even strong healthy people will be unable to fully
evacuate matter from lungs, especially biofilms. Next time you propose an
alternative, provide actual data supporting it. As a test, start doing it at
say peak of a 2200 meter mountain. (That would be 90% with no acclimation.)
See how far you can go.

Sleeping positions are irrelevant.

A positive pressure mask or cannula with O2 concentrator or supply is likely
sufficient, not necessarily a full blown ventilator, and is much easier to
sterilize. Still, it does carry risks. And it's the O2 concentrator part
that's expensive.

~~~
goblin89
Reduced efficiency and inability to evacuate matter _fully_ (which you claim)
does not seem to make the method useless. Severity of the condition is likely
a spectrum too.

------
davidw
Anyone pitching in seems like they're doing a good thing, but isn't the
problem one more of political organization and scaling production?

In other words, the US president (he is the only one authorized to do it)
needs to activate the Defense Production Act, and get existing companies to
mass produce existing designs. Something similar needs to happen elsewhere.
This is a matter of days or weeks, not months.

Please gently correct me if I have this wrong.

~~~
labcomputer
My understanding is that the various open source ventilator projects are
attempting to use readily-available COTS parts (by, for example, using a
constant-speed blower and valves operated by RC hobby servos instead of a
variable-speed blower). So that should, at least partially, solve the scaling
problem.

As for political organization, I would think that almost takes care of itself
if someone presents a turn-key, scalable solution.

~~~
hackcasual
So if these open source ventilators are needed in any number, it's going to be
dependent on the RC hobby servo motor supply chain?

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thekalinga
Went over many comments. I see many people who are worried about an opensource
project because its going to throw the apple cart of existing price gouging
players in the market, but they are not open about it

This is an excellent foray of opensource into a space thats currently
extorting people to live, i.e medical industry

------
chrisseaton
> 15-20% of infected people require hospitalization for respiratory problems

This is wrong - it's 15-20% of _identified_ , _diagnosed_ and _subsequently
monitored_ infected people, isn't it?

I thought there was a mass of unidentified infected people, and even basically
diagnosed but told to just deal with it at home with no further contact as
they're low risk and minimal symptoms, and (obviously) 0% of these groups are
going into hospital? This is what Wikipedia says at the moment.

Or am I wrong?

~~~
ldng
You're absolutely right. But does it _really_ matter ?

A lot more ventilator are going to be needed, not in % but in hard cold real
absolute number. Isn't that more important ?

~~~
chrisseaton
> But does it really matter ?

Yes - I think we should challenge misleading information wherever we see it in
this situation. Fighting panic is part of the problem and bad numbers cause
panic.

I mean, if we don't really care that the numbers aren't accurate because it's
more important to emphasise why the project is important, we might as well go
all the way and say 99% of people need a ventilator and really sell the
project.

There was a news report recently implying a 50/50 survival rate, due to this
same kind of assuming everyone realises that you're talking about some group
that's already in a bad way, but not actually saying that in the text.

~~~
ldng
I don't think this project wants to create panic. To me it rather is trying to
help and be prepared. I'd rather have too many than too few.

Plus, we don't know when the site was set up. Two weeks ago ? Four weeks ago ?
Our collective knowlegde is changing every day. Could just be they have been
busy and did not find the time to update it ?

And finally, blueprint for a cheap OSS FEV will always be useful. COVID or
not.

~~~
__blockcipher__
They’re not arguing against having an open source spec, they’re just pointing
out that you can do the open source ventilator thing while not spreading
misinformation.

Please don’t confuse the two. It’s hard enough to fight the misinformation as
is without well-intentioned people such as yourself introducing red herrings.

Again, your point is coming from a good place. But we need to be really
careful about not accepting misinformation.

