Anyone here working on a ventilator design?

I thought my factory was going to get on board but they decided not to. So I am working with a couple friends to come up with a simple emergency ventilator for Covid patients. I have a relative who is an intensivist specializing in lungs and she is giving us some solid medical advice so we do not go barking up pointless trees. It may get no farther than a clunky old thing made of cast off plumbing supplies, but after a few days of studying and thinking I have a basic idea mapped out. It is a really interesting project, and it looks like there will be a need for quite a few of them in the coming weeks or months. If you are interested, I know there are lots of very smart and mechanically inclined people on here. 

https://cdn.fs.agorize.com/eeVFkxUWQgSQRR9b6Q5K

If you Google Bird Mark 7, or look at some of the ones sprouting up on the webs and tubes, you will get an idea what is required. At a minimum people are starting to reproduce some of the necessary valves and other components. 

These are resperator valves 3D printed in Italy 

With 3D print technology there is a lot that can be done in this area. Where it gets tricky is litigation for failures and patent infringement.

Was talking to someone who was working on such a project and he was looking for a cheap pressure sensor that could be easily integrated, The easy button might be a blood pressure transducer that can be had for like $8 and even cheaper in bulk. Maybe an arduino interface of some sort?

My thoughts are that this will run into what I call the saline wall: All of NA saline comes from PR and it was shut down by the hurricane. Took years to get the supply stable again. The whole time there was another plant in Mexico that supplied a big part of the world, just missing some FDA sticker for NA. Good enough for the rest of the world but not for NA. The FDA would have let people die before they broke the rules. Probably the same patent and liability barrier.

NOHOME said:

With 3D print technology there is a lot that can be done in this area. Where it gets tricky is litigation for failures and patent infringement.

That was the problem in Italy and the "makers" said screw that and did it anyway and posted on social media about it and that they may have problems with patents ,  they basically shamed the patent holder who then said it was OK......

I think the world needs millions of these for the 3rd world , something simple , something that can work with no electric , 

I hope they can do it....

There are all sorts of ways to make air delivery systems and no patients need to be broken. After all, they have been around since the fifties. I am sure the intubation part has some patented unobtanioum but at a minimum these can be CPAP. The idea is just to get a steady and reliable supply of air to a distressed patient whose lungs are full of fluid. This is not to intubate a premature infant for months.

I'm a little disillusioned by my attempt at helping my local hospital.  I reached out and got in touch with a resident.  dialed everything in and got a couple breathers printed up while he talked with the admin.  They basically came back and said "that's not from an approved supplier, therefore we can't use it."

It really sounded like they didn't want to use it due to liability reasons

In reply to Mr_Asa :

They do have to be approved at some point. I don't think I will get to that point but it's still an interesting exercise and want to see how far we get. I am fortunate in that I have some fairly well placed medical decision makers in the family. 

The profane but brilliant YouTuber AvE is working on one up in Canada.

In reply to Crxpilot :

I can't sit through those videos. But I did skip through the last one and it does not look like he actually moved any air. Yet anyway.

I know DILYSI Dave is, but I am not sure he has posted about it on GRM.

Mr_Asa said:

I'm a little disillusioned by my attempt at helping my local hospital.  I reached out and got in touch with a resident.  dialed everything in and got a couple breathers printed up while he talked with the admin.  They basically came back and said "that's not from an approved supplier, therefore we can't use it."

It really sounded like they didn't want to use it due to liability reasons

What type of breathers did you make?  Is it an open source design?

Did you speak with any approved suppliers or large companies regarding it?

I understand them being hesitant.  Liability in this country is crazy.  

ProDarwin said:

I know DILYSI Dave is, but I am not sure he has posted about it on GRM.

Dave's solution is pretty damn clever too. Don't want to steal his thunder though.

Much respect to anyone who is trying to do the right thing and has the mental fortitude to deal with the idiotic bullE36 M3 that our medical/legal industry is going to throw in the way. I would think that the paper pushers could pump out a new form that allows a patient to waive liability rights in exchange for using a "non-traditional" ventilator. I mean, isn't that kind of form just an "anti-DNR"?

