Airbreak.dev: Jailbreak your CPAP machine to turn them into ventilators • Hacker News Board

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

#71

Post by gowld » Tue, Apr 14, 2020, 6:57 PM UTC

schuetze wrote: post #39

jauer wrote: post #28

Earlier quoted context omitted.

> 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 ven…

To be clear, your position is that we should eschew self care so that we can bankrupt ourselves by only getting care from doctors, who as you note are either hoarding critical medicines for themselves or using wrong medicine for treatment?

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

#72

Post by justicezyx » Tue, Apr 14, 2020, 6:59 PM UTC

Talking about cpap machine, I did some research on it, and found that they are regulated medical device and cannot be purchased without prescription.

I suffer chronicle dry nose, moderate empty nose syndrome on the right side (due to surgery done 20 years ago in China), and Deviated Septum (due to injury as kid). One thing often happen to me is during middle of nigh sleep, my left nose duct will be extremely dry, causing me to wake up and switch side (it seems my nasal cycle is completely gone).

One idea I wanted to try to fix is to use a cpap + humidifier to pump moisturized air.

And I found that I have to get prescription, which I tried with one lab sleep study causing $3000+, and concluded that I do not have sleep apnea, which is one of the symptoms to qualify cpap prescription.

Then I started to look for off market cpap machine on Craigslist. No luck, the machines are often old, and beat up after long usages.

I did not seriously research if cpap has risks to normal people. But it does not seem harmful, unfortunately it has to be regulated and possibly also become very expensive.

Edit: Thanks for the good recommendations. Buying from Chinese site (I often forgot this), nebulizer, etc.

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

#73

Post by the_fury » Tue, Apr 14, 2020, 7:00 PM UTC

minikites wrote: post #59

Tepix wrote: post #4

Earlier quoted context omitted.

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?

Absolutely, yes.

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

#74

Post by gfodor » Tue, Apr 14, 2020, 7:01 PM UTC

janoc wrote: post #57

shawnz wrote: post #37

Earlier quoted context omitted.

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 manufac…

Classic false dilemma.

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

#75

Post by gowld » Tue, Apr 14, 2020, 7:02 PM UTC

tibbydudeza wrote: post #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.

It's a standard technique -- binary patching.

https://en.m.wikipedia.org/wiki/Patch_(computing)

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

#76

Post by gowld » Tue, Apr 14, 2020, 7:02 PM UTC

reaperducer wrote: post #47

IdoRA wrote: post #36

There 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) meaning…

These are not normal times, and I can certainly see a doctor with tinkering skills modding his office's CPAP stock in order to save lives.

Not likely a doctor in a US hospital. Too much liability risk.

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

#77

Post by TylerE » Tue, Apr 14, 2020, 7:05 PM UTC

fwip wrote: post #62

jdjrirkfkfk wrote: post #51

Earlier quoted context omitted.

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 v…

CPAP machines are usually used when you're asleep, right? Since sleep apnea can sometimes be fatal, it seems like screwing up your CPAP machine could conceivably lead to your death.

For most, yes, but there are people who use them while awake... for instance, people who suffer from conditions like ALS or COPD.

Even as someone with just vanilla sleep apnea I'll occasionally strap mine on for a while when suffering from a head cold...certainly helps open things up.

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

#78

Post by peterangular » Tue, Apr 14, 2020, 7:12 PM UTC

minikites wrote: post #70

shijie wrote: post #65

Earlier quoted context omitted.

I believe so, yes. I like to think people can make reasonable decisions with information they are provided

If people can make reasonable decisions all of the time, why do we even have laws? Reasonable people wouldn't violate them anyway.

This is pandering to an extreme situation in order to make a case... I think anyone on HN will acknowledge that people are on a scale from "not reasonable" to "very reasonable".

You're pushing the comment you're responding to over to a binary point of view. I don't believe in good faith that shijie meant "all of the time" when they said "I like to think people can make reasonable decisions with information they are provided". To push their statement to "all of the time" while bringing the ethics of law into this conversation seems disingenuous to the safety/disclaimer concerns you originally called into question.

Personally, I found the disclaimer on the airbreak.dev site to be very clear and appreciated it was on the front-page directly following the product summary. It is clear to me that this is an "in-development" project that is not ready for real-world deployment yet - they're being quite clear/transparent with these facts.

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

#79

Post by cameldrv » Tue, Apr 14, 2020, 7:12 PM UTC

dpeck wrote: post #49

reaperducer wrote: post #46

Earlier quoted context omitted.

I'd be very surprised to see any airline restrict the use of a medical device onboard. The manual that came with mine states that airlines are required to let you use it, and the manufacturer sells an airline-friendly battery pack. Do you have a link to Delta's policy on this?

My mistake, I was wrong. They allow use, but it has to have its own power supply https://www.delta.com/us/en/accessible-travel-services/assis...

This would seem to be because they don't want to be held to providing medical grade reliability of electricity to the seat.

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

#80

Post by DanBC » Tue, Apr 14, 2020, 7:13 PM UTC

SkyPuncher wrote: post #64

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.

If you're using this where non-COVID patients could be exposed (e.g. at home) this is a very important consideration. In a hospital setting (aka an emergency), it's less of an issue. The situation that would warrant this would likely also warrant full PPE just to enter a unit or building.

> it's less of an issue. The situation that would warrant this would likely also warrant full PPE just to enter a unit or building.

Isn't it still important not to spray covid everywhere?

See for example this post: https://emcrit.org/emcrit/covid-airway-management/

> Critical Note: If you use the vent for preox, you MUST disconnect the vent circuit proximal to the viral filter before removing the mask. Otherwise, COVID will be sprayed all around the room!!!!! See Triple C below.

{EDIT: genuinely don't know why this got downvotes.}