~~~
ldng
This is one line on a whole page. And if usually people should cross-reference
at the very least 3 reputable sources before accepting an informations as
true. Maybe it is a good time to ingrain that message along the "wash your
hands"

------
arcticbull
Please, stop with these. As experts have shared many times on here, once you
need a ventilator, the ventilator is the _least_ of your problems. Trying to
apply a ventilator to a COVID-19 patient who needs one when you have no idea
what you're doing can create the same lung injuries as COVID-19 itself.

~~~
Mvandenbergh
Just treat it as harmless hobbyism, which is what it is. When engineers are
nervous, they build things. That is natural!

Will these open source designs save many lives? I doubt it. Large scale
manufacturers working with existing vent makers will do a much better job.
But... if it gets thousands of people thinking about artificial ventilation,
we might get a lot of interesting new ideas that we can use in the decades to
come.

~~~
dsl
> Just treat it as harmless hobbyism

Any other time, yes. In a time of widespread panic? Dangerous.

People are going to try to build and use these at home in an act of
desperation to "do something", and end up killing their loved ones.

~~~
nexuist
Think back to Wuhan. Imagine the hospitals have closed their doors because
they are already backed up. Your grandparent is dying in the room next door
because no doctor is available to treat them.

Who the hell cares if you build a ventilator and try it then? They're going to
die anyways. You are doing nothing except increasing their chance of survival
by _acting_ instead of _waiting._

Should you use this while hospital beds are still available? Obviously not.
But any care is better than no care and being treated by a Wikipedia doctor is
better than being treated by no doctor when you're already on your deathbed.

~~~
arcticbull
Doing something may well be worse than doing nothing.

Concrete example: you get impaled by something. Do you: (a) do absolutely
nothing and leave it in, and seek help or (b) rip it out as you see in movies
because doing something is better than doing nothing.

(b) will kill you and (a) will save your life.

By doing something you have no business doing, no understanding of the
mechanics and consequences you may will make it worse.

If everyone in Wuhan hooked up their loved ones to leaf blowers, the death
rate probably would have been massively higher.

------
brutus1213
I like the effort and project. I tried looking at it and the techcrunch
articles and was disappointed by this and the open source mask efforts. This
is going to sound horrible but I think there is something that needs to be
said. We shouldn't have to hack/make our way out of this shortage. I say this
as a diehard hacker/maker. A factory can put together high quality and high
volume versions of these two items. It is a national shame (I'm in Canada but
lived in the US for years) that we don't have domestic capacity and ability to
surge on these items. We can still surge. This is not bloody rocket science.
If we start today, we can have factories in a month. We should be surging on
this today. We should have been surging on this since January and not have to
deal with a shortage of bloody test swabs. I know raw materials and equipment
are in short supply. But if our economies are truly unable to find the
necessary parts in our just-in-time inventory or storage, we as a generation
should hold our heads in shame and leaders accountable.

------
dang
Loosely related threads from recent days:

[https://news.ycombinator.com/item?id=22453100](https://news.ycombinator.com/item?id=22453100)

[https://news.ycombinator.com/item?id=22573188](https://news.ycombinator.com/item?id=22573188)

[https://news.ycombinator.com/item?id=22573656](https://news.ycombinator.com/item?id=22573656)

[https://news.ycombinator.com/item?id=22573926](https://news.ycombinator.com/item?id=22573926)

------
TaylorAlexander
The page isn’t loading so I’m not sure what they’ve got, but I’m still trying
to get answers to a question I have. I did research Tuesday and it seems like
ventilators are positive pressure only, and they cycle between a low pressure
and a high pressure. If this is the case, could an air compressor with a
regulator be used as the pressure source? If so, a small device with just two
pressure regulators and an electronic valve could be used to cycle between
high and low pressures for each patient. I keep seeing open source ventilators
that use a fan and a motor, but those seem likely to fail. Air compressors are
abundant and could literally be taken from construction sites to be used. You
put a pressure regulator to go down to the (very low) pressures one might want
as a maximum for any patient, then you can gang that up to a whole bunch of
hoses. Finally a little box with a couple of regulators can adjust the per
patient high and low levels.

