People Are Trying to Make DIY Ventilators To Meet Coronavirus Demand (vice.com) 98
As countries affected by the coronavirus pandemic expect to run out of ventilators and other equipment, makers are desperately trying to fill the gap with proposals for open-source, do-it-yourself devices. From a report: Most cases of COVID-19 -- the disease caused by the novel coronavirus -- do not require hospitalization. But for people hospitalized with severe infections, coronavirus damages their lungs and makes it hard to breathe in and circulate the amount of oxygen that their bodies need. Ventilators, machines that provide the lungs with oxygen, are proving to be key to treating these people, who seem to comprise around 10 percent of cases. Governments are already preparing for what a shortage of ventilators could do to their health care systems.
In a call to U.S. governors on Monday that was shared with The New York Times, President Donald Trump told states not to rely fully on the federal government for equipment. "Respirators, ventilators, all of the equipment -- try getting it yourselves," he said, according to The Times. "We will be backing you, but try getting it yourselves. Point of sales, much better, much more direct if you can get it yourself." Anthony Fauci, the director of the National Institute of Allergy and Infectious Diseases, said on CNN that the U.S. has stockpiled 12,700 ventilators, but in a worst-case scenario that number might not be enough. In Italy, he added, physicians are having to make "very tough decisions" about whom to treat.
In a call to U.S. governors on Monday that was shared with The New York Times, President Donald Trump told states not to rely fully on the federal government for equipment. "Respirators, ventilators, all of the equipment -- try getting it yourselves," he said, according to The Times. "We will be backing you, but try getting it yourselves. Point of sales, much better, much more direct if you can get it yourself." Anthony Fauci, the director of the National Institute of Allergy and Infectious Diseases, said on CNN that the U.S. has stockpiled 12,700 ventilators, but in a worst-case scenario that number might not be enough. In Italy, he added, physicians are having to make "very tough decisions" about whom to treat.
Similarity to CPAP? (Score:4, Interesting)
How similar is a ventilator to a CPAP? That would particularly apply to the pressure-modulating CPAP machines - ResMed calls it "Exhaust Pressure Relief", the machine practically breathes with you, reducing pressure when you exhale, increasing when you inhale. Take that and turn the pressure up, and does it start to sound something like a (possibly weak, but strong enough for some patients) ventilator?
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"How similar is a ventilator to a CPAP? "
Perhaps if you combine it with an O2-concentrator from Amazon or China?
Re:Similarity to CPAP? (Score:4, Informative)
They are very similar. A CPAP or BiPAP machine is not intended to run 24/7. It's more of an FDA clearance thing, a well designed CPAP will serve as a ventilator in a pinch but don't rely on it for medical care.
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Your boy failed in the worse way. No point in trying to blame everyone willing to call him out on it. The nice thing is we don't have to keep him much longer.
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Well, if these are remotely useful, I'd start with whoever makes the best one and tell them to make a crap ton more. You might ask for some design changes on some other versions to increase reliability. Of course if they can change to making ventilators, that works too, but time is something we don't have.
From the way the news is talking we are probably following Italy's path. They have over 2500 dead and we are way bigger than Italy, nor is it over for Italy.
Donald Trump really needs to resign asap. He should apologize and beg forgiveness for not taking this seriously and telling everyone else not to and then resign. That might be enough to wake some people up and save lives.
So then I suppose the leadership in almost every other major country should start updating their resume by that standard since it looks to me like the United States still has a pretty low infection rate compared to other countries. Trump made the call to close off borders to certain countries early on and the TDS crowd criticized him as being racist and xenophobic because of that call. Now the TDS crowd is complaining that he's not doing enough. Trump has obviously been taking this seriously, but at the
Re:Similarity to CPAP? (Score:4, Informative)
So then I suppose the leadership in almost every other major country should start updating their resume by that standard since it looks to me like the United States still has a pretty low infection rate compared to other countries.
Let's not forget your brilliant leader road the hoax ponies on this issue for several weeks, instead of being proactive. As I remember him stating: all fake news from China. When that sad gelding finally started flagging, he switched horses and road the "fake plot by the Democrats to bring him down" filly for several days.
It's still early days in the USA, so any leadership judgment is premature. A lot of experts, inside and outside of the USA, are calling Trump out for his delays in taking the necessary and appropriate steps. As a Canadian, it's frightening when the American press and health experts point to the Canadian government as an example of how the USA should react in any crisis. Our political leadership is hardly a shining light or beacon of hope at the best of times.
