12 ms·

Low-Cost Arduino-Based Ventilator

211 points by guiambros 7y ago

guiambros 7y ago
Source: http://procrastineering.blogspot.com/2020/03/low-cost-ventilators.html http://procrastineering.blogspot.com/2020/03/low-cost-ventil...
PaulHoule 7y ago
All these things bug me because it is very easy to hurt your lungs with a ventilator.
- tw04 7y ago
  Death is also an easy way to hurt your lungs. I hope nobody is dumb enough to use something like this in place of visiting a hospital, but if hospitals are overrun this is better than nothing.
  - gravelc 7y ago
    Have to agree with this. Normally it would not be a good decision to use this or even advertise how to make it. These are however not normal times; more like we are at war and using combat medicine if the health system gets over run. This device needs improving and there is a fair degree of risk that it could be harmful, but a more advanced version made from easy to source parts could save many lives.
  - dv_dt 7y ago
    There has to be some middle ground risk between rolling in random but well intentioned pieces of equipment vs rejecting them because they haven't followed a conventional months long vetting and review. I wonder what kind of expert rapid requirements review and qualification process could be created? The comparable risk if the system is overwhelmed is life losses in triage or outright using using medical personnel as human ventilators - causing fatigue and mistakes too.
  - ploika 7y ago
    No, this is just something. This something is not necessarily better than nothing. It could be an awful lot worse than nothing, especially since it's coming from GitHub and not somewhere like the Red Cross or MSF, with experience of medical care in tough environments , that knows the difference between "actually better than nothing" and "just something".
    - gentleman11 7y ago
      Can anybody comment? How could it be worse than nothing, and is there a way to evaluate these designs? Imagine somebody had parents with lung issues and the hospitals were turning away old people with such conditions in 1-2 months
      - serf 7y ago
        >Can anybody comment? How could it be worse than nothing by giving those under-qualified to accurately diagnose a condition medical equipment that requires expertise to use, you increase the chances of incorrect use and non-indicated use.
    - unethical_ban 7y ago
      This is like someone saying "never put your cryptography project on Github, it's dangerous!" This person isn't necessarily saying "Go build this if you have trouble breathing", it's a proof of concept.
- hovden 7y ago
  Lock down a list of concerns, max / min pressures, limits of pressure change rates, etc. Generalize the device so it can be dialed in. If a ventilator can be powered by a brushed motor blower, this is quite doable and scaleable. There are unique opportunities to get maker grade devices enhanced and tested for production when lives are being lost. Certainly worth the effort while we sit on the sidelines.
  - JshWright 7y ago
    Cool, now how are you going to manage the countless other aspects of critical care? By the time you need a vent, you need a ton of other things as well.
    - fencepost 7y ago
      100% this. I'd been curious why I wasn't seeing discussion of negative pressure ventilators, also known as iron lungs, but more recent commentary that I've seen notes that the positive pressure is needed in part to force oxygen into the blood. Apparently with Coronavirus sick lungs are wet lungs and wet lungs don't work as well. That would imply that you also are going to need a supply of oxygen at a higher concentration than in the air which would imply either an oxygen generator or reliable tank based supply system. Other discussions I saw excluded concerns about significantly increased volume of aerosolized infectious droplets from improperly used ventilators.
      - souprock 7y ago
        For wet lungs, the person should be upside down to allow drainage, as if doing a head stand. Of course this is not easy or comfortable, but it helps.
zackbloom 7y ago
If you're interested we are working on various mechanical ventilator designs which don't require actuators or electronics. There are actually devices like that in the market, you can learn more in our collaboration docs: https://docs.google.com/document/d/1R25O2mKT3TfSjXTmheGEevIk6rTJ49o-sGCJU3QqP3M/edit?ts=5e700663#heading=h.zd4mdan4zmci https://docs.google.com/document/d/1R25O2mKT3TfSjXTmheGEevIk... Edit: Another design we're considering based on an Army prototype: https://docs.google.com/document/d/1Hcuu-55q2a3_-LmBwg0uBdgMe-ZNPQ9jSdtrimCYazs/edit# https://docs.google.com/document/d/1Hcuu-55q2a3_-LmBwg0uBdgM... If you would like to help please join us at the #project-pneumatic-ventilator room of the Helpful Engineering Slack: https://helpfulengineering.slack.com/join/shared_invite/zt-ct8p2gmd-2lmIbt6ee3uk1XXG4ywDWQ https://helpfulengineering.slack.com/join/shared_invite/zt-c...
- gentleman11 7y ago
  As a member of that group, I honestly wonder what use our work will be due to regulations. Most hospitals cannot use uncertified equipment or software. I think however that there might be a large policy shift where these projects may become acceptable for use after some new or temporary legislation in 1-2 months. At that time, the projects may be extremely valuable
  - Caspy7 7y ago