Another variation to this would be to berkeley going to the hospital for help and let the DIY ventilators setup shop in a shut down Starbucks. Then a YouTube vid for how to run the damn thing, the appropriate waiver forms and boosh, you're about to die from flooded lungs, the established medical system is tied up in their underwear so you bypass it all and get help from free enterprise.

ProDarwin said:

Mr_Asa said:

I'm a little disillusioned by my attempt at helping my local hospital.  I reached out and got in touch with a resident.  dialed everything in and got a couple breathers printed up while he talked with the admin.  They basically came back and said "that's not from an approved supplier, therefore we can't use it."

It really sounded like they didn't want to use it due to liability reasons

What type of breathers did you make?  Is it an open source design?

Did you speak with any approved suppliers or large companies regarding it?

 

I understand them being hesitant.  Liability in this country is crazy.  

I suspect it's not just liability, it's also actual risk. I've seen a pretty wide variation in 3D prints, for example. Would I be willing to trust someone else's life to something designed and produced by some random person without any oversight? I'd have to be pretty desperate. We may get to that point like Italy did, but we're not there yet.

A more likely scenario is to have hobbyists printing a specific design - or a throwback to older designs that aren't as sophisticated as current vents, but will be good enough. Heck, follow that down to the end and you end up with a bag being squeezed by a human being.

It looks like MIT is working on getting an open source ventilator through FDA approval: https://hackaday.com/2020/03/23/mit-ventilator-designed-with-common-manual-resuscitator-submitted-for-fda-testing/

In reply to ProDarwin :

Breather may be incorrect terminology.  I printed out two sets of these

https://www.thingiverse.com/thing:4193275

Its just designed to allow them to stretch the N95 masks a little more than they previously could.

In reply to Keith Tanner :

Very true, but it would also depend on the design.  As simple as this one is, I'd be hard pressed to see where it could go wrong.

Well, I've seen a lot of hobby level prints that wouldn't be airtight. So that would be a pretty major way for it to go wrong. Same with overall strength. You might have confidence in your printer's setup and material choices, but do I have the confidence to risk my health on it?

Also, who the hell is "TentaCat0702" and how do we know that the claims are legit? How fast does that small surface area contaminate and require replacement? How much extra resistance is there for the wearer, and thus higher breathing effort and thus fatigue on a long shift?

californiamilleghia said:

NOHOME said:

With 3D print technology there is a lot that can be done in this area. Where it gets tricky is litigation for failures and patent infringement.

That was the problem in Italy and the "makers" said screw that and did it anyway and posted on social media about it and that they may have problems with patents ,  they basically shamed the patent holder who then said it was OK......

I think the world needs millions of these for the 3rd world , something simple , something that can work with no electric , 

I hope they can do it....

 

 

The lawsuit stuff was internet huff and puff. As far as I know there has been no lawsuit or even a threat. They did have to officially reject the 3d print guys a DXF of the part and they had to reverse engineer it to make it though. 

Also there are a bunch of new splitter designs out there in the last few days that allow 8 people to be on the same ventilators with no modification to the machine itself.. 

Seems to me that another option instead of actual ventilator is to make remote breathing devices- much like what some use for painting a car.  Which can be very helpful for the people working in the screening area.

Use a stander HEPA filter that can be changed every once in a while.

That can be 3d printed.

The risk questions are valid. If I got infected right now and with the current shortage of testing kits and the (understandable) triage going on at hospitals, my understanding is I'm going to be in real bad shape before they'd let me in and consider sticking me into a ventilator. Being 61 and male, I might end up in the middle or bottom of the list. Which means by the time I got on a standard machine I might not have a fighting chance. And by the time I'm in the hospital and caught inside "the system", I can't get outside again and will be isolated from my family and friends.

Under the above gloomy scenario, I'd not give a E36 M3 about the risk and would gladly try out a DIY machine.

