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Tesla Ventilator
- panpanna 7y agoNot sure what to think of this. Any people working with real medical ventilators care to comment on this?
- heurifk 7y agoNot a doctor, but I did a crash course in ventilators recently and it has the main features - inspiration/expiration pressure, volume, rate, oxygen %. UK gov also put out a document with the MVP for a ventilator, and the Tesla one looks like it will cover most of the therapeutic features. The one thing I would worry about is software bugs in such a rushed project.
- toomuchtodo 7y agoTesla (and SpaceX) has experience with life critical code (running vehicle powertrains independent of the rest of the vehicle subsystems; please save Autopilot critiques for another thread). A fully validated ventilator is ideal, but if your other option is death, a ventilator that is "less than fully validated" might be preferable. EDIT: You're right to acknowledge there might be bugs, it's important to quantify risk. You decision based on the risk(s) raised.
- op03 7y agoFree PR nothing else (and nothing wrong with that). Those engineers didn't call up the marketing/pr dept and ask for a professional video crew to show up - "cause we just want to share an update with the world".
- Robotbeat 7y agoIt’s more than that. Tesla engineers themselves probably are itching to help. Check out GE’s workers getting mad that the company wasn’t helping to make ventilators. People join companies like Tesla and SpaceX because they want to be challenged, have a bias for action (of course, everything still needs to be qualified), and make the world a better place. In a global pandemic that can be helped by addressing a shortage of manufactured stuff, engineers aren’t going to want to just sit on their hands if there’s a chance their efforts could be helpful. It’s not just corporate PR. It’s not just Elon Musk. It’s also these workers wanting to help the world.
- op03 7y agoThat's pretty much what Trump and his team say too. It's all PR to me, until they are standing next to their product, in use, saving lives.
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- xiphias2 7y agoThat would be an unwise decision. Doctors can be replaced with other doctors, but if an engineer working on the ventilator gets sick, and possibly infects the whole team, they are hard to replace, as other engineers don't have the experience and expertise that they got in the last couple of weeks (and maybe years).
- zebrafish 7y agoI'll be interested to see how well they can scale this up. Production functions are always dependent on the most scare component. Hopefully Tesla can leverage their already existing supplier base to easily source everything needed for this design.
- gullyfur 7y agoI'm interested in this too. In the video, they said they're attempting to make this using as many car parts as possible, to prevent themselves from taking supply away from other ventilator manufacturers. That's a noble goal, as well as it helps them leverage their existing supply chain.
- heleninboodler 7y agoI'm curious what the mixing chamber is used for in an electric vehicle. Is it part of the climate control system?
- zodo123 7y agoIt said “Continental” as the manufacturer on it. If I had to guess, I would say it was the reservoir for their adjustable height air suspension.
- heleninboodler 7y agoAh yes, that makes a lot of sense. It looks quite beefy for climate control.
- yoda_sl 7y agoExtremely curious the outcome... I hope they can get some folks in the medical field to provide quickly some feedback.
- toomuchtodo 7y agoTesla is working with Medtronic (per Medtronic's CEO on CNBC Mar 25th) to rapidly iterate on their designs.
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- vernie 7y agoIs this like the kid-size submarine or does it have a chance of being mass-produced?
- dkdbejwi383 7y agoDefinitely a PR stunt like the "submarine". See this comment: https://news.ycombinator.com/item?id=22794211 https://news.ycombinator.com/item?id=22794211
- sschueller 7y agoFor more background info on what is needed for a ventilator and why it isn't that simple: https://news.ycombinator.com/item?id=22779665 https://news.ycombinator.com/item?id=22779665
- Retric 7y agoThe Tesla prototype seems much closer to a medical ventilator than most of the overly simplified models shown in that video. Working Medtronic is likely a large advantage here. Adjusting air temperature and humidity seems like the biggest missing piece.
