Open source ventilator? Time for us to make it happen. - Page 2
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  1. #21
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    Quote Originally Posted by Garwood View Post
    Why are you giving up?

    Us Fins have this ability or disability we call Sisu. We mis-interpret naysayers as cheerleaders. Usually works out surprisingly well.

    Im not giving up.
    See, Im part Norsk, part Amish.... you figure the rest out.
    Dad liked pie and a well kept home.
    Im just very disheartened that in a time of need, the only shit Im hearing is REGULATION.

    Im not talking about using lead smelters as breathing devices..
    Its a simple mechanical device that we could use to fill the gap with.

    Thank you Garwood + Ziggy

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    Not criticizing you at all, mcds. But ventilators are pretty simple and production could be kicked up fast and there's probably quite a few already available. You've got a week or so before it really hits the fan.

    What's not going to be rampable is ecmo machines. China has a LOT, and the US does not. And they used them a lot, they weren't decorations. Those don't grow on trees.

    China also has a LOT of CAT scanners, which they used and the US does not.

    Again, no trees available.

    And intensive care beds ... we wouldn't want them hospitals to spend an extra dollar on facilities, would we ? That'd cut into life insurance bonuses.

    Contrary to early speculation, I think the US will have a higher mortality rate than China, South Korea, and Taiwan. We wouldnt want to interfere with people's constitutional right to assemble, would we ?

    Italy alone is now within a few hundred of China's total mortality number, with 1/3 as many cases. I bet they pass us today. The US has the boomers ....

    All the more reason to stay home early.

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  4. #23
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    Right then.
    Lets build some fucking ventilators!
    The Epa, esa, blah fucking blah, can suck our nuts....

    Insurance would be well ahead if they let us just work away. Fuck them.
    Those bastards are one of the biggest reasons they pay out, but they're to god damned foolish to realize it.

    Its time for us to just get to work and do whats right, without all the bullshit hovering over our heads.
    Im not wrong.

  5. #24
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    I have tons of airway support equipment/supplies we couldn't give away to missions, may try some hospitals now with the looming crisis.

    The supply chains for hospitals is like aviation or nuke stuff, traceability and, regulatory approval. That may get short circuited but it wont go away, a major player may get a pass, a start up unlikely.

    Steve

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    Quote Originally Posted by EPAIII View Post
    I hate to sound like the voice of doom here, but the VERY FIRST thing that you need to do is to make sure you AND EVERYONE ELSE who you involve in this is 100% completely covered by insurance. If such a device were used, there will be deaths of the patients who use it. That is sad, but is not avoidable. And then there will be lawsuits.
    I'm leading a small team working on a scaleable Automated Bag Valve Mask (BVM) project as we speak. We're rolling our first prototype out in a couple of days.

    Our approach is that you are sort of 100% correct - there is absolutely no way a team could ever mass-manufacturer from scratch a contemporary mechanical ventilator found in hospitals. These things are crazy wicked advanced, for fuck sakes - most are turbine driven. Multiple data points are collected, monitored, and self-adjusted. Numerous specialty modes of operation are offered. They are self-powered in a power loss. They have 6 Sigma levels of reliability. They also cost from about $20k for the low end model to well over $100k for the latest Medtronic PB 980. The current manufacturers think they might be able to 5x output of these devices if given unlimited POs and maximum government assistance - which gets you ~3000 of these things over the next 6 months.

    Imperial College of London's latest model for the US puts us at about 200,000 vents short on the moderate outcome.

    70 years ago before we were building mini AI jet engines to do this job, the Bag Valve Mask was invented by a German and a Dane. Over those years, the design has been meticulously optimized and turned into a highly advanced, medical grade, commodity item of such reliability that you don't even think about them going wrong. These are what paramedics are gonna be squeezing to keep you breathing. They are how you get oxygenated before the airway gets shoved down your throat. They are always within arms reach of the Porsche priced ventilator if/when something goes wrong with it. They are as reliable as a wood burning stove, inexpensive, hundreds of thousands are trained how to use them, and every hospital has one in almost every room already.

    So it is simple - you make a device that automates this. Simple bag squeeze mechanism, very basic microcontroller, servo motor. Existing sensors for airway pressure plug right in to guide it. Teams from Rice and MIT have already validated the concept in multiple student engineering products to create a low-cost ventilator for 3rd world countries.

    With this design - the entire air circuit is a known-quantity, carrying complete FDA certification, made from biocompatible materials, intrinsically patient safe. If the automation portion stops working? You yank the bag out from between the squeeze mechanism and go old fashioned - the patient might not even notice.

    The design we are working on is focused on ease of manufacturing and component flexibility. The latter is the real problem - nobody on the globe is keeping anything in stock, we live in a Just In Time world. If you need 50,000 NEMA17 stepper motors, you can get them in 6 weeks from... China. Who won't be delivering anything in those quantities within the next 6 weeks because they are even more fucking hosed than we are. So we are optimizing the design to have a min/max component mix that can take any size motor, any electronics, any power supply we can get our hands on.

