It’s true, it is mostly a software change to upgrade a cpap into a bi-level device more like a ventilator. The barrier is really about procurement, and if they are proposing to reuse devices then it is all about shipping them to a location to be cleaned and tested, modified if necessary, repacked and shipped to a destination with new masks, hoses, and proper updated manuals.
Airbreak.dev: Jailbreak your CPAP machine to turn them into ventilators
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Re: Airbreak.dev: Jailbreak your CPAP machine to turn them into ventilators
#32Earlier quoted context omitted.
Agreed. BiPaP to ventilator already seemed like a somewhat questionable transformation, and now we're going CPAP ----questionable software hackery ----> BiPaP --- questionable hardware hacking ---> Ventilator This is hubris. Ventilators are not iPhones circa 2010. It's irresponsible for non-medical researchers to not only pursue, but also disseminate, these jailbreaks. A significant portion of medical device RnD is r…
This is a real adaptation being used by real doctors in real hospitals to save real people's lives. There is a pandemic on.
I actually have yet to hear any reports of improvised ventilators being used outside of ventilating multiple patients from a single ventilator. A big reason is that doctors and nurses simply aren't trained to use improvised devices in a way they can trust to be safe.
First, do no harm.
Re: Airbreak.dev: Jailbreak your CPAP machine to turn them into ventilators
#33Messing with vents if you don't know what you're doing sounds like a sure fire way to kill yourself.
Looks dicey to me too, but if you are going to die anyway, what's the harm? The choice is between definitely dying with no ventilator or possibly not dying with the aid of a hacked CPAP. No one would use this if they had access to a proper ventilator.
Re: Airbreak.dev: Jailbreak your CPAP machine to turn them into ventilators
#34"The breath extension replaces the function at 0x80bb734"
It sounds what Naughty Dog did to get RAM on the PSX for Crash Bandicoot ... they grabbed memory already allocated by the Sony runtime libs and would use it if it not do anything bad.
A crashing game console is not a ventilator but a good hack nonetheless.
Re: Airbreak.dev: Jailbreak your CPAP machine to turn them into ventilators
#35ventilators don't just pump air. they also monitor and control the amount of air, and beep when something is wrong. plus a bunch of other features...
A typical modern CPAP also takes measurements, and makes limited adjustments based on what it sees. It doesn't just pump air. Not that it's as capable as a real ventilator, but it's not just a simple air pump, either.
You also need to warm and humidify the air because ventilators are inserted past the part of your respiratory system that does that.
Re: Airbreak.dev: Jailbreak your CPAP machine to turn them into ventilators
#36There is a reasonable chance that this will not be as useful as the team hopes:
1) They are increasing maximum pressure and pressure rate changes beyond the built-in design parameters. If these new parameters are outside what the engineering requirements document spec, these changes are a problem in seeking EUA.
2) In regulatory affairs, authorized, cleared, and approved have very specific (and enforceable) meanings. If someone is loose with how they use these words, it suggests they don’t have someone with regulatory experience involved (a negative sign). The earlier the team can engage with someone with regulatory experience, the better.
Re: Airbreak.dev: Jailbreak your CPAP machine to turn them into ventilators
#37Messing with vents if you don't know what you're doing sounds like a sure fire way to kill yourself.
Agreed. BiPaP to ventilator already seemed like a somewhat questionable transformation, and now we're going CPAP ----questionable software hackery ----> BiPaP --- questionable hardware hacking ---> Ventilator This is hubris. Ventilators are not iPhones circa 2010. It's irresponsible for non-medical researchers to not only pursue, but also disseminate, these jailbreaks. A significant portion of medical device RnD is r…
I think it's irresponsible to not be donating our full talents as engineers to assisting those medical researchers in getting a head start on such developments. We have the ability to offload trivialities from those researchers like developing a firmware flashing process, so that they can focus on ensuring the reliable operation of such hacks.
Re: Airbreak.dev: Jailbreak your CPAP machine to turn them into ventilators
#38Not a doctor. A major issue with using this type of CPAP machine on a Covid-19 positive person is the high amount of aerosolized virus particles it exhausts. Anyone using this should be extremely careful and know what they're doing. That being said, doctors in many countries are using positive air pressure machines with an air-tight helmet/bag with filtered exhaust.
What's scary is that CPAP machines are allowed on airplanes. If they really aerosolize virus particles, maybe they shouldn't be.
At least on Delta flights they’re not allowed to be used, I’m not sure if the same policy exists on other airlines.
Edit: I was wrong, see below
Re: Airbreak.dev: Jailbreak your CPAP machine to turn them into ventilators
#39Earlier quoted context omitted.
Agreed. BiPaP to ventilator already seemed like a somewhat questionable transformation, and now we're going CPAP ----questionable software hackery ----> BiPaP --- questionable hardware hacking ---> Ventilator This is hubris. Ventilators are not iPhones circa 2010. It's irresponsible for non-medical researchers to not only pursue, but also disseminate, these jailbreaks. A significant portion of medical device RnD is r…
> it's irresponsible for non-medical researchers to not only pursue, but also disseminate, these jailbreaks. A good portion of medical device RnD is related to creating technology that is hard to misuse and result in accidental death, and I just don't see that here. This is simply wrong, both from a user perspective and a general research perspective. Positioning a jailbreak like this as a solution to general vent sh…
Perhaps this is aimed at non-American healthcare systems, but I have not seen a single report of American hospitals running out of ventilators, let alone BiPaP machines. In order for this to be a responsible hack — used under the guidance of medical professionals — we would need to have run out of both.
If anything, at least in the American context, I'm more worried about running out of the sedative necessary for ventilation.[1]
I have nothing against hardware hacking in non-pandemics. If you want to hack your own insulin pump or create epi-pens on your own (non-crisis) time, that's fine by me.
But I think the cost-benefit-risk analysis changes in pandemics, because people are too hungry for easy fixes and make ill-advised decisions under pressure. For example, even doctors (ostensibly medically-literate professionals) are prescribing themselves hydrochloroquine [2], which does not seem to be a miracle cure and sometimes, itself, dangerous (and also leaves lupus sufferers at risk of a disrupted supply chain).
[1] https://www.vox.com/2020/4/6/21209589/coronavirus-medicine-v...
[2] https://www.nytimes.com/2020/04/12/health/chloroquine-corona...
Re: Airbreak.dev: Jailbreak your CPAP machine to turn them into ventilators
#40Earlier quoted context omitted.
This is a real adaptation being used by real doctors in real hospitals to save real people's lives. There is a pandemic on.
I actually have yet to hear any reports of improvised ventilators being used outside of ventilating multiple patients from a single ventilator. A big reason is that doctors and nurses simply aren't trained to use improvised devices in a way they can trust to be safe. First, do no harm.
https://www.nytimes.com/2020/04/14/nyregion/new-york-coronav...
The Italians are using adapted CPAP machines as well.