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...
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
In italy its so bad they are triaging to the point of not even treating the worst/most elderly cases. In extreme circumstances projects like this could save lives, regulations be damned.
Do note the vaccine testing skipped the normal animal testing phase and went straight to human trials.
I'm pretty sure the regulator is willing to work with you. Also you should contact them now. It is actually possible you can tap into a lot of incidental industry experience if they point you toward someone who has spent a lot of time doing medical equipment certs or ventilator certs before.
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.
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
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?
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. :(
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.
"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.
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.
I just wonder to what extent an emergency would change that situation. Let’s say I had a really nicely working design that some medical professionals helped test. Let’s say I was able to fabricate hundreds of them. I feel like some emergency exemptions could be offered if the alternative is people dying due to lack of ventilators.
Thank you so much. Ive just done some server maintenance and tried the new user flow with another email address. I was able to sign up, confirm my email, log in and post. Hopefully it’s fixed now.
Also I’ve worked out a potentially simple functional solution. I’m going to try to make a YouTube video to appeal for input.
> Where is the core team of 12 people plus 108 collaborators that should have been assembled a month and a half ago
You don’t understand where things were at a month ago. I had a fight with my wife at Costco because she thought I was wasting money and overreacting when I purchased the 50 lb bag of rice (among other items).
She understands now. We all do. But a month ago people were in absolute denial about the inevitable and it was impossible then to convince them otherwise.
The beds aren't really anything special. "Beds" is code for capacity in an ICU ward with ICU level medical equipment and doctors/nurses trained to provide that level of care.
Any hospital bed + a ventilator is probably good enough. Sounds like the government and hospitals are putting in orders wherever they can.
But I imagine hospitals aren't going to buy slapped together untested products unless its really really bad.
In Norway at least it isn't the beds themselves that are the issue it's the infrastructure needed for this in the hospital rooms of which the most important seems to be oxygen outlets. I'm not sure how safe it is to hook up gas tanks directly to DIY respirators.
Not that we are in a shortage yet, there are only 50 people hospitalised but it's expected to rise.
Exactly. Still, with prioritization, this team can be assembled, isolated, and funded without limit, even now during shutdowns. But there's too many such leverage points to ... leverage. So, we use the same response Europe had to the Plague.
The bubonic plague killed 50% of infected and the septicemic plague killed 100%.
This one is trending towards 0.6%-0.1% so you can see why the response may not be the same given the 3 orders of magnitude lower estimated fatality rate. Yeah it’s serious but don’t kid yourself, it’s not the plague.
For instance I don’t think the UK would be contemplating just giving it to everyone young enough if it were to kill half to all of them. I don’t recall Thanos getting elected prime minister.
My employers are industrial equipment dealers who remember WW2, and the pivoting of industrial production that it took to win the war.
We can still make a major difference if we are able to manufacture open source ventilators en masse.
What am I doing about it? First I'm reaching out to the engineering departments of two major academic institutions to find local engineering leads that can help in conceiving or identifying sound open source plans for a ventilator. The goal being to find consensus and validate a ventilator design that we can mass produce as fast as possible in North America. In parallel we would reach out to our provincial government to pitch this initiative. For this to be a success we need local as well as national government support. Not delegating the work to government but rather getting their legal support.
My employers know some local manufacturers, some in the USA, and in Mexico; all of them capable of manufacturing various parts as well as assembling on site. The knowledge, equipment, and production facilities are scattered. We just have to identify who can do what part in their shop as per plans that have been reviewed and approved. Ultimately we could use this production model for all essential equipment to fight Covid-19.
About patents. No patents were required during WW2 if governments had to produce equipment that would win the war. The Covid-19 pandemic might be worst than war so to win it patents should not be an impediment.
There are multiple online forums where a low-cost or open source ventilators are being discussed. I'm not seeking to add noise to this very important endeavour but I do feel the need to at least contribute towards a coordinated, structured effort.
I'm actively searching for open source ventilator initiatives all over the world to identify the most promising ones: I need your help in getting this done, the world needs your help, so please reach out via opensourceventilator@gmail.com along with your suggestions and advice.
