3 ms·

I would imagine an epidemic of ventilator associated lung injury if people started rolling out homemade ventilators in quantity.

oxymoran 7y ago
I mean, it would only be used as a last resort. So lung injury or death seems like a pretty easy choice.
jtms 7y ago
if my choices were risk of lung injury or probable death, i think id likely pick risk of lung injury
yourapostasy 7y ago
Please don't take this as a personal address to your specific comment. Yours was simply the last drop of water that tipped the scales in me to comment on an overall trend I'm seeing. What I'm beginning to see in a lot of these types of discussions is those calling for caution/compliance are missing the term "in extremis". I've seen no one is suggesting that these DIY/hacking efforts of all stripes replace the existing healthcare infrastructure. What I see is concern the existing infrastructure is not scaled to handle what we anticipate will happen even in a moderate scenario. We have in this very thread a real MD who confirms that post-ICU ventilation is not being addressed but still needs to be, yet that confirmation seems to fly by those who say that DIY isn't advisable. My position on the mitigation however, starts from these two premises: In Extremis, any action is better than no action at all. In Extremis, don't let perfect be the enemy of good. When asked, I believe many will opt for a 1% chance of living on a DIY ventilator intubated by recently-out-of-license nurses emergency-authorized during the pandemic when no other intubation staff are available in the time required to attempt saving a life, than a 100% chance of dying with no ventilation option whatsoever. What I'm not seeing are any alternative solutions offered by those who want to stick to the "official" script. Let's in about 6-8 weeks from now our healthcare infrastructure is overwhelmed by severe respiratory distress cases, starting in the June timeframe. What do you suggest we do to prepare for that starting now instead of any of the DIY efforts you deem too risky/non-compliant? I'm honestly asking in response your specific post, now. Even an answer like "triage non-comorbid over comorbid patients, let the comorbid patients die" is acceptable. Even if your response is, "I'm no domain expert, I'm leaving it all up to the experts", that works for me, too. I'm just trying to figure out what your mitigation angle is. What doesn't help improve our probabilities nor mesh with my personal philosophy is giving criticisms with either no alternatives or no position statement of what you believe is an acceptable protocol going forward. It's in my nature to seek answers and address my curiosity, even if it only leads to a partial answer. If that's not you, then you live your best life, and thanks for the note of caution, it is definitely a concern to manage as best as we can.
- 01100011 7y ago
  Yeah but there is a non-zero portion of the population that may choose to use a home-brew solution instead of seeking proper medical care. Sure, we want to give people tools to be self-sufficient, but we don't want billybob hooking grandma up to the vacuum cleaner to save money.
  - MockObject 7y ago
    > What doesn't help improve our probabilities nor mesh with my personal philosophy is giving criticisms with either no alternatives or no position statement of what you believe is an acceptable protocol going forward.
- projektfu 7y ago
  I think it’s better than the hubristic and idiotic mentality of hackers thinking they can hack the medical field. This ventilator design sucks. It was designed without input from a pulmonologist friend. People are talking about it like it’s a reasonable response to the problem. This madness is worse here than anything.

oxymoran 7y ago

I mean, it would only be used as a last resort. So lung injury or death seems like a pretty easy choice.

jtms 7y ago

if my choices were risk of lung injury or probable death, i think id likely pick risk of lung injury

yourapostasy 7y ago

Please don't take this as a personal address to your specific comment. Yours was simply the last drop of water that tipped the scales in me to comment on an overall trend I'm seeing. What I'm beginning to see in a lot of these types of discussions is those calling for caution/compliance are missing the term "in extremis". I've seen no one is suggesting that these DIY/hacking efforts of all stripes replace the existing healthcare infrastructure. What I see is concern the existing infrastructure is not scaled to handle what we anticipate will happen even in a moderate scenario. We have in this very thread a real MD who confirms that post-ICU ventilation is not being addressed but still needs to be, yet that confirmation seems to fly by those who say that DIY isn't advisable. My position on the mitigation however, starts from these two premises: In Extremis, any action is better than no action at all. In Extremis, don't let perfect be the enemy of good. When asked, I believe many will opt for a 1% chance of living on a DIY ventilator intubated by recently-out-of-license nurses emergency-authorized during the pandemic when no other intubation staff are available in the time required to attempt saving a life, than a 100% chance of dying with no ventilation option whatsoever. What I'm not seeing are any alternative solutions offered by those who want to stick to the "official" script. Let's in about 6-8 weeks from now our healthcare infrastructure is overwhelmed by severe respiratory distress cases, starting in the June timeframe. What do you suggest we do to prepare for that starting now instead of any of the DIY efforts you deem too risky/non-compliant? I'm honestly asking in response your specific post, now. Even an answer like "triage non-comorbid over comorbid patients, let the comorbid patients die" is acceptable. Even if your response is, "I'm no domain expert, I'm leaving it all up to the experts", that works for me, too. I'm just trying to figure out what your mitigation angle is. What doesn't help improve our probabilities nor mesh with my personal philosophy is giving criticisms with either no alternatives or no position statement of what you believe is an acceptable protocol going forward. It's in my nature to seek answers and address my curiosity, even if it only leads to a partial answer. If that's not you, then you live your best life, and thanks for the note of caution, it is definitely a concern to manage as best as we can.

01100011 7y ago
Yeah but there is a non-zero portion of the population that may choose to use a home-brew solution instead of seeking proper medical care. Sure, we want to give people tools to be self-sufficient, but we don't want billybob hooking grandma up to the vacuum cleaner to save money.
- MockObject 7y ago
  > What doesn't help improve our probabilities nor mesh with my personal philosophy is giving criticisms with either no alternatives or no position statement of what you believe is an acceptable protocol going forward.
projektfu 7y ago
I think it’s better than the hubristic and idiotic mentality of hackers thinking they can hack the medical field. This ventilator design sucks. It was designed without input from a pulmonologist friend. People are talking about it like it’s a reasonable response to the problem. This madness is worse here than anything.