Open Source Ventilator Project • Hacker News Board

Re: Open Source Ventilator Project

#11

Post by IAmEveryone » Fri, Mar 20, 2020, 7:29 PM UTC

TaylorAlexander wrote: post #5

The page isn’t loading so I’m not sure what they’ve got, but I’m still trying to get answers to a question I have. I did research Tuesday and it seems like ventilators are positive pressure only, and they cycle between a low pressure and a high pressure. If this is the case, could an air compressor with a regulator be used as the pressure source? If so, a small device with just two pressure regulators and an electron…

I believe hospitals do use systems with a single, central supply of pressurised air.

However, I'm also getting the sense from reading about these efforts that creating pressurised air is the easiest part of the setup. You need to control that pressure with a precision unlike any other application of air pressure. Just alternating high and low pressure isn't going to work, for example: you need to slowly ramp up pressure, then slowly release, on a specific schedule. Every patient also has individual needs, to the point where even for two people of the same gender and similar age/weight, the settings ideal for one might kill the other, and vice versa.

If I understand it correctly, these machines use feedback loops with sensors for blood oxidisation, acidosis, the elasticity of the lung, and other factors. Without such mechanisms, you'd be constantly adjusting the settings––consider a heating system or AC where you can't set the desired temperature, but only flow rate and power of the heating/cooling instrument. You need constant attention to keep such a setup within a comfortable range. And that attention will also be in short supply when hospitals are overrun.

Re: Open Source Ventilator Project

#12

Post by rawfan » Fri, Mar 20, 2020, 7:30 PM UTC

davidw wrote: post #7

Anyone pitching in seems like they're doing a good thing, but isn't the problem one more of political organization and scaling production? In other words, the US president (he is the only one authorized to do it) needs to activate the Defense Production Act, and get existing companies to mass produce existing designs. Something similar needs to happen elsewhere. This is a matter of days or weeks, not months. Please g…

It‘s already happening elsewhere voluntarily. Sharp is producing masks and Draeger is AFAIK working on massproducing ventilators.

Re: Open Source Ventilator Project

#13

Post by whatshisface » Fri, Mar 20, 2020, 7:32 PM UTC

arcticbull wrote: post #8

Please, stop with these. As experts have shared many times on here, once you need a ventilator, the ventilator is the least of your problems. Trying to apply a ventilator to a COVID-19 patient who needs one when you have no idea what you're doing can create the same lung injuries as COVID-19 itself.

Please, continue with these. As experts have shared many times on here, ventilator shortages will soon become commonplace, and medical professionals have been discussing ways to use a bag, facemask and manual labor to work as a ventilator. Trying to apply a ventilator to a COVID-19 patient when you're a medical professional isn't possible when you don't have any free ventilators. Every bit helps.

Re: Open Source Ventilator Project

#14

Post by jka » Fri, Mar 20, 2020, 7:32 PM UTC

vr46 wrote: post #9

What is the point of all these? Large scale manufacturers have already been sent blueprints of ventilators and have the engineering ability and production lines to make them. Then you need trained nurses and staff to operate them.

Open source designs could help scale up production in times of need by allowing manufacturers to self-assess whether they're capable of providing additional capacity.

Yes, we assume blueprints have now been shared and that production is scaling up - but it has required a lot of time, effort, communication and bargaining.

That said, open source alone is not a panacea. Questions should be asked of open source designs:

- Do the designs meet regulatory standards for the market(s) they are intended for?

- Is the quality assurance process equally open, so that manufacturers & recipients can verify whether products are authentic and fit-for-purpose?

It looks like the OSV project are aware of these questions and provide their working assumptions and information about work-in-progress on their homepage.

Re: Open Source Ventilator Project

#15

Post by arcticbull » Fri, Mar 20, 2020, 7:43 PM UTC

whatshisface wrote: post #13

arcticbull wrote: post #8

Please, stop with these. As experts have shared many times on here, once you need a ventilator, the ventilator is the least of your problems. Trying to apply a ventilator to a COVID-19 patient who needs one when you have no idea what you're doing can create the same lung injuries as COVID-19 itself.

Please, continue with these. As experts have shared many times on here, ventilator shortages will soon become commonplace, and medical professionals have been discussing ways to use a bag, facemask and manual labor to work as a ventilator. Trying to apply a ventilator to a COVID-19 patient when you're a medical professional isn't possible when you don't have any free ventilators. Every bit helps.

Not every bit helps. Sometimes trying to do something, badly, will cause more harm than not trying. I sympathize, it's frustrating, and it's difficult to sit on your hands sometimes feeling like you should be doing something.

In totality, however, furthering things like DIY ventilators (like DIY open-heart surgery) can cause more harm than good.

We've got governments, experts and professionals mobilizing to prepare for this, let's allow them to do their jobs. This is what they've trained for.