I suspect this is not getting much press in most of the States, but, several Canadian provincial governments have been begging Americans to stay on their side of the border. Why? The spread rate in the USA is currently much higher than here (so far), and too many jurisdictions in the USA are still delaying implementing even the basic necessary measures now universally in place in Canada.
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2 weeks? Toronto hospitals have closed. Their system collapsed about a week ago, they're sending most of their non-critical patients home without any treatment. Non-critical basically means - if you're not close to death already, they won't treat you - if you have cancer or needed surgery for something that's not immediately going to kill you, tough shit, you'll die in 6 months, that's non-critical rationed care for you. In response, a lot of Canadian people are overwhelming NY hospital systems.
When Cuomo c
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Well, if these are remotely useful, I'd start with whoever makes the best one and tell them to make a crap ton more. You might ask for some design changes on some other versions to increase reliability.....
My thoughts as well. All are computer controlled, so, in theory, a bit of programming tweaking might be all that's needed, and, like a printer, many of the newer ones can be updated via the Internet. Won't be a perfect solution but as a stop-gap measure, more likely to be effective than anything cobbled together in a garage.
Unfortunately, even for factories in North America, many of the required components come from all over the world - Mexico, Malaysia, China, Germany among others.
With the world-wide medic
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With the world-wide medical supply chain already struggling, hard to believe there would still be any surplus of CPAP masks and hoses. Adapting those to other more suitable devices feels like obvious solutions for shortages.
CPAPs are notorious for a high level of non-compliance. There are likely millions of used ones gathering dust in closets all over the USA. I personally know of multiple people including myself who has one but doesn't use it.
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According to my nurse wife, anyway, there's also a significant difference involving filtration. Ventilators are designed to filter out harmful pathogens from the exhausted breath. CPAP/BiPAP machines just blow it into the air, causing the virus to circulate even more.
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Filters are for incoming air, not exhaled, designed for dust and pollen. Most CPAP systems would require updated filters as the N factor for any filters is inadequate for anything as small as a virus. And few have filtration of any description for exhaled air.
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Filters are for incoming air, not exhaled, designed for dust and pollen.
Yup, exactly. I have ResMed's latest BiPAP machine, and its only filter is a dust/pollen grade filter for the input air. Same thing for my wife's CPAP (don't know the brand).
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That matters in a hospital setting. For a home setting or isolated (negative pressure) room, doesn't matter. So you can send people that aren't very critical but need assistance home with a CPAP machine until they recover.
We're talking emergency response, not ideal circumstances.
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The CIA and MI6 could have told the CDC but that would have risked in use spying methods?
Keep the methods safe for more important work than wuflu spreading..
A bit like the Tet Offensive. The NSA knew but did not want to tell the US mil, to keep their methods safe..
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We had two months of Wuhan locked down in public before we started getting a major outbreak here. The Chinese could have been more transparent... but you know what? Trump stopped the CDC from telling old people not to get on airplanes two weeks ago because he didn't want to spook the stock market, so it's not like Americans have a leg to stand on here in terms of truthful and transparent government. The NY Times had to leak the CDC's worst case scenario last week which is what triggered at least state level
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Something most advanced nations could have had ready in time if Communist China would have told the world of its wuflu problem at the start.
Governements knew, they just assumed the problem would stay in China. And when it became obvious it was spreading faster than expected, most governments still denied the possibility of it getting even worse. They all bowed to pressure from many special interest groups, including branches of their own governments, and collectively decided the risk was worth taking to avoid impacting the stock market, or trade, because losing 10 points on the Dow is not an option.
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People are listening to what I said on March 9th. Finally.
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I forgot the link.
"The US has 44% of the world's oxygen concentrators. We also have a huge number of CPAP machines. There are literally millions of dusty oxygen concentrators and CPAP machines sitting unused. This is something China dos not have. Most "oxygen concentrators" in China are the small, battery powered things that produce 30% O2, not 99% O2 like our floor models do. None of these machines are without risks. Some people do not do well on CPAP machines. Oxygen concentrators should not be used aroun
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Some people do not do well on CPAP machines.
Unfortunately this is this is case. Some people have a claustrophobic response to the masks that are used. Others object for cosmetic reasons. (And yes, if you're not in a stable relationship, you wonder how your new partner will react when slipping into a CPAP mask is at the end of your afterplay.) Lately, nasal prongs have been developed. They're not canulas: they have a soft seal (marketed as "nasal pillows") that don't work as well as masks at higher CPAP pressures.