Last but not least, I just registered opensourceventilator.org and will gladly donate it if needed to centralize efforts in this fight.
Thank you for taking the time to read this, good night, and have a pleasant tomorrow.
all medical startups are legal heavy, there's not much space for gung-ho attitudes.
imagine the shitstorm that would ensue if someone dies on a makeshift ventilator. and they will, because being ventilated gives no guarantee of survival.
Who would have thought that a loudmouthed self promoter with an overinflated sense of his own intelligence and a history of making thoroughly unrealistic and unscientific predictions would get this one wrong too?
Musk has missed just about every goal he's ever set by a wide margin and has only managed to pull through because hordes of taxpayers and investors continue to line up to dump money into his black hole projects on the back of his self-aggrandising.
> Musk has missed just about every goal he's ever set by a wide margin
Yes, but everyone else in the space sector has missed by a bigger margin.
How’s the Bush Mars mission coming along? Bush senior that is, initiative announced 1989.
> and has only managed to pull through because hordes of taxpayers and investors continue to line up to dump money into his black hole projects on the back of his self-aggrandising.
You mean the rockets which are half the cost of any other provider including both government and private launch agencies?
Or do you mean the car company which turned electric cars from a hippy fantasy into a rich person fantasy and just made its millionth vehicle?
That seems like a disingenuous comparison given how much control a President has vs a CEO in this context. Bush Sr. had less than four years.
This isn’t meant to bash Musk, just to point out the somewhat unfair comparison. I actually think entities like SpaceX are necessary to combat the political risk inherent in administration turnover
You have a valid point; however the point I had been trying to make was more along the lines of “Musk isn’t particularly bad even when he doesn’t meet his own goals; the goals are really hard”.
With the cars, I've come to the realization that most people just don't realize how hard it is or how many people have tried. I'm a big fan of the car industry and have looked at many of the past attempts (eg, Tucker, Bricklin, Delorean, Fisker, and now Tesla).
I can only think of one that topped 20,000 units, and they've hit 1 million. Being the only company since WWII to startup and do that is not a small feat.
Sure, I could listen to all of his hype and crazy rosy projections. I could also listen to the things his worst detractors say sometimes. Both sets are just as wrong, though, so I prefer to pay attention to what his businesses are actually doing.
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.
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.
>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.
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.
Planned obsolescence - just tell the hospitals that the cheap $5K ventilator is less durable than the $40K model, and won't be supported after the outbreak. And get the FDA (or whoever certifies medical devices) to do the same - give the cheap units an accelerated approval with a short expiration date.
Ventilators aren't expensive because manufacturers are sitting around scheming how to buy more yachts. Those devices require a lot of testing, insurance and quality assurance. If someone dies because your device malfunctioned, you're going to get sued - and you should.
The last thing we want is for "the government" to go around seizing production capacity from companies that have successfully produced these units for decades. When you imagine "the government", don't imagine your ideal policitian in a cape - you should imagine the bloke down at the local tax office who keeps opening obvious malware emails.
Corporations are not your faceless enemy, they're the ones who've helped your hospitals become amazing in the last few decades.
> Why would a manufacturer consider damaging what is a potential mega cash cow?
There's no way the current problem is only the price, for sure they are already trying to sell the most they can, they simply can't produce enough of them. Allowing some kind of shadow production, handled by the manufacturer can only means much more product made thus sold. It's a win-win for both the manufacturer and the government.
> 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.
Sure that would work, but that's always been true for anything. If the government could seize production, it would be "cheaper" to produce because the cost of R&D and production has been already done. That's not healthy though, that will now be an added risk in the industry that will have a cost to be mitigated.
So, believe it or not. The Government is a lot better as a procurer than a manager in the long run. Private industry is much more free to morph the way they do things than the government is, and a lot of the government is already specialized around the logistics of outsourcing to private industry vs. doing any of the work themselves.
The arrangement does actually work fairly well in a crisis; you just need the sense of urgency to get everyone in the private sector all cranking on the same problem.