    If things get bad enough they might use the state of emergency to relax that regulation.
  - addHocker 7y ago
    If its this, or triage, a bloody thump up should be sufficient. If the regulators dont like it, let them come down and out to review procedure.
  - koheripbal 7y ago
    ...also, if China and Italy are any example, you might be taking care of mom/dad at home because the hospitals cannot accept any more patients. ...and at home, the FDA isn't there to tell you not to use your home-made respirator.
rootedbox 7y ago
BEWARE: Even medical grade ventilator / CPAP is dangerous.
- MuffinFlavored 7y ago
  Can you expand why please? What can go wrong?
- battery_cowboy 7y ago
  Understatement of the year, it's probably more dangerous to use these at home than just using simple oxygen and someone to help you remember to breathe for a few days. If you're to the point that you need a ventilator for covid-19, you're also going to need a ton of meds and attention from trained medical staff. I could see a CPAP machine being useful for lighter cases just to help out, but even then I'm not a doctor. Some things are good to DIY, but not this, we need HN to stop allowing these dangerous posts.
  - squidfish 7y ago
    Yeah, I have news for you ... I'm slapping my CPAP on any family member in a medical crisis where their O2 is bottoming out (I have o2 monitor too .. cheap from amazon) that potentially may be coming. If they are unable to breathe and we can't get them medical help/ventilated, it is no brainer. Here is my experience: CPAP (actual APAP) for a several years now. Godsend for me. Don't even nap without it. In addition to the sleep apnea and impact it had on my life and long term health, there has been one other remarkable benefit. I have had no lung issues (bronchitis, asthma, pneumonia or even just wheezing), since not long after started using. For decades prior (I'm 50 now), I had yearly bouts with bronchitis due to my mild asthma combined with allergy seasons, etc. I also had couple which progressed to pneumonia. I have had NONE of that since starting and we are on the 4th year now. The APAP helps expand lungs and breath deeply, in addition to the intended benefit of keeping my airway from collapsing / sleep apnea. CPAPS aren't dangerous. I've already thought about scenario where I'd use it on loved one over past couple weeks (prior to reading this article). Damn believe I will if have to. Alternative is potentially death. Yes, ventilator (to me implying being intubated) is of course totally different.
Mvandenbergh 7y ago
What we really need is a simple ventilator, designed by manufacturers who already know how to design and build these and produced at enormous scale using a shadow factory system similar to that developed in world war 2. In this model, the original manufacturer steps in to guide production, carry out quality control and probably supply the control electronics and software. All physical objects on which our civilisation depends are mass produced.
- shiftpgdn 7y ago
  Devil's advocate: Why would a manufacturer consider damaging what is a potential mega cash cow? I read earlier that ventilators generally sell for $40-70,000USD to hospitals (who then go on to charge $20-40k for ventilator based treatment.) We're much better off right now with the government seizing the means of production and figuring out how to make as many as possible.
  - deleted 7y ago
    [deleted]
  - lightgreen 7y ago
    Because that manufacturer is not a monopoly, if they won’t produces, other will. Also, government is much less effective at producing things than private companies.
    - reillyse 7y ago
      Is there actual evidence for this? That governments aren't as effective at producing things. This gets bandied about a lot but I'm not sure it's true. I think governments can be highly effective at producing things.
      - DenisM 7y ago
        The evidence was presented 50 years ago under the label of Soviet Union. USSR couldn’t produce shit.
taf2 7y ago
I really like this as DIY - I also found this video https://www.youtube.com/watch?v=okg7uq_HrhQ https://www.youtube.com/watch?v=okg7uq_HrhQ - explaining how the virus eventually kills by causing failure of the lungs. After explaining the functional parts he goes on to explain what seem like some interesting things to consider when designing a ventilator with respect to how they were used during the SARS outbreak. e.g. tidal forces causing iteration and more inflammation, which then cuts off more air flow. So thinking about how you maintain a constant air pressure instead of more pushing force... at least the explanation made sense intuitively but I'm not a doctor and don't know if this video or your Ventilator are safe - but I do like the DIY aspect of it and figure thinking about or sharing ideas can't be bad...
squidfish 7y ago
Actually, Resmed and Philips can probably reflash firmware on almost all there basic CPAP machines manufactured within past few years, thereby making them into BiPAP type devices. BiPAPs are sort of "in between" a CPAP and a ventilator. This would actually be a good public service if they would do for free and provide to hospitals, etc. for emergency use.
- gentleman11 7y ago
  I hear a lot of CPAP owners hack their devices for privacy reasons. I wonder if just any technical user could do this today? What would be required?
  - squidfish 7y ago
