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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

#51

Post by jdjrirkfkfk »

dontparticipate wrote: post #6

Messing with vents if you don't know what you're doing sounds like a sure fire way to kill yourself.

Only if you're unconscious, and in that case you should be in a hospital anyway.

If you're conscious you'll just pull the mask off if you start feeling like you are not getting the right air. These machines, and masks, have all kinds of safety features and safety valves on them.

I have a CPAP, oxygen concentrator and assorted hoses and masks, and I've messed around with them these days while watching ventilator 101 videos on YT. If you're a technical person, the basics are not that hard to grasp.

Re: Airbreak.dev: Jailbreak your CPAP machine to turn them into ventilators

#52

Post by rootusrootus »

reaperducer wrote: post #44
favorited wrote: post #23

The CPAP jailbreak community was eye-opening when I first learned of it. I never expected something like that, but with the draconian policies it's not surprising. For example, my CPAP has a CDMA radio inside, which transmits usage data back to the manufacturer & my doctor. Insurance won't pay for it unless the machine tells them I'm using it – so a medical device company has a record of when I sleep and wake, which…

Once the insurance has finished paying for it (eight months in my case), you can disable the radio. Some doctors (mine included) prefer getting your data off the memory card when you visit the office, rather than downloading it from the internet anyway. The radio has to be optional for people whose beds are in places with unreliable or no cellular service (high up in buildings, in basements, fringe areas, etc...)

IIRC the data sent over the cellular connection is just summary information, it doesn't contain a full dump of the detailed measurements that will be stored on the SD card.

Re: Airbreak.dev: Jailbreak your CPAP machine to turn them into ventilators

#53

Post by joshstrange »

favorited wrote: post #23

The CPAP jailbreak community was eye-opening when I first learned of it. I never expected something like that, but with the draconian policies it's not surprising. For example, my CPAP has a CDMA radio inside, which transmits usage data back to the manufacturer & my doctor. Insurance won't pay for it unless the machine tells them I'm using it – so a medical device company has a record of when I sleep and wake, which…

You might also find the hacks for diabetes pumps to create closed loops equally fascinating. That and all the projects around it like Nightscout [0].

[0] http://www.nightscout.info/

Re: Airbreak.dev: Jailbreak your CPAP machine to turn them into ventilators

#54

Post by w0mbat »

fowkswe wrote: post #15

Also worth understanding that a ventilator is not always the best option - there have been findings recently that a tactic called 'proning' is often enough to increase blood oxygen: https://www.nytimes.com/2020/04/14/nyregion/new-york-coronav...

TLDR; They treated patients who presented with low blood oxygen by lying them on their belly or side and giving them oxygen through a nasal tube. No machine required. In many cases it worked perfectly.

Re: Airbreak.dev: Jailbreak your CPAP machine to turn them into ventilators

#55

Post by favorited »

reaperducer wrote: post #44
favorited wrote: post #23

The CPAP jailbreak community was eye-opening when I first learned of it. I never expected something like that, but with the draconian policies it's not surprising. For example, my CPAP has a CDMA radio inside, which transmits usage data back to the manufacturer & my doctor. Insurance won't pay for it unless the machine tells them I'm using it – so a medical device company has a record of when I sleep and wake, which…

Once the insurance has finished paying for it (eight months in my case), you can disable the radio. Some doctors (mine included) prefer getting your data off the memory card when you visit the office, rather than downloading it from the internet anyway. The radio has to be optional for people whose beds are in places with unreliable or no cellular service (high up in buildings, in basements, fringe areas, etc...)

I actually already have the option of disabling it (it has an airplane mode), but it spams me to turn the network back on.

I just kinda gave in, to be honest. They're going to get the data anyway, and it is valuable to the doctor. I just don't need the device manufacturer to be storing it.

Re: Airbreak.dev: Jailbreak your CPAP machine to turn them into ventilators

#56

Post by wormyrocks »

Hi, I worked on this project and have a couple comments to address the issues people are raising.

- There are established medical protocols to treat COVID-19 patients with BiPAP machines, including the addition of a viral filter to mitigate aerosolizing the virus. People are using these protocols now and we link to them from the site.