In a year or two the whole situation may be different and I might gladly walk into the ER and let "normal" medicine do their thing. On an expensive machine with all the right tolerances and paperwork and lawyers and insurance people happy. But the next XX months are going to be (or maybe I should say "could be") confusing, chaotic and risky in a different way than risky technically.

alfadriver said:

Seems to me that another option instead of actual ventilator is to make remote breathing devices- much like what some use for painting a car.  Which can be very helpful for the people working in the screening area.

Use a stander HEPA filter that can be changed every once in a while.

That can be 3d printed.

That's what the Ford sketches are right now, yes? Basically a positive pressure hood driven by an off-the-shelf fan and running off a work tool battery. It's a good idea to help protect those who are caring for the sick.

alfadriver said:

Seems to me that another option instead of actual ventilator is to make remote breathing devices- much like what some use for painting a car.  Which can be very helpful for the people working in the screening area.

Use a stander HEPA filter that can be changed every once in a while.

That can be 3d printed.

A lot of the supplied air respirators for painting a car are probably let even less things through than an N95 mask - the SOP for testing a lot of the painting gear is to see if it keeps out banana odor, which if you've ever packed a ripe banana in your lunch box, you'll know how hard THAT is to seal out of anything. Their main problem is expense.

I've seen a lot of efforts to make a bunch of DIY surgical masks, which are more for keeping a health care provider's germs in than a patients' germs out. These aren't too hard to sew at home, although finding material that works well can be a challenge. Still, even an improvised cotton surgical mask is an improvement over having completely run out of surgical masks.

My background: My daughter was on a ventilator for basically her entire life; my mom is a nurse, my dad is a retired Big Pharma (including hospital products like infusion pumps, although he never had respirators or ventilators to my knowledge) guy who used to deal with the FDA on a regular basis.

Keith has nailed this on the head. There are a lot of designs that will probably work as a last resort, but a ventilator usually damages the lung on its own. Too much oxygen, too much pressure, and it could be very bad news. The amount of R&D that a medical device goes through is staggering, as are the QC measures... and there are still recalls, failed products, accidental deaths. Also, the other thing that I think a lot of people miss, is that if you're on a vent, you're probably in the ICU. That means that you have a nurse with you 24/7. To introduce a new machine that has effectively no user manual and no R&D and no FDA approval, when they're normally using a precision instrument is... scary. 

I think that these DIYers are great. I think that this is bringing a lot of good out in the world. But would I feel comfortable using them? Not unless it was the last resort. Maybe we're there, or close to it. But until we are, I'd be very, very cautious and I definitely understand why health providers would hesitate to use them.

In a similar vein, I wonder if there is a single ECMO machine available in the country right now. Usually hospitals that have them keep at least one on backup. When my daughter was on it, everyone knew where the backup ECMO machine was just in case - about 23 feet away. EDIT: I doubt ECMO would be a good idea for Covid, after thinking about it, unless the damage it causes to lungs is reversible. Otherwise it is just permanent life support in the hospital. Not a good idea.

MadScientistMatt said:

alfadriver said:

Seems to me that another option instead of actual ventilator is to make remote breathing devices- much like what some use for painting a car.  Which can be very helpful for the people working in the screening area.

Use a stander HEPA filter that can be changed every once in a while.

That can be 3d printed.

A lot of the supplied air respirators for painting a car are probably let even less things through than an N95 mask - the SOP for testing a lot of the painting gear is to see if it keeps out banana odor, which if you've ever packed a ripe banana in your lunch box, you'll know how hard THAT is to seal out of anything. Their main problem is expense.

I've seen a lot of efforts to make a bunch of DIY surgical masks, which are more for keeping a health care provider's germs in than a patients' germs out. These aren't too hard to sew at home, although finding material that works well can be a challenge. Still, even an improvised cotton surgical mask is an improvement over having completely run out of surgical masks.

A local quilting store has worked with a local hospital to get the right material and members of the associated quilting guild are now sewing up masks for them. 

I know I can't smell anything when I'm wearing my painting gear, it's always a bit of a shock when I take it off.