    Google. There are handful of sleep apnea forums with instructions on how to enter into the "clinician mode" of most machines. From there, you can adjust modes, pressure levels, etc. Said forums also have wealth of information on WHAT to change. There is also software called "sleepyhead" that is free and downloadable if you really want to geek out and understand the data saved by the machine. I "hack" (not really, just doing stuff / adjustments that clinics supposed to do) my machine for no other reason than they clinicians are useless once they sell you a sleep study and machine. You are typically on your own once you get it unfortunately, which is why the success rate of people using CPAP machines is usually pretty low. It can be a frustrating process without help and even if you do have good clinician, it is still frustrating to get used to it (some moreso than others).
- jdoss 7y ago
  I was just thinking the same thing. My 5yo son has a wimpy immune system and asthma. We have spent some scary times in the ER/PICU when he gets a bad lung based cold. I am thinking about how I can convert one of my old CPAPs into a ventilator if I can't get him into a hospital to get the care he will need due to the healthcare system being overwhelmed. It should be obvious, but I will say it to be clear. This would be a last resort kind of thing on my end. The last thing I want to do is "wing it" with any kind of medical care on my kids.
HumblyTossed 7y ago
Scary. Wouldn't/isn't it easy to hurt your lungs with something like this?
pkaye 7y ago
Trump says the states are all on their own if they want to get ventilators. Looks like we better stock up on the Arduinos. https://www.sfgate.com/news/article/Trump-to-Governors-on-Ventilators-Try-Getting-15135205.php https://www.sfgate.com/news/article/Trump-to-Governors-on-Ve...
- zdragnar 7y ago
  You are misquoting your own source: "We will be backing you, but try getting it yourselves. Point of sales, much better, much more direct if you can get it yourself." The post-meeting press also asked him if that meant the feds wouldn't help, and he explicitly said no, that many states already have their own contracts and connections to various suppliers, and if they used those they would be better off buying direct rather than the federal government acting as a middle man for the same outcome.
hyperion2010 7y ago
This probably should have gone on the thread about flattening the curve not being enough. But. Where is the core team of 12 people plus 108 collaborators that should have been assembled a month and a half ago to figure out how to retune US manufacturing to start producing stripped down ICU beds and the supplies needed to keep them operational? This game is easy. The parameters are well understood. You could assign the basic problem to a middle schooler. Getting realistic numbers? Well it doesn't matter, no matter what those number are, every single fully functional ICU bed that can be brought online in the next 2 weeks is probably going to save 2 lives. According to some of the other economic analysis that has been posted here today suggesting that we let people die, that is 18 million dollars in human lives. How many fully stocked ICU beds can you make for 18 million dollars? There's your startup idea for the next 2 weeks. Not ignoring the fact that you need a team to staff it and work it, but guess what, you ALSO have two weeks to train as many people as you can to run these things. WHERE IS THIS TEAM?
- deleted 7y ago
  [deleted]
- 3fe9a03ccd14ca5 7y ago
  > Where is the core team of 12 people plus 108 collaborators that should have been assembled a month and a half ago You don’t understand where things were at a month ago. I had a fight with my wife at Costco because she thought I was wasting money and overreacting when I purchased the 50 lb bag of rice (among other items). She understands now. We all do. But a month ago people were in absolute denial about the inevitable and it was impossible then to convince them otherwise.
- tylerl 7y ago
  > WHERE IS THIS TEAM? Now they're all sheltering in place in their homes. It's amazing how big a difference you can make in the world if you can just get started... a month ago.
  - jvanderbot 7y ago
    Exactly. Still, with prioritization, this team can be assembled, isolated, and funded without limit, even now during shutdowns. But there's too many such leverage points to ... leverage. So, we use the same response Europe had to the Plague.
abakker 7y ago
Can anyone explain why normal ventilators don't just use flow meters on compressed air with a solenoid? A standard pilot valve pneumatic solenoid can switch much faster than this. with regulated air pressure, and an air filter on the air, it seems possible to make it work pretty easily just using compressed air.
- linuxftw 7y ago
  Compressed air contains lots of moister. You don't want this. It can also contain oil or other contaminants.
  - chipsa 7y ago
    What about a scuba supply? That's breathing safe.
- kortex 7y ago
  It's a lot more complicated to modulate the pressure. You need to titrate the pressure to each patient/setup, and often inhale vs exhale. Motor with ESC? Easy. Solenoid valve has only on/off, so you have to manually tune a pressure valve for each level. Also the pilot kind like those in sprinkler systems don't work well with low pressure air.
Metallurgist 7y ago