- baybal2 7y agoIndeed, all what I saw in last few weeks on other side of the Pacific were not advancing past what Chines factories without any prior health device engineering experience were able to come with in the first month. To add to that, most of those factories don't even have real engineers with 6 years long education. I think this is the best proof to the immense potency of Ctrl-C & Ctrl-V approach to doing things. America is loosing a lot by shying away from it.
- mschuster91 7y agoThat video's author says he worked for Medtronic. Well... coincidental or not: Medtronic bought up Covidien, who have been alleged to intentionally sabotage a contract with the US government for a national ventilator stockpile back in 2012: https://www.nytimes.com/2020/03/29/business/coronavirus-us-ventilator-shortage.html https://www.nytimes.com/2020/03/29/business/coronavirus-us-v...
- m4tthumphrey 7y agoI just love the environment in the video! It looks like they're all in college experimenting! Loving the rowdy shirts and leather jackets!
- vorpalhex 7y agoThis looks promising. They're being smart to use their own supply chain as much as possible, but obviously things will get interesting when it comes to getting clearance to deploy the device. Even if the design can't be used in it's entirety, they may be able to fill part of the supply chain for other manufacturers. One complaint - everyone keeps touching their damned masks. Keep your booger picker away from your face.
- ha4fsd3fas 7y agoIt's because their masks keep dropping when speaking. It's surprisingly hard to fit the mask in a way that you do not feel the urge to adjust it every now and then.
- gruez 7y agoAre there certification requirements for newly designed ventilators? If so, how long would that take?
- dannyw 7y agoI’m sure Trump’s FDA would grant an exemption.
- Balgair 7y agoYears, decades? It really depends on a lot. But on average, 12 years. FDA can work fast, and likely will here. But even for something 'simple' it can take a while. Medical devices are really complicated and take a lot of testing. It's not like NASA or something where you're only blowing up John Glenn. We're dealing with a million dead babies/grandmothers/new brides/etc, potentially. https://www.drugs.com/fda-approval-process.html https://www.drugs.com/fda-approval-process.html
- penagwin 7y agoThis might be one of those scenerios similar to what's currently happening with PPE - where we just have to use uncertified equipment because we have nothing that is certified left. Like many others have pointed out, if the option is this uncertified machine or certain death - which would you choose? Actual proper testing and certification would likely take years - and we need them within the next few weeks.
- viklove 7y agoWho pays the liability when the ventilator backs up and blows the patient's lung apart?
- ProAm 7y agoHopefully they get these right instead of ordering C-PAP machines [1] [1] https://www.forbes.com/sites/billroberson/2020/04/04/health-officials-say-ventilators-donated-by-tesla-are-wrong-type-and-not-powerful-enough/#1554fae56264 https://www.forbes.com/sites/billroberson/2020/04/04/health-...
- michelb 7y agoSome hospitals converted those C-PAP machines into ventilators using these modifications: https://engineering.berkeley.edu/news/2020/04/turning-sleep-apnea-machines-into-ventilators/ https://engineering.berkeley.edu/news/2020/04/turning-sleep-...
- post_break 7y agoI see this everywhere. I also saw where they literally listed what machines they needed, and Tesla brought the exact machines they wanted, including B-PAP and C-PAP machines.
- ProAm 7y ago[1] https://www.inputmag.com/tech/where-are-elon-musks-promised-ventilators https://www.inputmag.com/tech/where-are-elon-musks-promised-...
- Beltiras 7y agoI just took possession of a Model 3 about 2 weeks ago. Feel like I underpaid for it when seeing how some of the residuals are being used now.
- pdq 7y agoYes, this is an impressive amount of work done in a few weeks by a small team at Tesla. However, medical devices, especially for life support systems, are not a Hackathon project. These devices breathe air into patients lungs. They need to be manufactured in clean room conditions, with medical grade parts, not plumbing parts from a big box store. They must be designed and tested to ISO specifications. If this fails, the patient can die. I can't imagine any hospital or doctor careless enough to connect one of these to a patient, even in this current emergency. The smarter idea is to ramp up existing proven designs, not reinvent the wheel and basically do a publicity stunt about your engineering talent.
