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'Pandemic ventilator' could offer solution in potential 'worst case' scenario

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Re: 'Pandemic ventilator' could offer solution in potential 'worst case' scenario

#31

Post by inferiorhuman »

DoreenMichele wrote: post #7
iqster wrote: post #3

Earlier quoted context omitted.

The key insight that made me want to post this is we should actively try to move to an older ventilator design (does bulk of the work, not optimized but easier and simpler). I have encountered this in my life as a software engineer. MFC (Microsoft Foundation Classes) in the mid 90s was hard to grok .. you had this huge book by Jeff Prosise to absorb. I cracked it when I chanced upon a manual for MFC 1.0. It was super…

There are people in the world who live with very serious lung issues who do home management daily in order to survive. Non-mechanical lung clearance methods are a part of their daily routine. I've left some comments here on the possibility of doing lung clearance in the absence of sufficient numbers of ventilators: https://news.ycombinator.com/item?id=22640905 I don't really care to argue it with anyone. Please go fi…

If the respiratory distress caused by SARS-CoV-2 were manageable in an outpatient setting we would not be seeing ICUs overrun with patients.

If people with COVID-19 could cough their way to health they would. If onions provided protection, we'd've heard about it by now given how much China is pushing TCM. Instead we see hucksters with no medical training hawking false treatment.

You know what happens when folks start taking medical advice from people with no medical training? This:

https://www.bloomberg.com/news/articles/2020-03-21/nigeria-r...

Chloroquine poisonings. Chloroquine is a safe, well understood drug. It's also not available over the counter in most countries because it is dangerous if not used correctly.

You are not a doctor. Please stop peddling your reckless medical advice.

Re: 'Pandemic ventilator' could offer solution in potential 'worst case' scenario

#32

Post by 14 »

arbuge wrote: post #4
iqster wrote: post #3

Earlier quoted context omitted.

The key insight that made me want to post this is we should actively try to move to an older ventilator design (does bulk of the work, not optimized but easier and simpler). I have encountered this in my life as a software engineer. MFC (Microsoft Foundation Classes) in the mid 90s was hard to grok .. you had this huge book by Jeff Prosise to absorb. I cracked it when I chanced upon a manual for MFC 1.0. It was super…

> I think if the Malaria Med+Antibiotics treatment from the French study don't work (we'll know in about a week I think), we need to move to a war footing and start producing ventilators. My back of the envelope math has scared the crap out of me (best case 500K Canadians dead, worse case 3 million). We should assume they won't work. War footing time is now.

It is going to be bad. People are still out and about touching everything then touching their face. I saw one lady today leave Walmart then upon getting to her car put all the groceries in the back then grabs a bag of chips and pops them open and starts eating them just moments after handling her shopping cart. Are people not seeing the videos of the people dying or on ventilators struggling for oxygen? Mean while the number of people around here being infected is slowly getting larger and larger each day. I have been telling people wash your hands before you do anything. They say social distancing, but that is the dumbest thing if you ask me because people seem to think that means if I am out and about and I stay 3 feet away from other people I will not get sick. What it really means is when you are out and about you need to not be in contact with other people or objects that other people may come in contact with. If you do come in contact with an object another person may have come in contact with, you may be exposed to the virus. Any time you touch an object others may have touched wash your hands. Social Distancing= Distancing from People and Any Objects they may have Touched. The other huge thing is do not touch your face, if you must it should only be after you thoroughly washed your hands. I am a home care aide and look after hundreds of elderly. This is getting crazy and feels as if we are just about to blow up in numbers. I wish people would take this more seriously. Vancouver Island is starting to take off. Good luck every body

Re: 'Pandemic ventilator' could offer solution in potential 'worst case' scenario

#33

Post by pmoleri »

tcbawo wrote: post #30

If you read enough news and Twitter, you will find some really heartbreaking descriptions of the folks on ventilators. For most, this is a Hail Mary attempt with only 50% survival rate. Many will have significant lung damage if they survive. We need more ventilators to be sure. But we desperately need to find ways to halt the progression of runaway lung inflammation that leads to needing a ventilator. Edit: this deve…

Interesting, so a little improvement there may lead to less ICU beds and sorter overall time at the hospital. Wonder if that's possible.

Re: 'Pandemic ventilator' could offer solution in potential 'worst case' scenario

#34

Post by andrewflnr »

DoreenMichele wrote: post #7
iqster wrote: post #3

Earlier quoted context omitted.

The key insight that made me want to post this is we should actively try to move to an older ventilator design (does bulk of the work, not optimized but easier and simpler). I have encountered this in my life as a software engineer. MFC (Microsoft Foundation Classes) in the mid 90s was hard to grok .. you had this huge book by Jeff Prosise to absorb. I cracked it when I chanced upon a manual for MFC 1.0. It was super…

There are people in the world who live with very serious lung issues who do home management daily in order to survive. Non-mechanical lung clearance methods are a part of their daily routine. I've left some comments here on the possibility of doing lung clearance in the absence of sufficient numbers of ventilators: https://news.ycombinator.com/item?id=22640905 I don't really care to argue it with anyone. Please go fi…

And here I thought I was an idiot for wondering if just having people sleep in a position to help fluid drain from their lungs would help. I guess I wasn't so far off.