US Patent 3,419,029 Breathing Valve Assembly HH Straub Dec 31 1968 This appears to be simpler solution that can be AM'd quickly Also, medical staff prefer not to use face masks because if the mask does not fit well on to the patients face there is a potential to aspirate body fluids and aerolise the virus.
jes 7y ago
Possibly of interest, w/r/t improving availability of ventilators in a medical crisis: https://www.youtube.com/watch?v=uClq978oohY https://www.youtube.com/watch?v=uClq978oohY
threwr32424 7y ago
For those of us outside the US/EU, can someone explain about the change in tone here on HN ? There was a similar post a few weeks back and top-voted comments were uniformly scornful about such DIY medical equipment, and about how a ventilator was just one component in the ICU ecosystem. Now, though, there is a complete 180 ? What gives ? There is also the question of supply-side issues - uCs and IC boards are overwhelmingly manufactured in East-SE Asia. These projects can't get around these issues, right ? If only there were someway to hack the abundant numbers of smartphones in order to do something useful.
- pbourke 7y ago
  > For those of us outside the US/EU, can someone explain about the change in tone here on HN ? HN is being HN, for better or worse. First skepticism, then shallow takes, then acknowledgement and analysis, now frenzied problem solving. > a ventilator was just one component in the ICU ecosystem. Yes, the ventilator is a CPAP machine on steriods. The Respiratory Therapist, Intensivist and Critical Care Nursing staff are what actually keeps someone alive. It's not uncommon for one or more of these to have multiple touches per hour for evaluation and adjustment of the parameters, management of other life support, etc. We need to buy a shit-ton of ventilators and PPE from existing manufacturers and provide relief for the front-line staff who will be using them.
  - carlmr 7y ago
    >It's not uncommon for one or more of these to have multiple touches per hour for evaluation and adjustment of the parameters Maybe a stupid question, but why can't this be automated?
    - salawat 7y ago
      Everyone is different, and one size does not fit all; thereby causing complications which require a trained eye to appreciate (read: carry in your head the list of people/procedures to execute in case of problems, and list of things to ignore) in order to accomodate that. It's called the "practice of medicine" for a reason. You can do everything "right" by the book and still have things go wrong. There is no substitute for eyes on the patient. Ever.
sub7 7y ago
Cool but almost all covid patients who get to a stage where they need ventilation need invasive, mechanical ventilation. NIV does not allow the lungs to clear fluid and mucus. It also allows the virus to spread via aerosol and infect anyone without full PPE in the vicinity.
- koheripbal 7y ago
  How can it be modified to provide lung drainage?
  - sub7 7y ago
    You can make a Philips cough assist type device which uses abrupt pressure changes to expel fluid. Need to be super careful with these you can do real damage if not used correctly. Those are also nowhere near as effective as the real deal i.e. intubation where you stick a tube down the lungs that sucks out fluid and pushes in air.
- salawat 7y ago
  At the risk of sounding like a rube... Why don't we have people upside down when stuff like lung fluid drainage is a concern? I do it at home when I've got bronchial issues going on and while not pretty, gravity does a great job at assisting fluid expulsion as long as you can keep the swelling to a reasonable level. Yes, you look silly, and your head can get a bit stuffy; but in the long run I've found it an invaluable practice when I've already tapped out everything else I have to throw at the problem for myself At home. Inversion tables aren't exactly difficult to manufucture either; even if you do need to make sure you have someone else around for safety sake.
antimatter15 7y ago
This appears to be by Johnny Chung Lee, who did all the experiments with head tracking, and finger tracking with the Nintendo Wii controller many years ago (http://johnnylee.net/projects/wii/ http://johnnylee.net/projects/wii/).
forkexec 7y ago
Untested equals unsafe. Amateurism doesn't help anyone except the virtue-signaler.
- MockObject 7y ago
  This is only being considered as a device of last resort, if and after the medical system has collapsed and there are no alternatives.
anfractuosity 7y ago
Would 'approved' ventilators use multiple MCUs/FPGAs/.. and a 'voting' system so that if there are issues with one, others take over?
eigenvalue 7y ago
I think most people reading this who want to protect themselves at home should instead focus on getting an oxygen concentrator and not a ventilator. These devices enrich the oxygen level in air and connect to a person through a cannula or face mask. They are pretty easy to use and safe, and can be purchased from eBay or Ali for around $300 to $400 shipped. Only problem is that shipping from China is slow now so it will likely take 2-3 weeks to arrive. But this is what most people would get at a hospital unless they are gravely ill and require intubation.
beenBoutIT 7y ago
The CPAP part of this project is by far the most expensive component required and it's the part lots of people already own and don't use or have a use for. Anybody with an unused CPAP can buy an Arduino for next to nothing and put this together, you really need to put 'CPAP' somewhere in the title.