- rubidium 7y agoI agree. But one comment worth considering: does it take longer to retool an assembly line to make a new verified part, or to come up with a new design based on existing verified parts? My money is on the former and they'd be better retooling some of the line _if_ there was an off-the-shelf set of designs to work from. That said, there's room for all sorts of approaches. I just don't see this one reasonably panning out or being used.
- kiba 7y agoThe whole point of this project is not to use up supplies needed to build ventilator but to compliment the ventilators they are already building by using Tesla parts. This is fundamentally a logistics project. Plus, they have access to Medtronic engineers, and as long as the FDA approve the devices, I have no problem with it.
- Cthulhu_ 7y agoBut how long will an FDA approval take? Are they likely to take shortcuts because it's an emergency? I mean personally I wouldn't object to them lowering requirements temporarily because we're in a crisis situation, but I hope they won't give permanent approval for all of the hacked ventilators that a lot of companies seem to be producing right now - once the pressure is off, stop using the temporary ones until they've been pulled through the FDA wringer thoroughly.
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- LittleNemoInS 7y agoThis is not Tesla, but Seat has already done it : https://www.seat.com/company/news/company/from-making-cars-to-ventilators.html https://www.seat.com/company/news/company/from-making-cars-t... Less techie, more down to earth, they used wipe motors.
- jsight 7y agoThat's actually really impressive. I didn't realize any of these efforts were that far along. It will be interesting to see how long certification takes.
- JorgeGT 7y agoIt was certified 3 days ago and today they have started deliveries to hospitals: https://www.abc.es/motor/reportajes/abci-correos-comienza-repartir-hospitales-respiradores-seat-202004061322_noticia.html https://www.abc.es/motor/reportajes/abci-correos-comienza-re...
- ericzawo 7y agoThank you for sharing, super cool stuff.
- bonestamp2 7y agoThat's great. I hope wiper motors can take that kind of continuous actuation -- it's not really what they're designed for. I'm sure they'll stress test the hell out of it.
- gpm 7y agoDriving for hours in heavy rain results in pretty continuous actuation of wiper motors. I'm far from a mechanic but I can't say I've ever heard of a wiper motor failing either. I'm sure they have real data on it instead of this handwaving, but as an outsider I would be surprised if it was an issue.
- Frondo 7y ago
- nsxwolf 7y agoAre ventilators even helping? I see numbers like a 30% survival rate in some places, but they don't mention if that means "aren't dead yet" or recovered and removed from the ventilator. I definitely read about people who have successfully been removed and are recovering, but that's all anecdotal.
- Spare_account 7y agoThe information we need is: 1. Percentage of patients who needed ventilation, got ventilation in good time, and recovered vs died. 2. Percentage of patients who needed ventilation, didn't get ventilation due to lack of resources, recovered vs died. Then we'll know how much ventilators are helping. I understand that prior to this pandemic, typical survival rates for patients who required invasive ventilation was in the region of 30%. 70% die even with ventilation. I've also heard that of Covid-19 patients that require ventilation, 80% die even with ventilation. So it has a slightly lower survival rate than other illnesses.
- adrianN 7y agoIf you need ventilation and don't get it the mortality is really close to 100%.
- xkjkls 7y agoThe 30% survival rate means that 30% of patients are saved by ventilators. People who aren't dying without a ventilator aren't put on a ventilator, which is an extremely invasive medical procedure.
- detaro 7y agopreviously: https://news.ycombinator.com/item?id=22789605 https://news.ycombinator.com/item?id=22789605
- Hamuko 7y agoCan Elon Musk remotely deactivate my air supply?