Or at least it has worked well before. Things like the F-22, F35, and Littoral Combat Ship aside... There is a point where stuff turns into a nightmare. The medical equipment needed though isn't really a problem where you should run into the sort of slog those projects ran into though.
Because the government will seize their assets to the sound of the cheering public, and after this is over they will end up in jail. In war time conditions, governments ask nicely only once. So choose good publicity and being ethical vs having no business anymore.
Generally when this kind of thing happens, the private supplier is paid quite handsomely for their "IP". It's a win-win arrangement; think of it as funding open research by paying a "prize" after the fact as opposed to an ordinary "research grant". I don't generally support strict IP rights in the first place but if they're going to exist, opening them up to "shadow" suppliers should be commonplace.
> 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.)
Because capitalism only works with a functioning economy. If everything goes all pear shaped, and we have tens of thousands of people dying because we don't have enough ventilators (and the numbers suggest that this is quite possible), these companies that have been filling their bathtubs with cash are going to have angry gun toting mobs of newly homeless and bereaved Americans using their office windows for target practice. This will happen regardless of what's right or wrong, legal or illegal. We haven't seen this here before because we haven't had a strong enough economic collapse yet (excluding the Great Depression of course, where some of this did happen). It's happened in many other countries, and may happen here too if CEOs don't take a more long term perspective on pricing.
Is there actual evidence for this? That governments aren't as effective at producing things. This gets bandied about a lot but I'm not sure it's true. I think governments can be highly effective at producing things.
Read up on Venezuela's oil problem. They seized the oil from private entities and then royally destroyed the entire industry as the equipment fell into disrepair and production efficiency fell until nearly stopping.
It often couldn't figure out how to produce enough of the right things -- pricing signals were better across a wide variety of consumer goods. It did pretty well at some things.
Pricing signals are also bad at some things.
Saying "the government is bad at producing things" is an overgeneralization. It'd be bad to put it in charge of producing everything. But putting markets in charge of producing everything has points of failure too, which is why we're having this conversation.
> But putting markets in charge of producing everything has points of failure too
No it doesn’t. As soon as governments clearly states that they want to purchase a hundred billion masks and ventilators, market will react very quickly.
They got first to space, but people were starving, healthcare was shit, there were no freedom (including no freedom of moving within USSR), and generally quality of life was very poor. Hardly an achievement.
If these rocket engines are cheaper, why not buy something from someone who is producing them below production cost? Good for US, they save money.
Rocket engine purchases were/are a strategic decision to keep the rocket scientists employed rather than having them sell there wares on the black market.
Counterpoint:
Global geopolitics and Military Logistical Strategy 101: sometimes you can't trust who you're buying that widget from when the widget in question has a significant contribution to maintaining National Security.
There are also risks to having someone else manufacture a widget that incorporates technology you'd rather not spread around.
This is why there will always be at least one domestic chip foundry, and most of the critical components of ICBM's /nuclear weapons are manufactured domestically as I understand it. Medical equipment also falls under that umbrella. Hell, even taps and dies do. God bless Admiral Rickover in that regard.
They actually didn’t. German rocket scientists were smart people and they surrendered to US to avoid horror of dealing with NKVD.
That said, there are reasons why USSR was first in space. For example, USSR deliberately ignored human life cost. In particular, they seriously considered first human flight to be a failure, so they announced it publicly only after Gagarin landed successfully.
British empire did war mostly on the sea, so US and British Empire were much better at producing ships, aircrafts, and also radio, radars and other electronics.
Tanks is good but it is much less important than strategy, logistics, food, drugs and saving human lives.
USSR killed a huge number of own citizens (including execution of so called deserters). Well, good for the rest of allies.
Stalin fleeced the Kuleks to pay for Americans to build factories just before WW2, after Ford's River Rouge industrial city was completed.
He did a good job on T-34 production, but around half of Soviet armaments came from the USA during WW2. The tanks were directly driven to the front - no parking lot needed! :)
Stalin is portayed as a monster because he was. But he was also the great leader his country needed at that time.
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.