This to me seems much simpler and more reliable than ventilators with their
own fan. But I don’t have a good way of reaching anyone. I’ve created a thread
on my website with my sources, thinking, and some questions. If anyone knows
about this please reply here or there and let me know. Thanks.

[https://reboot.love/t/coronavirus-towards-a-cheap-and-
easy-t...](https://reboot.love/t/coronavirus-towards-a-cheap-and-easy-to-
manufacture-ventilator/281/11)

~~~
Mvandenbergh
To quote an earlier comment of mine:

So there are four main ways for breathing machines to be powered: 1) By
compressed air from a wall port (majority of ICU machines)

2) With bellows (anesthesia machines)

3) Turbine, either dynamic or constant speed with a proportional valve (home
use or patient transport)

4) Piston

Let's assume that we use a pneumatic device driven by centrally purified air
as that is simplest. The parts then are:

-Gas blending to mix O2 and HP air. In many designs this is done using two solenoid valves.

-A fast, precise, and accurate proportional solenoid valve. This turns the constant pressure into the desired waveform

-another valve for controlling exhalation pressure. Can be another proportional solenoid, alternatively a manually adjustable valve to ensure constant minimum end exhalation pressure (PEEP)

-Flow sensor (range of options, typically variable orifice or hot wire anemometer but other type exist)

-Pressure sensor (silicon waver transducer)

-Overpressure valve

-O2 sensor (highly desirable, arguably you can estimate from O2 blending settings but that will work better on a very well characterised design which this would not be. Anyway O2 sensors are widely used so this will never be a constraint.

-Piping to connect it all together

-A control and alarm system to drive desired waveform based on user settings and sensors

-Patient circuit: Humidifier / heat exchanger, patient valve (one time use), viral filters for intake and exhalation air (one time use), ET tubes (one time use) Probably the limiting factor as far as parts go are the valves since this is a niche application. Here's the problem: as a civilisation, if we had to make a hundred million vents by the end of the year it would be easy. Expensive, sure, but not that hard in an emergency. It is much harder to make an extra 50,000 in a few weeks because it just takes time to turn the machinery of mass production in a different direction.

Let me know if you want me to send my list of ventilator reading. I'm not an
expert either, just trying to soothe my Corona-madness by thinking about
building things.

~~~
TaylorAlexander
Thank you! I will copy your comment to the thread on my website and link back
to your comment here. Feel free to share your reading, but the stress of
feeling like I can help is a bit much. I’m going to collect information but
for now I’m hoping the major manufacturers committed to ventilator
manufacturing are going to pull through.

------
mikeInAlaska
Has anyone looked at Cuirass ventilators? The (seemingly only) manufacturer
says they are great for clearing lungs and breathing. They even seem to
indicate them for use with Covid. They are basically iron lungs revamped. They
look easier to amateur build than invasive ventilators and with no intubation,
anyone could apply one.

------
classics2
Sure, have some home made barotrauma and pneumonia to go with your COVID.

------
charliewallace
This is a project based in Ireland. For a similar US-based project, see
[https://www.projectopenair.org/](https://www.projectopenair.org/)

------
Gatsky
I am 90% sure there will be a useful antiviral therapy available soon, whether
it is remdesivir, favipiravir or even chloroquine. This will change the game
in humanity's favour. Antivirals are also the only solution which can actually
scale to the problem, unlike these ventilator projects or even vaccines (at
least not for a very long time, bear in mind that under ideal conditions the
supply of seasonal flu vaccines is often dicey). The first use for antivirals
will be to reduce the number of patients with severe infection requiring
ventilatory support.

Making these antivirals as useful as possible is of great importance, and that
means going all in on mass producing a quick and reliable and broadly
applicable diagnostic test.

I would much rather see open source projects targeting diagnostic tests or
manufacturing nasopharyngeal swabs. Admittedly, this is much harder to achieve
for people not involved in life science research or without access to
virological specimens.

------
aceperry
There are a few other open-source and crowd-source projects like this that
I've seen. It's interesting to see so much volunteer response to the crisis.