I don't know what pressures ventilator
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How similar is a ventilator to a CPAP? That would particularly apply to the pressure-modulating CPAP machines - ResMed calls it "Exhaust Pressure Relief", the machine practically breathes with you, reducing pressure when you exhale, increasing when you inhale. Take that and turn the pressure up, and does it start to sound something like a (possibly weak, but strong enough for some patients) ventilator?
I've been wondering the same thing. CPAPs are notorious for non-compliance. I personally know multiple people who have one collecting dust including myself. The default settings are "assisted breathing" where you have to start to take a breath before it kicks in which is likely good enough for many patients but I know you can adjust the settings for both stronger breaths and presumably more forced and continuous operations as well.
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I'm all for the emergency efforts, and I honestly have no idea how bad this will get. Cautiously nervous like everybody else I guess. But trying to remain rational.
I see this as being a world problem, that if we fuck up how we respond too badly, the world may not look anywhere near the same as it used to, and by used to I mean last week.
But I wonder, if we over-react, does that leave ourselves in a position where we have a lot of extra stuff to work through? I mean I'm sure we are going to see a fair sha
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EU and UK terms like bed blockers bad.
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In other words, if we end up taking decades to work off a backlog of surplus ventilators, or heaping them up in landfills, I agree right now not to cry scandal, so long as things are done in good faith and profits are kept in check.
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100%, also, we cannot forget that the solution also lies in us, the regular people. Regardless of what state is or is not willing to do, we do have the option to voluntarily(to varying degrees) isolate or socially distance ourselves from one another. At this time, taking 2 weeks to stay at home can prevent the spread in a similar way to having a vaccine, if there are no hosts to infect, it cannot spread. I'm not sure if we know how long it is contagious yet though. My country (Canada) is saying about 2
Re: This should basically be a wartime effort (Score:2)
We will be quarantined and socially distant for at least the next 6 months, probably 12+ months, because we didn't act fast enough to isolate ourselves earlier.
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And then what? By the time you build the factories, the emergency is over.
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Comment removed (Score:4, Insightful)
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All are easily available in other countries
I call BS on this specifically. I am a citizen of part of that amorphous collections you sneer at as "other countries". BS as well as the rest of your post.
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Agreed.
The death of thousands of Americans will be on his hands due to his lackluster and incompetent response to this crisis.
For the record (Score:4, Insightful)
Just posting this for reference and because I find it relevant, now that Trump is telling states to "find your own ventilators and stuff lol".
January 22: “We have it totally under control. It’s one person coming in from China. It’s going to be just fine.”
February 2: “We pretty much shut it down coming in from China.”
February 24: “The Coronavirus is very much under control in the USA Stock Market starting to look very good to me!” (The market crashed later that day)
February 25: “CDC and my Administration are doing a GREAT job of handling Coronavirus.”
February 25: “I think that's a problem that’s going to go away They have studied it. They know very much. In fact, we’re very close to a vaccine.”
February 26: “The 15 (cases in the US) within a couple of days is going to be down to close to zero.”
February 26: “We're going very substantially down, not up.”
February 27: “One day it’s like a miracle, it will disappear.”
February 28: “We're ordering a lot of supplies. We're ordering a lot of, uh, elements that frankly we wouldn't be ordering unless it was something like this. But we're ordering a lot of different elements of medical.”
March 2: “You take a solid flu vaccine, you don't think that could have an impact, or much of an impact, on corona?”
March 2: “A lot of things are happening, a lot of very exciting things are happening and they’re happening very rapidly.”
March 4: “If we have thousands or hundreds of thousands of people that get better just by, you know, sitting around and even going to work — some of them go to work, but they get better.”
March 5: “I NEVER said people that are feeling sick should go to work.”
March 5: “The United States has, as of now, only 129 cases and 11 deaths. We are working very hard to keep these numbers as low as possible!”
March 6: “I think we’re doing a really good job in this country at keeping it down a tremendous job at keeping it down.”
March 6: “Anybody right now, and yesterday, anybody that needs a test gets a test. They’re there. And the tests are beautiful. the tests are all perfect like the letter was perfect. The transcription was perfect. Right? This was not as perfect as that but pretty good.”