211 points by guiambros 7y ago

Source: http://procrastineering.blogspot.com/2020/03/low-cost-ventilators.html http://procrastineering.blogspot.com/2020/03/low-cost-ventil...

PaulHoule 7y ago

All these things bug me because it is very easy to hurt your lungs with a ventilator.

tw04 7y ago
Death is also an easy way to hurt your lungs. I hope nobody is dumb enough to use something like this in place of visiting a hospital, but if hospitals are overrun this is better than nothing.
- gravelc 7y ago
  Have to agree with this. Normally it would not be a good decision to use this or even advertise how to make it. These are however not normal times; more like we are at war and using combat medicine if the health system gets over run. This device needs improving and there is a fair degree of risk that it could be harmful, but a more advanced version made from easy to source parts could save many lives.
- dv_dt 7y ago
  There has to be some middle ground risk between rolling in random but well intentioned pieces of equipment vs rejecting them because they haven't followed a conventional months long vetting and review. I wonder what kind of expert rapid requirements review and qualification process could be created? The comparable risk if the system is overwhelmed is life losses in triage or outright using using medical personnel as human ventilators - causing fatigue and mistakes too.
- ploika 7y ago
  No, this is just something. This something is not necessarily better than nothing. It could be an awful lot worse than nothing, especially since it's coming from GitHub and not somewhere like the Red Cross or MSF, with experience of medical care in tough environments , that knows the difference between "actually better than nothing" and "just something".
  - gentleman11 7y ago
    Can anybody comment? How could it be worse than nothing, and is there a way to evaluate these designs? Imagine somebody had parents with lung issues and the hospitals were turning away old people with such conditions in 1-2 months
    - serf 7y ago
      >Can anybody comment? How could it be worse than nothing by giving those under-qualified to accurately diagnose a condition medical equipment that requires expertise to use, you increase the chances of incorrect use and non-indicated use.
  - unethical_ban 7y ago
    This is like someone saying "never put your cryptography project on Github, it's dangerous!" This person isn't necessarily saying "Go build this if you have trouble breathing", it's a proof of concept.
hovden 7y ago
Lock down a list of concerns, max / min pressures, limits of pressure change rates, etc. Generalize the device so it can be dialed in. If a ventilator can be powered by a brushed motor blower, this is quite doable and scaleable. There are unique opportunities to get maker grade devices enhanced and tested for production when lives are being lost. Certainly worth the effort while we sit on the sidelines.
- JshWright 7y ago
  Cool, now how are you going to manage the countless other aspects of critical care? By the time you need a vent, you need a ton of other things as well.
  - fencepost 7y ago
    100% this. I'd been curious why I wasn't seeing discussion of negative pressure ventilators, also known as iron lungs, but more recent commentary that I've seen notes that the positive pressure is needed in part to force oxygen into the blood. Apparently with Coronavirus sick lungs are wet lungs and wet lungs don't work as well. That would imply that you also are going to need a supply of oxygen at a higher concentration than in the air which would imply either an oxygen generator or reliable tank based supply system. Other discussions I saw excluded concerns about significantly increased volume of aerosolized infectious droplets from improperly used ventilators.
    - souprock 7y ago
      For wet lungs, the person should be upside down to allow drainage, as if doing a head stand. Of course this is not easy or comfortable, but it helps.

zackbloom 7y ago

If you're interested we are working on various mechanical ventilator designs which don't require actuators or electronics. There are actually devices like that in the market, you can learn more in our collaboration docs: https://docs.google.com/document/d/1R25O2mKT3TfSjXTmheGEevIk6rTJ49o-sGCJU3QqP3M/edit?ts=5e700663#heading=h.zd4mdan4zmci https://docs.google.com/document/d/1R25O2mKT3TfSjXTmheGEevIk... Edit: Another design we're considering based on an Army prototype: https://docs.google.com/document/d/1Hcuu-55q2a3_-LmBwg0uBdgMe-ZNPQ9jSdtrimCYazs/edit# https://docs.google.com/document/d/1Hcuu-55q2a3_-LmBwg0uBdgM... If you would like to help please join us at the #project-pneumatic-ventilator room of the Helpful Engineering Slack: https://helpfulengineering.slack.com/join/shared_invite/zt-ct8p2gmd-2lmIbt6ee3uk1XXG4ywDWQ https://helpfulengineering.slack.com/join/shared_invite/zt-c...

gentleman11 7y ago
As a member of that group, I honestly wonder what use our work will be due to regulations. Most hospitals cannot use uncertified equipment or software. I think however that there might be a large policy shift where these projects may become acceptable for use after some new or temporary legislation in 1-2 months. At that time, the projects may be extremely valuable
- Caspy7 7y ago
  If things get bad enough they might use the state of emergency to relax that regulation.
- addHocker 7y ago
  If its this, or triage, a bloody thump up should be sufficient. If the regulators dont like it, let them come down and out to review procedure.
- koheripbal 7y ago
  ...also, if China and Italy are any example, you might be taking care of mom/dad at home because the hospitals cannot accept any more patients. ...and at home, the FDA isn't there to tell you not to use your home-made respirator.

rootedbox 7y ago

BEWARE: Even medical grade ventilator / CPAP is dangerous.