- DanBC 7y agoThis is good, and I'm glad they're doing it. They've clearly got involvement with existing ventilator manufacturers. Are they talking to doctors in ITUs? Here's a recent Facebook thread from people involved in London's new hospital: https://www.facebook.com/permalink.php?id=103930280957826&story_fbid=217689892915197 https://www.facebook.com/permalink.php?id=103930280957826&st... It shows that ventilation of covid-19 patients is not like ventilation of other patients. I'll paste part of it here because I know some can't visit Facebook. It's by Daniel Martin OBE, Macintosh Professor of Anaesthesia, Intensive Care Lead for High Consequence Infectious Diseases. ---everything below this point is a direct quote from Daniel Martin--- Ventilation - Early high PEEP is probably not the right strategy and may be harmful. This is not ARDS in the early phase of the illness. - Avoid spontaneous ventilation early in ICU admission as also may be harmful. - There is clear microvascular thrombosis happening in the pulmonary circulation, which leads to an increased dead space. - Also some evidence of early pulmonary fibrosis reported from Italy, possibly oxygen related, possibly inflammation related. - Not many patients have reached extubation yet in London, re-intubation seems to be common. I highlighted our experiences of airway swelling / stridor / reintubation. - Brompton are seeing wedge infarcts in the lungs on imaging, along with pulmonary thrombosis without DVT. - Proning is essential and should be done early. Don’t just do it once. Threshold for many centres is a PF ratio of 13, but all agreed, do it even earlier. - Early on in the disease, the benefit of proning lasts < 4 hours when turned back to supine, as the disease progresses into a more ARDS type picture, the effect is more long lasting. - Many centres using inhaled nitric oxide and prostacyclin with good effect. Tachyphylaxis with NO after 4-5 days. - Generally people are using humidified circuits with HMEs. - A very interesting thing they are doing at Georges is cohorting by phase of disease i.e. early, late, extubation / trachy. It involves more moving of patients but helps each team to focus on things more easily. - Leak test before extubation is crucial, others are also seeing airway swelling. - Wait longer than usual before extubating, high reintubation rates reported. Do not extubatne if inflam markers still high. My conclusions from this are: - Less aggressive PEEP strategy at the beginning of the disease and go straight for proning. - Thromboembolic disease is prevalent, look for it. No one is sure about whether we should anti-coagulate everyone, this is probably too risky. - An extubation protocol is needed immediately. - We should consider using inhaled prostacyclin again (like we previously did) as it seems to be working early in the disease.
- nabla9 7y agoTesla didn't do this from scratch as people here seem to assume. Tesla partnered with Medtronic https://www.medtronic.com/us-en/index.html https://www.medtronic.com/us-en/index.html It seems that they also work as parts supplier for Medtronic.
- DubiousPusher 7y agoThe main criticism I see here is that without prolonged testing it's very possible for a piece of equipment like this to do harm to a person. On the other side I see people saying that for those that can't get a ventilator and are going to die anyway, why not use it. I'm curious if that category of patients exists though. With Covid are doctors able to make that call at any point? I've heard lot of Hail Mary treatments criticized because unlike in the movies there are many ailments where there's not really a clear point where someone's not coming back. Anyone know if it's a common scenario with this where a doctor knows someone is def going to die but there is still time left to do meaningful treatment?
- gok 7y agoThe FDA would take years to approve a new ventilator that was an old one with a new paint color. A new design like this would probably be approved for use in US hospitals around 2025 if they're lucky. Might be useful sooner in a country with a more functional administrative state.
- xkjkls 7y agoThere are many reasons for long testing on medical supplies. While there might be some laxing of them for a "hail mary pass" in the situation we are currently in, we shouldn't claim that equipment shouldn't have validation.
- salvagedcircuit 7y agoThis is pretty excellent. It is one of the first ventilator solutions that actually implements appropriate air sensors, a PEEP function and air flow monitoring. Hats off to the tesla engineers for throwing this together so quickly. It's pretty neat that so many car parts could be reused. I can imagine they are finalizing the software interface and optimizing the machining process to reduce the cut time on the custom manifold production. Again, awesome job guys!