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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

#111

Post by simplecto »

BurningFrog wrote: post #107
xnyan wrote: post #102

Earlier quoted context omitted.

>overly strict Disclaimer: my opinions, not my company. I worked as a project engineer for a major testing company (underwriters laboratories). This is a vast simplification, but in essence the difference between medical device testing verses say, household electronics, is that in practice household electronics get evaluated with a "safety checklist" of all the serious and common problems to that kind of device (plus…

I don't disagree. Testing should be as strict as is needed. I'm arguing/assuming that US testing standards for medical devices is overly strict. I think* there is the same "maximum" standard for all medical devices. But what's appropriate for a pacemaker is overkill for a CPAP machine. * but am happy to be corrected (Cunningham's Law)

Your are partly correct.

There are multiple classifications for medical devices.

CPAPs are class 2 devices whereas a pacemaker is class 3. I don’t want to over simplify, so I will link you to the FDAs entry point into the Byzantine maze of classifications.

https://www.fda.gov/medical-devices/overview-device-regulati...

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

#112

Post by jnwatson »

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…

This isn't a significant redesign of an existing device. It is essentially a DRM bypass.

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

#113

Post by gmueckl »

wormyrocks wrote: post #56

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…

> a near identical array of sensors

I don't know anything about the devices in question, but from what I know of engineering of medical devices, stating "near identical" makes me listen up.

If these devices malfunction, they could hurt people. I expect a device like this to have an extensive array of sensors and a lot of extra hardware for constant self-monitoring. If the two lines of devices don't have exactly identical hardware, the differences need to be checked carefully. The lower tier device may be missing some capabilities because of that.

Also, it is not obvious that the main development effort for a medical device often isn't about making a device perform its primary function, but to make it incapable of doing anything else. That includes automatic detection of malfunction and appropriate safe modes (simply turning it off may not be safe!). Of course, all of that needs to be tested and validated very thoroughly. If you ever want to use a hacked device on a patient, you will have to prove that it is up to the same engineering standards. That is no simple task, but it beats hurting or killing people because of bugs.

In short, this isn't a job for the regular basement-dwelling hacker, the kind who is happy to have his Roomba drive around with a hacked up firmware. This needs some serious and methodical engineering effort to become practical.

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

#114

Post by DenisM »

TylerE wrote: post #77
fwip wrote: post #62

Earlier quoted context omitted.

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.

> I'll occasionally strap mine on for a while when suffering from a head cold

Wait, how does this help? Does this clear up stuffed nose and such?

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

#115

Post by sneak »

gmueckl wrote: post #113
wormyrocks wrote: post #56

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…

> a near identical array of sensors I don't know anything about the devices in question, but from what I know of engineering of medical devices, stating "near identical" makes me listen up. If these devices malfunction, they could hurt people. I expect a device like this to have an extensive array of sensors and a lot of extra hardware for constant self-monitoring. If the two lines of devices don't have exactly ident…

> If these devices malfunction, they could hurt people.

I think that the circumstances under which these are being developed are a special emergency; the alternative to using such a less-safe, makeshift device here would be no ventilator at all, i.e. near-certain death.

In this specific circumstance, I think this sort of criticism should be withheld. I don't think anyone's talking about reflashing CPAPs to be life support outside of a temporary C19 emergency shortage.

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

#116

Post by DenisM »

reaperducer wrote: post #63
rootusrootus wrote: post #60

Earlier quoted context omitted.

> 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.

Mine makes a burning smell if I run out of water in the night. Wakes me up very quickly.

Turn off the tank heater?

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

#117

Post by electriclove »

SubiculumCode wrote: post #95
ars wrote: post #81

Earlier quoted context omitted.

The CPAP world is a microcosm of what's wrong in the medical world, i.e. why things cost so much. A CPAP machines costs about 10x as much as it should, and a part of that is insurance companies wanting to make sure they are not paying for a device you are not using. Which then increases the price, which makes insurance companies even more worried about them. Then you are paternalism where only a Dr. is allowed to cha…

Its worse than that. Before receiving a CPAP machine ~$1,000, most doctor's require a sleep study, which costs many thousands of dollars, and many times wait months to get the appointment. CPAP machines are usually the ultimate solution to reported sleep problems involving repeatedly waking up, and I don't see why they can't be prescribed immediately to see if they solve the problem.

Why is a prescription required anyway?

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

#118

Post by hanniabu »

electriclove wrote: post #117
SubiculumCode wrote: post #95

Earlier quoted context omitted.

Its worse than that. Before receiving a CPAP machine ~$1,000, most doctor's require a sleep study, which costs many thousands of dollars, and many times wait months to get the appointment. CPAP machines are usually the ultimate solution to reported sleep problems involving repeatedly waking up, and I don't see why they can't be prescribed immediately to see if they solve the problem.

Why is a prescription required anyway?

To keep the ponzi going

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

#119

Post by favorited »

SubiculumCode wrote: post #103
favorited wrote: post #99

Earlier quoted context omitted.

My insurance wouldn't even pay for a monitored sleep study before I did an at-home study. Luckily, the at-home device showed moderate apnea, so I didn't have to do the lab study.

That's what they did for me as well, but not for other people I know living in a less affluent area of California. The take-home solution is much more cost-effective, it is a wonder that it hasn't been adopted universally. Also, I LOVE my CPAP.

That's fair, I only know what happened at Stanford. Side note to anyone reading this: don't go to the sleep clinic at Stanford. If your doctor refers to there, ask for another referral. There's a reason they have 1.5 stars on Yelp...

And I totally agree about the CPAP – any morning after I accidentally take it off in my sleep (pretty rare, but happens especially as the seasons change), I feel like absolute garbage. It's amazing what actually breathing through the night can do for you.

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