51–60 of 164 posts
Earlier quoted context omitted.
Reporting in the UK says that half a dozen prototypes have been delivered to the NHS for manufacturing approval already.
Half a dozen somehow sounds more impressive than six...
This is ridiculous! Hacks are ok with web and app deployments where you are able to patch and fix to your heart's content and the damage is not life threatening. I have worked with the medical industry, the amount of formal validation and verification that goes through on software is insane compared to what we have in the "move fast and break things" world. Even if it is "temporary" and "desperate" I would stay away…
Different circumstances with different levels of risk, require the ability to adapt.
Nobody is suggesting 'sharing ventilators' would be normal practice because in normal circumstances we want to make sure that equipment is 99.999% reliable.
But as you imply, this requires extensive testing and regulation. Within these regulations are also significant safety margins that can be exploited if conditions change. If we can multiply the usage and maintain 99.99% reliability, then this is probably a risk worth taking.
Also - if you've worked in the medical industry, you know how vastly overpriced and bureaucratized everything is.
The situation of 'not enough ventilators' is literally happening right in front of us, and it is causing death.
The risk tolerance for utilizing the gear in such a manner is such that it may very well be possible to create better outcomes.
The individuals involved are medical practitioners who are well versed in the equipment, procedures, and inherent moral dilemmas, they're not fools.
This is exactly the kind of procedural innovation required in times of crises - hopefully, a few doctors and especially the Engineers from the manufacturer can be involved. The people who built the gear may be able to give a much better articulation of the actual risks involved, and they may even be able to mitigate, for example 'the risk will be power consumption' or 'the risk will be this specific valve which could wear and break' thereby implying the 'new operational procedure' would involve daily checking of said valve etc..
The world is facing crises we absolutely must be adaptive while trying to quantify risk and outcomes.
This is ridiculous! Hacks are ok with web and app deployments where you are able to patch and fix to your heart's content and the damage is not life threatening. I have worked with the medical industry, the amount of formal validation and verification that goes through on software is insane compared to what we have in the "move fast and break things" world. Even if it is "temporary" and "desperate" I would stay away…
In Northern Italy patients are being turned down on triage because there is not enough treatment capacity. They go home and many of them die. Just like you would use a sweaty t-shirt over an open wound in a life or death situation if there is no certified sterile bandage at hand. The calculus is different.
They 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…
Coronavirus destroys lung tissue and weakens the immune system. Then bacteria move in. It's the bacteria that cause the pneumonia. Different people will likely have different bacteria in their lungs.
Have governments made orders (legal or purchase) for manufacture of ventilators by large scale companies? Presumably ventilators are a relatively niche product - what's in them that the World's industrial complexes can't ramp up production of within a couple of weeks? I imagine it's the pumps that's the limiting factor? Given humanity already has the working tested, established designs. Can't governments requisition…
There is likely nothing magical from a purely mechanical standpoint about making a ventilator. The part that is difficult is:
* Have an adequate QA program for you and your suppliers, tracing safety-critical components down to the raw materials
* Adjusting your tooling, making molds, etc.
* Doing low-production runs followed by testing to validate your process
* Getting whatever certification is required; even if there is a flexible emergency process, I think we still want some demonstration of compliance
* Not having the lessons-learned of companies who have been doing this for years, and have worked through enough problems to have general domain knowledge
* etc.
My experience would lead me to believe that short-term returns would better come from finding ways to optimize the supply chain and manufacturing pipelines of existing manufacturers, which potentially could be done much more quickly.
If you look at the example of WW2, when auto factories converted to war production, it was not a quick or easy affair. The excellent book Arsenal of Democracy describes the conversion of the Willow Run factory to producing B-24s, it took at least a year and a half to get the plant producing planes at an acceptable quality and quantity.
Earlier quoted context omitted.
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.
"Risky hack" is not something I want to apply during a sanitary emergency
Earlier quoted context omitted.
Reporting in the UK says that half a dozen prototypes have been delivered to the NHS for manufacturing approval already.
Half a dozen somehow sounds more impressive than six...
if it comes to it, you can probably do three to a ventilator according to some people in the industry i have spoken with