    I have no idea if any of this is going anywhere, but at the very least, this is an interesting challenge and I finagled some super smart folks to work on it. The absolute worst case scenario is that some poor bastard would ever be getting kept alive with our work-product, because if that happens? We are all really totally fucked.

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    Quote Originally Posted by macds View Post
    Right then.
    Lets build some fucking ventilators!
    The Epa, esa, blah fucking blah, can suck our nuts....

    Insurance would be well ahead if they let us just work away. Fuck them.
    Those bastards are one of the biggest reasons they pay out, but they're to god damned foolish to realize it.

    Its time for us to just get to work and do whats right, without all the bullshit hovering over our heads.
    Im not wrong.
    Not new. Georgy Konstantinovich Zhukov turned his Red Army's success rate around by putting the backshooter Political Teams at the tip of the spear where they could show their dedication to "Da Rodina" by fighting for it - instead of murdering their own side from back of the line of battle. Good at it or failures, the morale of the entire REST of his armies surely improved, and the job got DONE!

    Not a fan of his political system, but he was a seriously pragmatic SOB and won his share of that war off the back of that characteristic.

    Time for inch-hoorance lackeys. lawsters - and "HUTA" legislators - to be hauled out from behind their armour-plated desks and put to dealing more directly with life or death choices, too - rather than safe-for-them insulated box-ticks that condemn OTHERS to lack of badly needed help?

    Could was...

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    Quote Originally Posted by macds View Post
    This will be a cross forum post.

    With whats going down, I feel it prudent for us as manufacturing leaders to step up.
    There IS available spindle time out there.

    So, Im asking you all.
    What can we do to hammer out the parts we need to build up the ventilators that ARE going to be needed?
    And fast?

    I imagine we need electronics, as well as plastics\rubber teams to get involved.

    I will be approaching my contacts, but I feel this needs to be a continental\global movement.

    Gentlemen, its time to make a stand for your country, and your family.

    God bless,

    Stu
    What's up with this "this will be a cross forum post" crap-ol-a ?

    and where's the "OT" in the title sir ?

    losasso.com — Servers is the place for YÜÜ

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    I think this could be a great idea, except...

    How many shops are ISO 13485? Not enough. Biggest problem is liability in a sue happy society. Even supply a screw to this and your opening yourself up to billion dollar lawsuits than could be decades in the future.

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    Quote Originally Posted by Larry Dickman View Post
    I think this could be a great idea, except...

    How many shops are ISO 13485? Not enough. Biggest problem is liability in a sue happy society. Even supply a screw to this and your opening yourself up to billion dollar lawsuits than could be decades in the future.
    Why doo you think this ?

    "I think these designers and engineers don't know what they are doing. I can bang out an old washing machine motor, some grocery bags and some hoover hose, and put them all to shame"

    "We don't need all these fancy things"

    You've just disrespected a whole industry sir.

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    Quote Originally Posted by Larry Dickman View Post
    I think this could be a great idea, except...

    How many shops are ISO 13485? Not enough. Biggest problem is liability in a sue happy society. Even supply a screw to this and your opening yourself up to billion dollar lawsuits than could be decades in the future.
    I think the litigious society we live in these days is worse than pathetic. I kid thee not if I am laid up mid afternoon resting my bad back watching broadcast TV there are up to two dozen lawyer ads run an hour (yes I have counted). A lot of them are ambulance chaser lawyer referral services looking for people supposedly harmed by consumer products.

    It seems the amount of ambulance chasing lawyers willing to sue anyone are breeding like rabbits. Are they looking for the big score finding a big business hating jury that will award substantial money without solid proof the product caused damage? Like J & J baby powder causing cancer. How could it be proved the baby powder caused the cancer and not something else? Also until recently with these grocery store cards that track your purchases how could someone prove they used the products long term? Or I wonder if they figure they will threaten to sue in mass hoping a lot will just settle for a good payday out of court.

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    Quote Originally Posted by Larry Dickman View Post
    I think this could be a great idea, except...

    How many shops are ISO 13485? Not enough. Biggest problem is liability in a sue happy society. Even supply a screw to this and your opening yourself up to billion dollar lawsuits than could be decades in the future.
    Not sure what ISO 13485 is, but I have made items in the past for the medical and food industry and they said I just needed to provide finishing certs and material certs as they would inspect them themselves and they had all the required certifications. It probably has to do with the application of the parts, but that is just my uneducated guess.

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    Quote Originally Posted by EPAIII View Post
    Build a ventilator! A ventilator to be used in hospitals and other care facilities to treat HUMAN patients. And you have no idea of the proper software, much less any standards that the hardware will be required to meet? Or what medical conditions it is expected to monitor? Or what patents exist to protect the present hardware and software?
    In normal times, I agree. But the projections - even if we "flatten the curve" is for the need for ventilators to far exceed the supply. Given the choice between 1) No ventilator and probably dying, and 2) a hackathon ventilator, and possibly living, I'd choose the latter. Right now, pretty much anything to address the need will be
    made way outside any GMP and without any engineering oversight.

