I've seen it discussed by intensivists on Twitter in January, that they've used it during 2009 pandemic
Risky hack could double access to ventilators
31–40 of 164 posts
Re: Risky hack could double access to ventilators
#32Earlier quoted context omitted.
Seems likely. Italy is currently seeing a 13% increase per day while the US is now very close to a 50% increase per day. There are news reports showing beaches and bars in the US are still fully packed. It probably relates the US culture of disregarding expert advice and doing the opposite to "own the scientists"
People stop very fast when people they know start to get sick and die.
When that happens, it's too late. Between the incubation period and the time to death it's about three weeks. At a 20% increase per day that means that even if you stop going out at that moment deaths will be multiplied by 46. If the rate is 30%, the multiplier is 247.
Re: Risky hack could double access to ventilators
#33Earlier quoted context omitted.
More than one person needs the only ventilator. Could you explain how they are worse of sharing a ventilator than being dead?
What types of infections are transmitted? Is it blood borne? What if you get cross infected with HIV? You get saved from the coronavirus, only to get HIV and die of AIDS. This is not a good trade off either.
[deleted]
Re: Risky hack could double access to ventilators
#34Earlier quoted context omitted.
> You get saved from the coronavirus, only to get HIV and die of AIDS. This is not a good trade off either. Dying from COVID19 in the next few days vs risking HIV and maybe AIDS years or decades later is a pretty obvious choice.
I don’t know. Having HIV and AIDS is the ultimate scarlet letter. It’s the mark of death. Even in this day and age, over 30 years later, the stigma of having it is socially unacceptable, regardless of what is publicly promoted.
What are you talking about? You're saying given the choice between dying of COVID-19 right now due to lack of a ventilator, and a hypothetical chance of getting AIDS (a treatable disease that you could very well live with for decades), you don't find the choice obvious? That doesn't make any sense.
Re: Risky hack could double access to ventilators
#35There is quite some discussion of it here
https://emcrit.org/pulmcrit/split-ventilators/
It has certain disadvantages (like not being able to trigger a breath on yiur own)
Re: Risky hack could double access to ventilators
#36I thought I remembered reading somewhere recently that 2:1 is already in use in some cases (maybe in Italy?), but I can't find a source. Is there increased risk of ventilator failure with this approach? That seems like it could be an additional terrible factor to weigh, because parts have become so scarce.
The 2:1 setup was used to save lives after a mass shootings in Las Vegas a few years ago. They paired patiets of similar size, put them on the same ventilator and double the flow rate. It was mentioned in a blog post by an ER physician linked from hn back then.
The article for the interested. It's a tough but good read.
https://epmonthly.com/article/not-heroes-wear-capes-one-las-...
Re: Risky hack could double access to ventilators
#37There are lots of problems with this, but I think it is possibly a better move than some of the home-built ventilators you see floating around.
I’m biased though: I’ve designed a 3D printed improvement on this idea that potentially allows you to ventilate multiple patients with different pressures: https://www.prusaprinters.org/prints/25808-3d-printed-circui...
Re: Risky hack could double access to ventilators
#38They kept giving reasons why this might not work... * not tested in humans * cross infection potential * different sized people mess it up ... but I see no reason why any of these things would stop me from using this in the real world. If things are bad enough that we need to do this, then we should be able to find relatively similar sized people. Cross contamination is not a concern when someone is dying here and no…
It's not exactly "different sized people mess it up". It's not just different lung capacities, but different lung compliance -- which also changes over the course of disease. Most simple pressure regulators will not fare well in the environment, either, because of the bidirectional flow, etc. The "Y" hack definitely has use, but finding matches and keeping patients matched definitely means we will only be able to use…
The flow direction issue is partly addressed by the unidirectional valves in many ventilators/anaesthesia machines. The bigger issue is staffing expertise, I fear.
Re: Risky hack could double access to ventilators
#39I've seen it discussed by intensivists on Twitter in January, that they've used it during 2009 pandemic
Here's a tweet saying they're already doing it now: https://twitter.com/PeterAttiaMD/status/1240293938684018688
Re: Risky hack could double access to ventilators
#40"Risky hack" is not something I want to apply during a sanitary emergency