MuffinFlavored 7y ago
Can you expand why please? What can go wrong?
battery_cowboy 7y ago
Understatement of the year, it's probably more dangerous to use these at home than just using simple oxygen and someone to help you remember to breathe for a few days. If you're to the point that you need a ventilator for covid-19, you're also going to need a ton of meds and attention from trained medical staff. I could see a CPAP machine being useful for lighter cases just to help out, but even then I'm not a doctor. Some things are good to DIY, but not this, we need HN to stop allowing these dangerous posts.
- squidfish 7y ago
  Yeah, I have news for you ... I'm slapping my CPAP on any family member in a medical crisis where their O2 is bottoming out (I have o2 monitor too .. cheap from amazon) that potentially may be coming. If they are unable to breathe and we can't get them medical help/ventilated, it is no brainer. Here is my experience: CPAP (actual APAP) for a several years now. Godsend for me. Don't even nap without it. In addition to the sleep apnea and impact it had on my life and long term health, there has been one other remarkable benefit. I have had no lung issues (bronchitis, asthma, pneumonia or even just wheezing), since not long after started using. For decades prior (I'm 50 now), I had yearly bouts with bronchitis due to my mild asthma combined with allergy seasons, etc. I also had couple which progressed to pneumonia. I have had NONE of that since starting and we are on the 4th year now. The APAP helps expand lungs and breath deeply, in addition to the intended benefit of keeping my airway from collapsing / sleep apnea. CPAPS aren't dangerous. I've already thought about scenario where I'd use it on loved one over past couple weeks (prior to reading this article). Damn believe I will if have to. Alternative is potentially death. Yes, ventilator (to me implying being intubated) is of course totally different.

Mvandenbergh 7y ago

What we really need is a simple ventilator, designed by manufacturers who already know how to design and build these and produced at enormous scale using a shadow factory system similar to that developed in world war 2. In this model, the original manufacturer steps in to guide production, carry out quality control and probably supply the control electronics and software. All physical objects on which our civilisation depends are mass produced.

shiftpgdn 7y ago
Devil's advocate: Why would a manufacturer consider damaging what is a potential mega cash cow? I read earlier that ventilators generally sell for $40-70,000USD to hospitals (who then go on to charge $20-40k for ventilator based treatment.) We're much better off right now with the government seizing the means of production and figuring out how to make as many as possible.
- deleted 7y ago
  [deleted]
- lightgreen 7y ago
  Because that manufacturer is not a monopoly, if they won’t produces, other will. Also, government is much less effective at producing things than private companies.
  - reillyse 7y ago
    Is there actual evidence for this? That governments aren't as effective at producing things. This gets bandied about a lot but I'm not sure it's true. I think governments can be highly effective at producing things.
    - DenisM 7y ago
      The evidence was presented 50 years ago under the label of Soviet Union. USSR couldn’t produce shit.

taf2 7y ago

I really like this as DIY - I also found this video https://www.youtube.com/watch?v=okg7uq_HrhQ https://www.youtube.com/watch?v=okg7uq_HrhQ - explaining how the virus eventually kills by causing failure of the lungs. After explaining the functional parts he goes on to explain what seem like some interesting things to consider when designing a ventilator with respect to how they were used during the SARS outbreak. e.g. tidal forces causing iteration and more inflammation, which then cuts off more air flow. So thinking about how you maintain a constant air pressure instead of more pushing force... at least the explanation made sense intuitively but I'm not a doctor and don't know if this video or your Ventilator are safe - but I do like the DIY aspect of it and figure thinking about or sharing ideas can't be bad...

squidfish 7y ago

Actually, Resmed and Philips can probably reflash firmware on almost all there basic CPAP machines manufactured within past few years, thereby making them into BiPAP type devices. BiPAPs are sort of "in between" a CPAP and a ventilator. This would actually be a good public service if they would do for free and provide to hospitals, etc. for emergency use.