    My understanding is that one of the really pernicious battlefield injuries is called a "sucking wound". When the diaphragm moves down to expand the lungs, the sucking wound admits air and the lung collapses (pneumothorax). There's been a lot of ad hoc solutions in the heat of battle. One such approach was the use of cigarette package cellophane held lightly over the wound. When the patient inhales, the cellophane acts like a check valve and doesn't let the wound "suck". One approach was to tape the cellophane down on three sides. Great in theory, less so in practice. So an Army doc in Vietnam came up with a rubber tube with the end squashed. The squashed end again, acted as a check valve. Hardly FDA approved! But IIRC, this invention was further developed and is now one approach used. I think its called an Asherman chest seal.

    Point is, in extremis, all the nice plans with checkmarks next to each plan element go out the window. I'm sure that someone, somewhere, will try to save a patient with a hot water bottle used as a bellows!


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    An open source DIY sorta-kinda ventilator already exists.

    GitHub - jcl5m1/ventilator: Low-Cost Open Source Ventilator

    But please, please, before you go out and buy up all the CPAP devices keep in mind that apnea and COPD patients need these devices and if their existing one fails they need an immediate replacement. Let's not start another panic buying spree that deprives people of what they NEED. Healthy people don't need masks (per the CDC) yet due to panic buying and hoarding infectious people and the immuno-compromised may have troubel finding them.

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    If I hear someone else mention regulations again I think I my head will explode. Fuck regulations. This is a great idea, great thread and we need to get this done. Hospitals are going to choose who lives and who dies. A diy ventilator at home will at least give the person a fighting chance. We're a community with great resources. Lets come together as Americans and make this happen and regulations be damn. If we have a proven, working unit shops around the country can focus on parts in their wheelhouse and we can ship to an assembly facility. I'll shut down all operations to focus on this. Lets make it happen.

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    Quote Originally Posted by metal-ica View Post
    If I hear someone else mention regulations again I think I my head will explode. Fuck regulations. This is a great idea, great thread and we need to get this done. Hospitals are going to choose who lives and who dies. A diy ventilator at home will at least give the person a fighting chance. We're a community with great resources. Lets come together as Americans and make this happen and regulations be damn. If we have a proven, working unit shops around the country can focus on parts in their wheelhouse and we can ship to an assembly facility. I'll shut down all operations to focus on this. Lets make it happen.
    The talk about regulations/liability is so silly. These are looking like the textbook of exigent circumstances.

    Look, the CDC is already putting out guidance on how to hook up 1 mechanical ventilator to a split for 4 patients. This has been tested on artificial lungs successfully, and UMC Trauma did it with 4 total patients across 2 ventilators during the Las Vegas shooting, but received new vents within 3 hours. For short term surge use in a trauma center? It is an amazing hack...

    But COVID-19 patients in ARDS typically need a week of ventilation. This split trick means you'll be taking these ventilators, and running them at maximum tidal volume, at maximum pressure, to get mid-level values to each patient. They'll be running at their maximum duty cycle for weeks (you also lose all those advanced ventilator features, since they are designed for a single patient, so your $100k PB980 becomes a basic air mover).

    And here is where it gets bad - when one of those vents fails, you now have 90 seconds to get 2-3 people in that room (per patient), disconnect them from the vents, get them on BVMs, and start breathing for them. Then you need to pull all 4 of them out of hypoxia.

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    It's not a great idea, it's a dumb idea.

    By the time all the open source geniuses get it done, there will be a massive glut of real ventilators on the market. Why? Because the people already making them will have made a billion of them, the government will have bought them, and they'll be sitting idle and unused and no one will want any more.

    There might (or might not) be an actual need for ventilators for a short time. Then it will be over.

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    Rampants are rumored that there will be a moratorium on the laws and patent restrictions for making emergency medical devices to help combat the impact of this crisis. The exact nature of these plans is not yet nailed down. It is even unclear where to find more information and/or what offices/sites should be monitored for the news. I do not put much trust in the present administration to work out a good working scheme too soon. Who knows they just might get some competent people and ideas working.

    Whatever people come up with ai seriously doubt that it would work out well to create a "public" model of respirator with all the associated functions of even the simplest commercial unit in a short enough time to have an impact. I think it is far more likely that orders will go out for components for an already tried-and-true project. Where those orders will come from and where they will go is anyones guess.

    -DU-

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    Quote Originally Posted by GregSY View Post
    It's not a great idea, it's a dumb idea.

    By the time all the open source geniuses get it done, there will be a massive glut of real ventilators on the market. Why? Because the people already making them will have made a billion of them, the government will have bought them, and they'll be sitting idle and unused and no one will want any more.

    There might (or might not) be an actual need for ventilators for a short time. Then it will be over.
    They UK gov disagree with you
    They want to get aircraft car and military manufacturers to stop what they're doing and "TURN THEIR PRODUCTION LINES OVER TO MAKING THESE".
    After all these year, i never realised it was THAT simple...


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