Why don't we have people upside down when stuff like lung fluid drainage is a concern?
I do it at home when I've got bronchial issues going on and while not pretty, gravity does a great job at assisting fluid expulsion as long as you can keep the swelling to a reasonable level.
Yes, you look silly, and your head can get a bit stuffy; but in the long run I've found it an invaluable practice when I've already tapped out everything else I have to throw at the problem for myself At home.
Inversion tables aren't exactly difficult to manufucture either; even if you do need to make sure you have someone else around for safety sake.
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.
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.
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.
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.
Google. There are handful of sleep apnea forums with instructions on how to enter into the "clinician mode" of most machines. From there, you can adjust modes, pressure levels, etc. Said forums also have wealth of information on WHAT to change. There is also software called "sleepyhead" that is free and downloadable if you really want to geek out and understand the data saved by the machine.
I "hack" (not really, just doing stuff / adjustments that clinics supposed to do) my machine for no other reason than they clinicians are useless once they sell you a sleep study and machine. You are typically on your own once you get it unfortunately, which is why the success rate of people using CPAP machines is usually pretty low. It can be a frustrating process without help and even if you do have good clinician, it is still frustrating to get used to it (some moreso than others).
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.
> 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.
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.
I’m still pretty scornful. There’s an existing satisfactory and easy to manufacture design (Manley ventilator) that addresses issues of controlling tidal volume and operating on whatever supply and even allowing manual operation. DIY could make thousands in a cottage industry if desired. Here we are instead with people designing devices and then asking for doctors to give them a pat on the back.
Sometimes it's good to remind yourself that HN comment threads are not written by single person and the opinions are not those of a single entity. Different posts attract different cross-sections of users which lead the discussion in various directions. In my experience it's not that uncommon to see completely different threads on similar posts here.
There is nothing wrong with an having an emotional factor in decision making. There is only shame in not being willing to eventually come to terms with writing the eventual rational check in order to pay for the inevitable run-up against the difference between the world as you imagine it vs how it actually is.
In fact, there is a much greater danger in abolishing emotion in its entirety from your decision making process period. It is very easy to end up in a situation where you create more problems than you created a solution for because you didn't take into account the fact you're dealing with other human beings. A practice famous for requiring good interpersonal communication; something dependent on being able to see things from another point of view.
Also, let them. The truly novel solutions tend to be hiding in places no one bothers looking because we're trying to take the rational structures have, and work backward to a solution whereby we can use as much of what we already have in place to make what we want. Working from a dearth of preconceived notions can lead to genuine innovation in some cases.
If it can get you a helicopter, it can get you a ventilator.
The calculus has changed; to put it simply. People don't like sitting around idly, and if there is the risk the official supply chain infrastructure can't keep up, people will rise to try to actually solve a problem.
Without the threat of an overwhelmed healthcare system, why worry about a DIY ventilator? It would comfortably register as SEP (Someone Else's Problem) on most people's radar given the complexity of the rat's nest of regulation around the industry. With the crisis being what it is, however, you suddenly have a very interesting optimization problem, with very high stakes.
I can't fault folks for at least trying; and at the end of the day, who knows, someone may make something better/more efficient/cheaper/reliable/good enough to help. You'll never know if you don't try.
Just remember: do your research, learn why the current state of the art is what it is first, then make sure you can justify any design alteration you make in your particular implementation, then consult a regulator. They are there to either help or to specifically be part of whether or not your design is good enough given the logistical shape of the field.
That doesn't mean everyone go spam the FDA at once, mind. You don't want to DDoS the regulatory pipeline. If you're serious about it though, and willing to jump through the hoops in hope of being able to provide an alternative just in case; do so. Note it doesn't hurt to put a little more strain on the regulatory infrastructure as well. It helps the regulator to justify innovating how they can do their job more efficiently to!
Then, once you have regulator buy-in, go to your investors, and make the case for getting some mass production spun up, or figure out whether your job is done in the sense you're more of a design person, and less of an implementer, and get your design to those who can run with it.