gentleman11 7y ago
I hear a lot of CPAP owners hack their devices for privacy reasons. I wonder if just any technical user could do this today? What would be required?
- squidfish 7y ago
  Google. There are handful of sleep apnea forums with instructions on how to enter into the "clinician mode" of most machines. From there, you can adjust modes, pressure levels, etc. Said forums also have wealth of information on WHAT to change. There is also software called "sleepyhead" that is free and downloadable if you really want to geek out and understand the data saved by the machine. I "hack" (not really, just doing stuff / adjustments that clinics supposed to do) my machine for no other reason than they clinicians are useless once they sell you a sleep study and machine. You are typically on your own once you get it unfortunately, which is why the success rate of people using CPAP machines is usually pretty low. It can be a frustrating process without help and even if you do have good clinician, it is still frustrating to get used to it (some moreso than others).
jdoss 7y ago
I was just thinking the same thing. My 5yo son has a wimpy immune system and asthma. We have spent some scary times in the ER/PICU when he gets a bad lung based cold. I am thinking about how I can convert one of my old CPAPs into a ventilator if I can't get him into a hospital to get the care he will need due to the healthcare system being overwhelmed. It should be obvious, but I will say it to be clear. This would be a last resort kind of thing on my end. The last thing I want to do is "wing it" with any kind of medical care on my kids.

HumblyTossed 7y ago

Scary. Wouldn't/isn't it easy to hurt your lungs with something like this?

pkaye 7y ago

Trump says the states are all on their own if they want to get ventilators. Looks like we better stock up on the Arduinos. https://www.sfgate.com/news/article/Trump-to-Governors-on-Ventilators-Try-Getting-15135205.php https://www.sfgate.com/news/article/Trump-to-Governors-on-Ve...

zdragnar 7y ago
You are misquoting your own source: "We will be backing you, but try getting it yourselves. Point of sales, much better, much more direct if you can get it yourself." The post-meeting press also asked him if that meant the feds wouldn't help, and he explicitly said no, that many states already have their own contracts and connections to various suppliers, and if they used those they would be better off buying direct rather than the federal government acting as a middle man for the same outcome.

hyperion2010 7y ago

This probably should have gone on the thread about flattening the curve not being enough. But. Where is the core team of 12 people plus 108 collaborators that should have been assembled a month and a half ago to figure out how to retune US manufacturing to start producing stripped down ICU beds and the supplies needed to keep them operational? This game is easy. The parameters are well understood. You could assign the basic problem to a middle schooler. Getting realistic numbers? Well it doesn't matter, no matter what those number are, every single fully functional ICU bed that can be brought online in the next 2 weeks is probably going to save 2 lives. According to some of the other economic analysis that has been posted here today suggesting that we let people die, that is 18 million dollars in human lives. How many fully stocked ICU beds can you make for 18 million dollars? There's your startup idea for the next 2 weeks. Not ignoring the fact that you need a team to staff it and work it, but guess what, you ALSO have two weeks to train as many people as you can to run these things. WHERE IS THIS TEAM?

deleted 7y ago
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3fe9a03ccd14ca5 7y ago
> Where is the core team of 12 people plus 108 collaborators that should have been assembled a month and a half ago You don’t understand where things were at a month ago. I had a fight with my wife at Costco because she thought I was wasting money and overreacting when I purchased the 50 lb bag of rice (among other items). She understands now. We all do. But a month ago people were in absolute denial about the inevitable and it was impossible then to convince them otherwise.
tylerl 7y ago
> WHERE IS THIS TEAM? Now they're all sheltering in place in their homes. It's amazing how big a difference you can make in the world if you can just get started... a month ago.
- jvanderbot 7y ago
  Exactly. Still, with prioritization, this team can be assembled, isolated, and funded without limit, even now during shutdowns. But there's too many such leverage points to ... leverage. So, we use the same response Europe had to the Plague.

abakker 7y ago

Can anyone explain why normal ventilators don't just use flow meters on compressed air with a solenoid? A standard pilot valve pneumatic solenoid can switch much faster than this. with regulated air pressure, and an air filter on the air, it seems possible to make it work pretty easily just using compressed air.

linuxftw 7y ago
Compressed air contains lots of moister. You don't want this. It can also contain oil or other contaminants.
- chipsa 7y ago
  What about a scuba supply? That's breathing safe.
kortex 7y ago
It's a lot more complicated to modulate the pressure. You need to titrate the pressure to each patient/setup, and often inhale vs exhale. Motor with ESC? Easy. Solenoid valve has only on/off, so you have to manually tune a pressure valve for each level. Also the pilot kind like those in sprinkler systems don't work well with low pressure air.