More prosaically, I think I've reduced durations of basic colds by deliberately coughing early on. Needs more experiments, but as you said side effects are minimal, so you may as well try. I'm starting to think this is a family of life hacks that should be much more widely known.

Re: 'Pandemic ventilator' could offer solution in potential 'worst case' scenario

#35

Post by thornjm »

femto wrote: post #28

What about a "Both Respirator"? [1] In the 1930s polio epidemic there was a shortage of "iron lung" respirators, which were expensive to produce. Edward Both invented a plywood version, which was cheap and easy to produce. A re-purposed car factory then churned them out by the thousand. Is a negative pressure ventilator relevant for COVID-19 treatment? (Any knowledgeable medicos here who can offer a critique?) If so,…

Med student here - so I know some of the theory only. The most relevant "law" is Fick's Law of Diffusion (https://d2jmvrsizmvf4x.cloudfront.net/CTU792sKR2evT2ezizQp_f...). Doctors can increase diffusion by increasing the partial pressure of oxygen.

In a diffuse infection a patient begins to lose both lung area (due to shunting) and the thickness of the diffusion barrier increases (due to inflammation). To help overcome this you want to increase pressure and oxygen concentration.

An iron lung helps ease the work of breathing by reducing thoracic pressure and thus creates a larger pressure gradient for inspiration. However, it does not cause an absolute partial pressure of oxygen change compared to the atmosphere.

Unfortunately, to bind haemoglobin in physiological lung conditions we need partial pressure of oxygen around 100mmHg. My guess is that an iron lung does not help increase the partial pressure of oxygen so it will do little but ease the work of breathing (which is better than nothing!).

Re: 'Pandemic ventilator' could offer solution in potential 'worst case' scenario

#36

Post by andrewflnr »

inferiorhuman wrote: post #31
DoreenMichele wrote: post #7

Earlier quoted context omitted.

There are people in the world who live with very serious lung issues who do home management daily in order to survive. Non-mechanical lung clearance methods are a part of their daily routine. I've left some comments here on the possibility of doing lung clearance in the absence of sufficient numbers of ventilators: https://news.ycombinator.com/item?id=22640905 I don't really care to argue it with anyone. Please go fi…

If the respiratory distress caused by SARS-CoV-2 were manageable in an outpatient setting we would not be seeing ICUs overrun with patients. If people with COVID-19 could cough their way to health they would. If onions provided protection, we'd've heard about it by now given how much China is pushing TCM. Instead we see hucksters with no medical training hawking false treatment. You know what happens when folks start…

You persist in attacking a straw man in direct reply to a post that explicitly disclaims it. Quit pattern matching on "non-doctor comments on medical issue" and look at what she's actually saying.

Re: 'Pandemic ventilator' could offer solution in potential 'worst case' scenario

#37

Post by wbl »

modoc wrote: post #16
wbl wrote: post #14

Earlier quoted context omitted.

All COVID-19 patients are intubated to control aerosol creation.

That is not true. Some are intubated if the mask respirators fail to provide proper oxygenation, but it is by no means the default. Source: my sister is a nurse at a hospital treating dozens of COVID-19 patients.

Sorry, I ment for ventilation. This is from a report in one hospital and it's possible other controls are being used.

We are all rooting for your sister.

Re: 'Pandemic ventilator' could offer solution in potential 'worst case' scenario

#38

Post by JohnBooty »

From the article:

   "We're talking about a device that we want to 
   have available in the worst case conditions and strangely
   enough, COVID-19 is not the worst case envisioned," he 
   said.
Made me think.

Perhaps in 3, or 5, or 20 years....

Maybe we'll be thankful that COVID-19 was sort of a "training wheels" pandemic... something that helped to prepare us for the even worse pandemics that are sure to follow.

Deaths due to COVID-19 will be staggering, but it's somewhat mild as far as possible pandemic scenarios go. Imagine if it had mortality rates comparable to ebola, TB, etc.

When this blows over, the world should be better prepared for the next one, with better procedures.... emergency stockpiles of ventilators, masks, etc.

(Or at least we will be... until we go ten years without a pandemic... and all those stockpiles get liquidated in order to help some politician to balance a budget or whatever...)

Re: 'Pandemic ventilator' could offer solution in potential 'worst case' scenario

#39

Post by ta1234567890 »

Is it possible to kill the virus inside the body, the same way we kill it outside?

For example, if one could hypothetically spray alcohol everywhere inside someone's lungs, would that kill the infection?

If so, could a liquid/gas mixture be developed to deliver the right virus-killer substance directly to the lungs?

Does anyone here know about PFCs-breathing treatments?[0]

0: https://www.realclearscience.com/blog/2019/08/15/can_humans_...

Re: 'Pandemic ventilator' could offer solution in potential 'worst case' scenario

#40

Post by sudosysgen »

ta1234567890 wrote: post #39

Is it possible to kill the virus inside the body, the same way we kill it outside? For example, if one could hypothetically spray alcohol everywhere inside someone's lungs, would that kill the infection? If so, could a liquid/gas mixture be developed to deliver the right virus-killer substance directly to the lungs? Does anyone here know about PFCs-breathing treatments?[0] 0: https://www.realclearscience.com/blog/201…

That would also kill the person in multiple different ways at once.
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