Re: Open Source Ventilator Project

#16

Post by DoreenMichele » Fri, Mar 20, 2020, 7:43 PM UTC

I made some remarks about ventilator alternatives here:

https://news.ycombinator.com/item?id=22624959

To pull out some pertinent details:

Ventilators for covid19 seem to be mostly for inflammation and fluid in the lungs (aka pneumonia), not lung or chest paralysis.

If you need a ventilator due to inflammation or fluid build up, you can do other things to address those issues.

If you are doing home care for serious lung issues, a downside of mechanical intervention is that you probably don't know how to adequately sterilize your equipment. This means nasty stuff grows on the equipment and then this nasty stuff gets delivered directly into the lungs.

So I'm not thrilled to pieces to see the emphasis on "ooh, shiny!" homemade technical solutions in place of non-invasive home care.

You can do lung clearance without mechanical intervention. This can make a ventilator unnecessary.

You can do lung clearance easily on your own in the shower by standing with your feet shoulder-width apart or a bit wider, bending over as far as you can and coughing hard.

If you bring up a lot of fluid from the lungs, it looks and feels a whole lot like vomiting. My sons and I call it "puking up a lung."

Inflammation can be combated with commonly available non drug remedies, like caffeine, lettuce, avoiding pro inflammatory foods (avoid peanut oil like the devil himself made it for you, limit or avoid bacon as it is hard on the lungs).

Etc.

Please see my previous remarks about best sleeping positions, etc.

I am very concerned that homemade ventilators are going to become a source of secondary infection and this secondary infection will be worse than covid19 because it will be bacterial or fungal and it will be antibiotic resistant.

If I had any idea how on Earth to start a counter movement, I would be all over it. I have no idea how to do that, so I occasionally leave a comment on HN giving some of my thoughts, which isn't likely to exactly catch fire. This is today's comment in that vein.

Re: Open Source Ventilator Project

#17

Post by arcticbull » Fri, Mar 20, 2020, 7:46 PM UTC

chrisseaton wrote: post #3

> 15-20% of infected people require hospitalization for respiratory problems This is wrong - it's 15-20% of identified , diagnosed and subsequently monitored infected people, isn't it? I thought there was a mass of unidentified infected people, and even basically diagnosed but told to just deal with it at home with no further contact as they're low risk and minimal symptoms, and (obviously) 0% of these groups are goi…

Yes, that number is negligently incorrect.

It's like saying 90% of basketball players require casts because, from the set who end up in ambulance, 90% of them have a broken arm. That doesn't mean 90% of basketball players require casts, and it certainly doesn't mean they need them all at once.

There was a study posted here recently that said as many at 86% of people were asymptomatic, then only some sliver of those with symptoms end up needing to go to hospital in the first place -- and 20% of that group that tests positive for the virus ends up needing a ventilator and 5% of them end up dead.

Net-net close to a 0% fatality rate under 29, 0.1% under 49.

Still gonna feel like crap tho.

Re: Open Source Ventilator Project

#18

Post by whatshisface » Fri, Mar 20, 2020, 8:07 PM UTC

arcticbull wrote: post #15

whatshisface wrote: post #13

Earlier quoted context omitted.

Please, continue with these. As experts have shared many times on here, ventilator shortages will soon become commonplace, and medical professionals have been discussing ways to use a bag, facemask and manual labor to work as a ventilator. Trying to apply a ventilator to a COVID-19 patient when you're a medical professional isn't possible when you don't have any free ventilators. Every bit helps.

Not every bit helps. Sometimes trying to do something, badly, will cause more harm than not trying. I sympathize, it's frustrating, and it's difficult to sit on your hands sometimes feeling like you should be doing something. In totality, however, furthering things like DIY ventilators (like DIY open-heart surgery) can cause more harm than good. We've got governments, experts and professionals mobilizing to prepare f…

>let's allow them to do their jobs

Do hobbyists rigging together servo motors to prepare for a worst-case scenario really interfere with the soon-to-be overwhelmed professional medical industry workers attempts to do their jobs? The only reason I can think of to be against this would be kind of like doing a trust fall, voicing against independent work to signal personal trust in the capacity of the medical system. Of course, that would be a purely social reason, not really helpful for saving lives or improving the system.

Re: Open Source Ventilator Project

#19

Post by tcbawo » Fri, Mar 20, 2020, 8:12 PM UTC

arcticbull wrote: post #17

chrisseaton wrote: post #3

> 15-20% of infected people require hospitalization for respiratory problems This is wrong - it's 15-20% of identified , diagnosed and subsequently monitored infected people, isn't it? I thought there was a mass of unidentified infected people, and even basically diagnosed but told to just deal with it at home with no further contact as they're low risk and minimal symptoms, and (obviously) 0% of these groups are goi…

Yes, that number is negligently incorrect. It's like saying 90% of basketball players require casts because, from the set who end up in ambulance, 90% of them have a broken arm. That doesn't mean 90% of basketball players require casts, and it certainly doesn't mean they need them all at once. There was a study posted here recently that said as many at 86% of people were asymptomatic, then only some sliver of those w…