Metallurgist 7y ago

US Patent 3,419,029 Breathing Valve Assembly HH Straub Dec 31 1968 This appears to be simpler solution that can be AM'd quickly Also, medical staff prefer not to use face masks because if the mask does not fit well on to the patients face there is a potential to aspirate body fluids and aerolise the virus.

jes 7y ago

Possibly of interest, w/r/t improving availability of ventilators in a medical crisis: https://www.youtube.com/watch?v=uClq978oohY https://www.youtube.com/watch?v=uClq978oohY

threwr32424 7y ago

For those of us outside the US/EU, can someone explain about the change in tone here on HN ? There was a similar post a few weeks back and top-voted comments were uniformly scornful about such DIY medical equipment, and about how a ventilator was just one component in the ICU ecosystem. Now, though, there is a complete 180 ? What gives ? There is also the question of supply-side issues - uCs and IC boards are overwhelmingly manufactured in East-SE Asia. These projects can't get around these issues, right ? If only there were someway to hack the abundant numbers of smartphones in order to do something useful.

pbourke 7y ago
> For those of us outside the US/EU, can someone explain about the change in tone here on HN ? HN is being HN, for better or worse. First skepticism, then shallow takes, then acknowledgement and analysis, now frenzied problem solving. > a ventilator was just one component in the ICU ecosystem. Yes, the ventilator is a CPAP machine on steriods. The Respiratory Therapist, Intensivist and Critical Care Nursing staff are what actually keeps someone alive. It's not uncommon for one or more of these to have multiple touches per hour for evaluation and adjustment of the parameters, management of other life support, etc. We need to buy a shit-ton of ventilators and PPE from existing manufacturers and provide relief for the front-line staff who will be using them.
- carlmr 7y ago
  >It's not uncommon for one or more of these to have multiple touches per hour for evaluation and adjustment of the parameters Maybe a stupid question, but why can't this be automated?
  - salawat 7y ago
    Everyone is different, and one size does not fit all; thereby causing complications which require a trained eye to appreciate (read: carry in your head the list of people/procedures to execute in case of problems, and list of things to ignore) in order to accomodate that. It's called the "practice of medicine" for a reason. You can do everything "right" by the book and still have things go wrong. There is no substitute for eyes on the patient. Ever.

sub7 7y ago

Cool but almost all covid patients who get to a stage where they need ventilation need invasive, mechanical ventilation. NIV does not allow the lungs to clear fluid and mucus. It also allows the virus to spread via aerosol and infect anyone without full PPE in the vicinity.

koheripbal 7y ago
How can it be modified to provide lung drainage?
- sub7 7y ago
  You can make a Philips cough assist type device which uses abrupt pressure changes to expel fluid. Need to be super careful with these you can do real damage if not used correctly. Those are also nowhere near as effective as the real deal i.e. intubation where you stick a tube down the lungs that sucks out fluid and pushes in air.
salawat 7y ago
At the risk of sounding like a rube... Why don't we have people upside down when stuff like lung fluid drainage is a concern? I do it at home when I've got bronchial issues going on and while not pretty, gravity does a great job at assisting fluid expulsion as long as you can keep the swelling to a reasonable level. Yes, you look silly, and your head can get a bit stuffy; but in the long run I've found it an invaluable practice when I've already tapped out everything else I have to throw at the problem for myself At home. Inversion tables aren't exactly difficult to manufucture either; even if you do need to make sure you have someone else around for safety sake.

antimatter15 7y ago

This appears to be by Johnny Chung Lee, who did all the experiments with head tracking, and finger tracking with the Nintendo Wii controller many years ago (http://johnnylee.net/projects/wii/ http://johnnylee.net/projects/wii/).

forkexec 7y ago

Untested equals unsafe. Amateurism doesn't help anyone except the virtue-signaler.

MockObject 7y ago
This is only being considered as a device of last resort, if and after the medical system has collapsed and there are no alternatives.

anfractuosity 7y ago

Would 'approved' ventilators use multiple MCUs/FPGAs/.. and a 'voting' system so that if there are issues with one, others take over?

eigenvalue 7y ago

I think most people reading this who want to protect themselves at home should instead focus on getting an oxygen concentrator and not a ventilator. These devices enrich the oxygen level in air and connect to a person through a cannula or face mask. They are pretty easy to use and safe, and can be purchased from eBay or Ali for around $300 to $400 shipped. Only problem is that shipping from China is slow now so it will likely take 2-3 weeks to arrive. But this is what most people would get at a hospital unless they are gravely ill and require intubation.

beenBoutIT 7y ago

The CPAP part of this project is by far the most expensive component required and it's the part lots of people already own and don't use or have a use for. Anybody with an unused CPAP can buy an Arduino for next to nothing and put this together, you really need to put 'CPAP' somewhere in the title.