Challenge to Pelican Engineering -> Let's design and build an open-source Ventilator!

[93nav]

Another low cost, simple ventilator from MIT

https://web.mit.edu/2.75/projects/DMD_2010_Al_Husseini.pdf

[Mahler9th]

From one of the links Wayne provided:

"What are some possible risks of a ventilator?

A ventilator places a person at high risk for infections.

You might find a ventilator to be uncomfortable.

You might try to pull the tube.

To prevent this from happening, you might be given medicine to make you sleepy or your hands might be restrained. Some people who need a ventilator do not recover to their previous level of function.

You would need a lot of help. Most people on a ventilator need to be monitored in an intensive care unit or similar setting.

Some people can be cared for in a nursing home or in their own home if they have care from professionals for monitoring and maintenance. "

[rusnak]

The FIA should get behind mas producing ventilators. Ship them to each automobile club member, such as AAA and the like.

The goodwill would be huge, and frankly much needed.

[Mahler9th]

"For the record, if things go badly for me, I would rather have a functional vent than not be able to get access to a FDA approved vent."

I would want a functional vent used by people with some level of skill, experience and training people in a care setting that does not make the vent superfluous. So I guess my specs are different.

"The purpose of this thread is to develop something for use in an emergency situation, not something for used or sale on the open market in normal circumstances."

Sorry, I missed that post by the OP.

[rusnak]

Right. When your emergency mask drops from the airplane cabin ceiling, you do not say "Not my brand" and refuse to put it on.

[93nav]

The group I posted about in post #10 is attempting to recreate this vent.

https://www.vortran.com/go2vent
https://www.youtube.com/watch?v=JRKIyEJAEhA&amp=&feature=emb_rel_pause

Last I read, as of the 16th, they have not been able to contact anyone at the company. As you would expect, things are hectic and there may be delay in their documentation.

[Mahler9th]

"Right. When your emergency mask drops from the airplane cabin ceiling, you do not say "Not my brand" and refuse to put it on. "

Interesting analogy, but you are missing the point. What difference does it make if the airplane is made of string, balsa wood and cloth?

And the pilots only have previous experience flying paper airplanes?

And they were trying to fly this plane over the Himalayas?

Would you even get on that plane? Maybe yes.

Would you put your loved one on that plane? Maybe yes.

I envision that if things get that bad we'll have other much bigger issues.

ICU is a health care "setting." Populated with teams of trained people.

If that setting becomes like a wartime battlefield, there may be larger issues in play than the availability of a custom engineered and built vent.

We'll see. Well hopefully we won't.

I wonder if a simple lack of vents in Italy has contributed to their challenges... or whether the challenges are larger in scope.

Sure a vent is an important tool in ICU settings for patients with major respiratory issues.

What term did we use.... necessary but may not be sufficient.

Just like the sample collection cotton swabs in Rhode Island... there cannot be a "test" without a sample. But a test is also impossible without a way to get a sample to a lab. And no one will work (without being forced) in a lab without PPE, and so on.

I see this as a "system."

[rusnak]

^ When there are not enough beds, respirators, health care workers, and they must choose between letting you live or die, you don't want to be "choosy".

You don't understand that this is not a drill. You can't be like the kid during fire drill who cries and wants to be carried. Normal "systems" and "settings" do not apply. Indeed, you are the one who is totally missing the important point.

[Mahler9th]

Vortran Medical appears to have less than 50 employees.

I wonder about the supply chains involved in the manufacture of their products...

I wonder about the manufacturing location of partial and final assemblies...

About they are located 7.5 miles from the State of California Public Health HQ.

We'll see.

[varmint]

What about a modernized iron lung. You’d need a human sized tube and a bellows.

[Mahler9th]

"When there are not enough beds, respirators, health care workers, and they must choose between letting you live or die, you don't want to be "choosy"."

Makes no sense. I would very very likely be incapacitated. So I could likely not be involved in "choosing."

But that is not the point. The points I make relate to the larger scope of what is necessary to keep people alive.

And of course as I have stated, giving prime consideration to the best places to focus resources with the highest likelihood of impact.

I envision if we ever get to a point here in the U.S. where folks are using cobbled together critical care equipment, there will be massive "civil unrest situations."

During the civil war, I reckon that they did a lot of amputations and a lot of casualties were due to disease and infections. A lot. In a lot of ways that is all they could do. And all they knew to do.

In this case, most if not all folks in jeopardy, and their loved ones will clearly know at some level the differences in likely outcomes between care settings (including equipment like vents) and caregivers that are part of our every day health care system, and those that are cobbled together and operated by laypeople.

So I can envision a scenario where people will fight hard, perhaps against each other for the former.

Anyway, I understand that in times like these it is leadership that helps guide impactful use of resources, including those that want to cobble and tinker.

