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Project Open Air

projectopenair.org

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Re: Project Open Air

#11

Post by klipt »

Gatsky wrote: post #6

This is madness. You can’t scale up ICU based ventilatory support to keep up with a pandemic. All resources should be going towards infection control measures, a quick and highly scalable diagnostic test, and antiviral therapy. In that order.

Exactly, you can't fix an exponential problem with a linear solution. If the caseload doubles every two days, shutting down cities two days earlier is better than doubling the number of ventilators (because even with ventilators, more infected means more deaths).

Note that Wuhan shut down when they saw 400 new cases in a day, and their hospitals were still overwhelmed. The USA is over 400 new cases daily already. That's comparing a country to a huge city, but in exponential terms that only buys you days at most.

See https://medium.com/@tomaspueyo/coronavirus-act-today-or-peop...

Re: Project Open Air

#13

Post by Fiveplus »

ColonelSanders wrote: post #10

An anonymous spinup website. For some reason, some feel the urgency to put affairs into order on when its trending. Not before that, though? Wouldn't hospitals, WHO, UN, whoever be able to come together with their capital and just buy out a medical company? Wouldn't this have to also get past regulations? I'm not too sure if I want a kickstarter for medical equipment. I'd love to see medicines and medical equipment m…

I wouldn't be surprised if this is the reasoning behind Apple and the likes preventing any new apps with the corona theme into the app store unless they come grin reputable sources like WHO.

Re: Project Open Air

#14

Post by tgsovlerkhgsel »

ggreer wrote: post #4

Neat idea, though I think it will be quite some time before it produces something that people can build or use. Another option might be to figure out ways to adapt existing ventilators to be used by multiple patients. If you find 4 patients with similar tidal volumes and body size, you can grab some Y tubing, attach them to the same ventilator, then set it to 4x the tidal volume and breathe for all of them. This has…

My understanding is that what a ventilator does is basically:

- supply pressurized air to patient - turn off the pressure, open exhalation valve and let patient exhale

Given that every hospital I've seen has compressed air outlets, wouldn't it be possible to get acceptable results with a pressure regulator and a timed set of valves? Or is the pressure required to fill a patient's lungs so high that the volume must be controlled?

Re: Project Open Air

#15

Post by mike_d »

"Open source ventilators" are a really really bad idea.

Patients on ventilators need to be intubated first, which involves using a specialized tool to insert a tube down past the vocal cords and inflating a balloon that seals the airway. You can kill a person before you've even turned on your nifty machine.

Once you have a patient tubed, you have full control of their respiration. If your calculations are wrong you either over inflate the lung and they literally burst, or you under oxygenate and the patient dies of oxygen deprivation.

I know engineers look at something like a ventilator and go "you don't have enough machines? I can make machines!" This is very admirable and I appreciate the desire to help, but I can't stress enough how dangerous this is.

Edit to add: This study showed that trained paramedics were only successful in tracheal intubation 52% of the time. You have a 0% chance of doing this at home. https://www.jwatch.org/na47414/2018/09/07/maybe-paramedics-s...

Re: Project Open Air

#18

Post by Gatsky »

klipt wrote: post #11
Gatsky wrote: post #6

This is madness. You can’t scale up ICU based ventilatory support to keep up with a pandemic. All resources should be going towards infection control measures, a quick and highly scalable diagnostic test, and antiviral therapy. In that order.

Exactly, you can't fix an exponential problem with a linear solution. If the caseload doubles every two days, shutting down cities two days earlier is better than doubling the number of ventilators (because even with ventilators, more infected means more deaths). Note that Wuhan shut down when they saw 400 new cases in a day, and their hospitals were still overwhelmed. The USA is over 400 new cases daily already. Tha…

Also people don't seem to realise, a patient on a ventilator is extremely unwell. They are the most unwell people in the entire hospital. They have 24 hour 1 on 1 nursing, constant invasive monitoring of vital signs, blood tests, X-rays, CT scans, antibiotics. They are managed by a team of extremely well trained and highly experienced senior medical professionals. And this goes on for a week or more. Then they leave ICU and proceed to be the most unwell people in the hospital except for those still in ICU. They might have various other complications, and need several more weeks to recover, often needing inpatient rehabilitation.

This does not scale.

Re: Project Open Air

#19

Post by Animats »

Or you could just order one on Alibaba.[1]

More likely to work than something from a website-first operation with no product and no manufacturing capability.

Now that the coronavirus epidemic is winding down in China, demand for those units is probably down in China, so getting delivery is probably not too difficult.

[1] https://www.alibaba.com/trade/search?fsb=y&IndexArea=product...

Re: Project Open Air

#20

Post by smdz »

mike_d wrote: post #15

"Open source ventilators" are a really really bad idea. Patients on ventilators need to be intubated first, which involves using a specialized tool to insert a tube down past the vocal cords and inflating a balloon that seals the airway. You can kill a person before you've even turned on your nifty machine. Once you have a patient tubed, you have full control of their respiration. If your calculations are wrong you e…

Agreed. Need for ventilator is quite bad enough state for the human body. And it gets complicated further after intubation. Most patients have to be sedated to reduce the distress and anxiety caused by the endotracheal tube. Extubation is also a risky process and patient may have to be re-intubated when though they have recovered but stayed in for a recommended max period around 2 weeks and lungs got weak. When patient is on ventilator, it requires many control parameters to help a patient live longer - the sedatives have to be just right depending on the patient, antibiotics, secondary infection risks, intravenous needles risks, pre-existing illnesses, allergies, etc, etc, etc. All this assuming that the ventilator machines and peripherals are perfectly safe. On a large scale during a pandemic, there aren't just enough doctors, experienced nurses and heath care workers who that can deal with it. Engineers can build the ventilators, but the logistical part is still a nightmare.
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