This is the magic of the market at work! Not some arbitrage scheme, but an honest to God shift toward creating a greater supply capability to fill increased demand.
I really like this as DIY - I also found this video 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...
I take issue with this claim regarding CPAPs/APAPs There are many doctors who support making CPAP machines purchasable without prescriptions. The story line that they need to remain prescriptions only is, not surprisingly, funding/pushed by sleep clinics and the machine industry players because ... you guessed it ... profit.
I started using an APAP (Resmed10 autoset) about 2 years ago. My sleep study (overnight onsight at clinic) said I needed CPAP for sure and they slapped one on me in the middle of the night to "titrate" it just right for me. After got my machine, they were useless to adjust it. I did bare amount of research and found everything I needed to really adjust settings to work for me over couple months. I don't even take 30 minute nap without it now. Godsend.
I've also snagged the same model machine off ebay with only 30 hours on it (VERY hard to come by because the machine manufacturers are diligent and aggressive in getting them off resale market because of their status as prescribed medical equipment). Anyway, put my brother on said ebay machine, spent week or so of monitoring results and titrating his settings and he has been happy camper since. He had worse apnea than me, but alas no medical coverage at that time.
Of course, ventilators are in different class. That said, keeping CPAPs as prescription only medical devices is a scam and many lives could be extended and saved if could buy without script.
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.
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.
CPAPs are great machines.. they literally can be lifesavers.. But you should never share a CPAP!!! A CPAP is setup for YOU! You can blow out a lung using it on a loved one.. also you can bust your stomach/gut depending on a loved one if they have something as simple as GERD. They seem simple.. but they are not.. they are setup for YOU.
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.
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.
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.
It's a lot more complicated to modulate the pressure. You need to titrate the pressure to each patient/setup, and often inhale vs exhale. Motor with ESC? Easy. Solenoid valve has only on/off, so you have to manually tune a pressure valve for each level. Also the pilot kind like those in sprinkler systems don't work well with low pressure air.
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/).
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.
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.
Have to agree with this. Normally it would not be a good decision to use this or even advertise how to make it. These are however not normal times; more like we are at war and using combat medicine if the health system gets over run. This device needs improving and there is a fair degree of risk that it could be harmful, but a more advanced version made from easy to source parts could save many lives.
There has to be some middle ground risk between rolling in random but well intentioned pieces of equipment vs rejecting them because they haven't followed a conventional months long vetting and review.
I wonder what kind of expert rapid requirements review and qualification process could be created?
The comparable risk if the system is overwhelmed is life losses in triage or outright using using medical personnel as human ventilators - causing fatigue and mistakes too.
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".
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
>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.
Lock down a list of concerns, max / min pressures, limits of pressure change rates, etc. Generalize the device so it can be dialed in.
If a ventilator can be powered by a brushed motor blower, this is quite doable and scaleable. There are unique opportunities to get maker grade devices enhanced and tested for production when lives are being lost. Certainly worth the effort while we sit on the sidelines.
Cool, now how are you going to manage the countless other aspects of critical care? By the time you need a vent, you need a ton of other things as well.
100% this. I'd been curious why I wasn't seeing discussion of negative pressure ventilators, also known as iron lungs, but more recent commentary that I've seen notes that the positive pressure is needed in part to force oxygen into the blood. Apparently with Coronavirus sick lungs are wet lungs and wet lungs don't work as well. That would imply that you also are going to need a supply of oxygen at a higher concentration than in the air which would imply either an oxygen generator or reliable tank based supply system. Other discussions I saw excluded concerns about significantly increased volume of aerosolized infectious droplets from improperly used ventilators.
"We will be backing you, but try getting it yourselves. Point of sales, much better, much more direct if you can get it yourself."
The post-meeting press also asked him if that meant the feds wouldn't help, and he explicitly said no, that many states already have their own contracts and connections to various suppliers, and if they used those they would be better off buying direct rather than the federal government acting as a middle man for the same outcome.
Edit: Another design we're considering based on an Army prototype: https://docs.google.com/document/d/1Hcuu-55q2a3_-LmBwg0uBdgM...
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...