Even during WW2 I am sure that some well-meaning folks eschewed working at the airplane factory and decided to try to design and build their own war planes.

We are all human.

[unclebilly]

Mahler - you seem to have some knowledge here.

What air volume is needed per aspiration, how much pressure is needed, how many aspirations per minute?

Help us out with this information. That would be far more useful than the tirade you are on. We get it, you would rather die waiting for a brand name vent that took years to get approval on. The rest of us want to built an improvised splint so we can walk out of the Bush with a broken leg because that could be the only option available.

[rusnak]

^ Mahler, You WILL BE INCAPACITATED. You will not be able to choose. The healthcare workers will have to choose who lives or dies if the system is overwhelmed. Literally the choice seems to be, "let you die", or "try something else". That is why we see talented engineers even contemplating home-made ventilators. The issue is whether they let you die or not. The Agnelli family, owners of Ferrari, donated $10M USD to help do what? Buy more ventilators and medical equipment for those who are sick and dying. "Best practices" is a phrase that does not apply. It is meaningless when the "standard of care" threshold has been exceeded by a factor of more than 2. In these cases, by more than 4.

Do you ever leave the pot fields of Nor Cal long enough to watch or read about what is happening in Italy? That is what the USA is trying to avoid, that is the reason for this thread, and that is what everyone else is talking about. I guess you would be one of those who would be allowed to die while you wait for your chosen brand of medicine to show up.

[Mahler9th]

As soon as you same I am waiting for a brand name you don't understand how healthcare or medicine works or the points I am trying to make.

I understand that I cannot teach you about this... all I can do is suggest a broader perspective.

You cannot walk out of the bush with a broken leg with just a safe and effective cobbled together ventilator.

You might even be better off spending your money on Alibaba immediately:

https://www.alibaba.com/trade/search?fsb=y&IndexArea=product_en&CatId=&SearchText=medical+ventilator

I doubt much, if any of the The Agnelli family's donation has been or will be spent on vents with unknown safety and efficacy (including things as simple as safe materials and QC) from Alibaba.

You can buy a pulse ox for probably $10, and that won't be designed and manufactured under the US CFR. And in a pinch that might be good enough compared to one from Tyco or Massimo that is sold into hospital settings.

But a vent is a different animal.

Much, more complicated... not necessarily in its composition, but often (perhaps usually) more critical in its application.

[Won]

Originally Posted by Mahler9th

Related link:

"Pandemic Ventilator Project "

https://panvent.blogspot.com/2020/03/how-lethal-is-covid-19-and-will.html

The original article on Instructable from Wayne's OP was uploaded in 2007 (!). The same author setup the blog above also. Regarding the published articles, I'm actually quite happy to learn that health authorities (as well as backyard mechanics) have had plans for the next big influenza pandemic. I never paid any attention to this before and I'm sure the vast majority of people didn't care either, otherwise we would always have had toilet paper shortage!

[rusnak]

I hope so too, Won. Never mind the Hippie from Northern California.

[Mahler9th]

There are plenty of places to read up on respiratory physiology, et cetera.

And of course for the basics (though my training is from 1983) I suggest starting with the hypothesis that Guyton is a good place to start.

I also suggest learning about the ICU setting as a system.

I think it is a great idea to think about these things, but like I said, I think it might be a better contribution for many to instead work in the airplane factory. In this case, one with a bivouac where workers are protected from infection.

And maybe, just maybe, take some junior pilots (like medical students pre-MD) and engage them. Wait, that is likely already happeneing.

[93nav]

This is from the UK I believe, based on the url. Putting out their requirements for a "Rapidly Manufactured Ventilation System (RMVS)"

https://www.britishchambers.org.uk/media/get/Specification%20For%20RMVS%20Challenge.pdf

[Mahler9th]

Hippie? Cool!

I am a black man with an Ivy league education (advanced engineering) that has been involved with medical devices and capital equipment for a long time (engineering summer student 1978 - 1984 and on the business side immediately after engineering grad school 1985 to basically present).

Huge companies like GE healthcare, and start-ups. In two of those I worked with two of the three of inventors of pulse OX.

Was a pre-med in engineering grad school (where I focused on biomedical and electrical engineering) so elected to take all the pre-med orgo classes and a medical physiology class.

Most of my friends will find it funny that I have been labled a hippie on social media.

Oh and I am a pretty unapologetic capitalist.... perhaps headed toward venture capital next.

I am not a big believer in ad hominem in general nor do I generally participate in social media.

Big believer in cobbling and disruption in healthcare.

[Mahler9th]

Here ya go:

"(The UK) Health department says NHS has 5,900 ventilators but could need as many as 20,000"

https://www.theguardian.com/business/2020/mar/16/vauxhall-owner-psa-car-shuts-european-plants-amid-coronavirus-fears

Nosotros veremos.