- There are two separate firmware hacks presented. The first one modifies ~20 bytes and provides UI access to BiPAP code left in the existing binary, which would allow the more common CPAP machines to fulfill the same limited function. The second is a PoC of a 'full ventilator' mode.

- The manufacturer's CPAP and BiPAP lines have identical mainboard designs and a near identical array of sensors, which provide realtime data including tidal volume calculations. This project exists as a PoC to show that it would be possible - simple, even - for the manufacturer to convert CPAPs to BiPAPs via an OTA update - or, with significantly more effort, to fully featured ventilators. It is likely that they are reluctant to acknowledge this is possible in fear of destroying the market for the BiPAP machines.

- If you are a SleepyHead/OSCAR developer, or have access to an AirCurve S10 and an ST programmer, I would love to talk.

Re: Airbreak.dev: Jailbreak your CPAP machine to turn them into ventilators

#57

Post by janoc »

shawnz wrote: post #37
schuetze wrote: post #12

Earlier 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…

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.

The problem is that those talents are being used to solve totally wrong problems because of engineers going gung-ho and starting to "engineer" before they understand the subject. The problem is not lack of designs or ideas for ventilators.

This sort of hack still requires that someone makes those things at scale. That's a supply chain issue, same as taking an existing, proven and actually certified design and manufacturing it at scale. Hacking up a few CPAP machines really doesn't solve the problem when the hospitals need tens of thousands ...

Even if we ignore the legal and medical bits (only in an extreme emergency with no other options and where the alternative is an inevitable death would anyone even contemplate using something like this on a patient), this machine isn't really a ventilator suitable for people with failing lungs. Patients that have to be intubated and the machine actually breathes for them, filters, humidifies and warms the air, allows sucking of phlegm without spewing virus everywhere ... And those are the machines that are in short supply. This hack doesn't do anything from that.

And finally, it doesn't address the issue of having enough trained staff that will operate and supervise the ventilators - these things have to be supervised 24/7, sometimes for weeks. One ICU nurse is commonly supposed to handle up to 6 patients, tops. You can't just add ventilators without adding nurses, because if anything goes wrong, people will die - and where do you get those nurses from? Especially if they have to deal with a gizmo that isn't as failsafe as a real ventilator (because it wasn't meant to be)? If you need more staff to run fewer ventilators/beds, then you haven't really solved anything, have you?

And the lack of trained staff is not something a jailbreak or an Arduino can solve.

People should stop messing with building "ventilators" and focus on things where they can actually make a difference - e.g. the production of face masks, face shields and similar gear, which are in extremely short supply and don't require much sophistication to build. That would make a much bigger difference than pretending that we are somehow solving the lack of ventilators with hacked CPAP machines ...

Re: Airbreak.dev: Jailbreak your CPAP machine to turn them into ventilators

#58

Post by [deleted] »

w0mbat wrote: post #54
fowkswe wrote: post #15

Also worth understanding that a ventilator is not always the best option - there have been findings recently that a tactic called 'proning' is often enough to increase blood oxygen: https://www.nytimes.com/2020/04/14/nyregion/new-york-coronav...

TLDR; They treated patients who presented with low blood oxygen by lying them on their belly or side and giving them oxygen through a nasal tube. No machine required. In many cases it worked perfectly.

[deleted]

Re: Airbreak.dev: Jailbreak your CPAP machine to turn them into ventilators

#59

Post by minikites »

Tepix wrote: post #4
tcbawo wrote: post #3

Not 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.

That's what it says right there on the page already: "Additional equipment like viral filters are also required."

So it's okay to show someone how to make something extremely hazardous as long as you include a flimsy nonspecific disclaimer?

Re: Airbreak.dev: Jailbreak your CPAP machine to turn them into ventilators

#60

Post by rootusrootus »

reaperducer wrote: post #48
hangonhn wrote: post #35

Earlier quoted context omitted.

You also need to warm and humidify the air because ventilators are inserted past the part of your respiratory system that does that.

You also need to warm and humidify the air because ventilators are inserted past the part of your respiratory system that does that. Many (most?) CPAP's do that. When you have to fill the reservoir every night you get an interesting perspective on the amount of water you breathe in eight hours.

> When you have to fill the reservoir every night

I accidentally found out one night that I don't need the air to be humidified. That was a revelation, and one that's saved me a lot of work since.

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