Treating the most serious cases of COVID-19 calls for the use of ventilators. We’ve all heard this, and also that there is a shortage of these devices. But there is not one single type of ventilator, and that type of machine is not the only option when it comes to assisted breathing being used in treatment. Information is power and having better grasp on this topic will help us all better understand the situation.
We recently wrote about a Facebook group focused on open source ventilators and other technology that could assist in the COVID-19 pandemic. There was an outpouring of support, and while the community is great when it comes to building things, it’s clear we all need more information about the problems doctors are currently dealing with, and how existing equipment was designed to address them.
It’s a long and complicated topic, though, so go get what’s left of your quarantine snacks and let’s dig in.
COVID-19 can seem like a paper tiger, when looking at bare mortality rates. The far greater problem is the increase in fatalities as health systems are stretched to the limit. With thousands of patients presenting all at once, hospitals quickly run out of beds and resources and suddenly, normally survivable conditions become life threatening. One Italian hospital found themselves in such a position, running out of valves for a critical respirator device needed to save their patients. Supplies were running out – but additive manufacturing was able to save the day.
While the article uses the term “reanimation device”, it’s clear we’re talking about respirators here, necessary to keep patients alive during respiratory distress. The valve in question is a plastic part, one which likely needs to be changed over when the device is used with each individual patient to provide a sterile flow of air. After the alarm was raised by Nunzia Vallini, a local journalist, a ring around of the 3D printing community led to a machine being sent down to the hospital and the parts being reproduced. Once proven to work, things were stepped up, with another company stepping in to produce the parts in quantity with a high-quality laser fusion printer.
Unnerving reports from Italy show that when the virus hits the susceptible population groups the device that becomes the decider between life and death is a ventilator. Unfortunately they are in short supply.
The problem gets tricky when it comes to what kind of respirator is needed CPAP, BIPAP, or Hi-Flo oxygen NIV are all out. These systems aerosolize the virus making it almost guaranteed that anyone around them will get infected.
What we need is a Nasal cannula-based NIV. This system humidifies air, mixes it with oxygen and then pushes a constant stream of it into people’s lungs. If we can design a simple and working system we can give those plans to factories around the globe and get these things made. If the factories fail us, let’s also have a version people can make at home.
If you aren’t sure if a ventilator is something you can work on there are other problems. Can you make algorithms to determine if a person needs a ventilator. Can we recycle n95 masks? Can we make n95 masks at home? Workers also require a negative pressure tent for housing patients. This will be especially useful if we need to build treatment facilities in gyms or office spaces. Lastly if you’re a medical professional, can you train people how to help?
Let’s beat this thing. The ultimate medical hackathon begins.
Most of us have probably heard the old Tootsie Pop slogan, “How many licks does it take to get to the center of a Tootsie Pop?” [E-Smoker2014] had a similar question about his e-cigarettes. These devices are sometimes advertised with the number of puffs they are good for. [E-Smoker2014] had purchased an e-cigarette on a trip to Belgium that advertised 500 puffs. After a bit of use, he started to suspect that he wasn’t getting the advertised number of puffs in before the battery would die. Rather than just accept that the world may never know for sure, he decided to test it out himself.
There aren’t many details on this build, but you can tell what’s going on from the video below. [E-Smoke2014r] built a machine to artificially puff on an e-cigarette. The e-cigarette is hooked up to what appears to be vinyl tubing. This tubing then attaches to a T-splitter. One end of the splitter is hooked up to a DIY actuator valve that can open or close the port. The other end of the splitter is hooked up to more tubing, which in turn is attached to a plastic cylinder placed in a container of water.
To simulate breathing, the computer first opens the relief valve in the splitter. It then mechanically lowers the plastic container into the bowl of water, pushing out a bunch of air in the process. The valve closes, and the computer then raises the plastic container out of the water. This action creates suction that draws air in through the e-cigarette like a normal user would do with their lungs. The computer increases the puff count and then repeats the process, expelling any vapor out of the relief valve.