March 6: “I like this stuff. I really get it. People are surprised that I understand it Every one of these doctors said, ‘How do you know so much about this?’ Maybe I have a natural ability. Maybe I should have done that instead of running for president.”
March 6: “I don't need to have the numbers double because of one ship that wasn't our fault.”
March 8: “We have a perfectly coordinated and fine tuned plan at the White House for our attack on CoronaVirus.”
March 9: “This blindsided the world.”
March 10: "I've been briefed on every contingency you could possibly imagine. Many contingencies. A lot of positive. Different numbers, all different numbers, very large numbers, and some small numbers too."
March 13: "I don't take responsibility at all."
March 16: “I’d rate it a 10,” Trump said at a White House press briefing Monday when asked by a reporter how he would rate his response to the pandemic.
March 17: "The country is very strong - -it has never been so strong."
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Now nations lost weeks to get ready and have to DIY medical parts...
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The WHO had its top experts on stigmatization out to tell the world about what words to use. Now nations lost weeks to get ready and have to DIY medical parts...
Have you lost your mind? The US and every other country on the planet is completely independent from the WHO when it comes to pandemic response. So even if what you are saying is true how does it impact the US response? The US has accepted basically nothing from the WHO - including test kits. So quit your fingerpointing and your excessive drug use because you're definitely not living in reality.
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I like this notion that the WHO is some agency that's supposed to save us or something.
The WHO is an advisor to what's happening. If National leaders don't want to listen, the WHO can't make them do squat. The failures here are the leaders of these countries that are having people die from this. The failure here are the leaders of these countries that are running short on supplies. The failure here are the leaders of these countries that allowed panic crowds to flood grocery stores, airports, and elsewh
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The WHO is an advisor to what's happening.
Yes, and here, they've been hammering about soft-racism and stigmatization and arguing names instead of advising countries on measures and responses.
Time to get these nutjobs who push racism and sexism and gender crap into everything out of these organisation.
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Justin Trudea is a poster boy progressive. He handled things worse than Trump. You progressives *do not* have a better grasp on things.
That's nice, but we're not talking about Justin Trudeau; we're talking about Trump. Please focus, and do try to keep up.
CPAP is probably enough for most cases (Score:5, Informative)
You really don't need to reinvent the wheel here. A CPAP is effectively a "ventilator" that doesn't require an invasive entry to your windpipe (ie, they cut a hole in your neck and attach it there). If you're brain dead, you'll need a ventilator. If you can still breath on your own but have some difficulty, a CPAP could potentially work instead. We won't use them in the US as a ventilator substitute because the FDA prevents healthcare providers from being inventive on-demand, but I'm a bit surprised we haven't seen other countries jumping at that opportunity.
Staff and beds, not vents (Score:5, Insightful)
I'm posting this because I think it's important but by all means use the skills that you have to help. If you're an engineer, see if you can solve the supply problems of ventilators, it can't hurt.
But I hope we're solving the right problems. I have a friend who is an ECMO nurse, right now providing life-support to people in respiratory collapse due to COVID-19. I asked her if lack of ventilators are the problem, she tells me that down the line she see two bigger problems, lack of beds and lack of staff:
"Covid already on my service and increasing daily. We are all so creeped out by this. Most of us clinicians assume we have been exposed, since....supplies are being rationed, and nobody gets a mask unless their patient had a fever, despite 70% of infected people being asymptomatic.... Other countries are gowning and gloving and masking (if not monkey suiting) their entire hospital staff."
So the lack of protective equipment is going to lead to the critical staff getting sick and there won't be the clinical capacity to provide the care.
I'm just hearing this now, I don't know the right answer: offer our protective gear to hospitals? I have 10 N95 masks in my garage I don't really need.
In any case, if you can support a nurse or a doctor somehow, please do, they are the frontline. You might not believe that this is going to be the all-out disaster many are predicting, but these people are overwhelmed already and will get sick.
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Not my words, those of a nurse who is caring for patients with COVID-19 today. She may be wrong about that - although she is an experienced professional in the field and I'm guessing that you are not - but the fact is that she doesn't have adequate protection and she's scared. I don't blame her.
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She is pretty much right though, and many of them may already have gotten infected. In Europe protection is mandatory when dealing with suspected cases. Of course, it is not the "entire staff", but it is anybody possibly coming into contact with the infected and it is decidedly not only suspected cases running a fever. Added measures are no visitors to hospitals and you do not go to the ER when you suspect, you call. At the moment it looks like protecting the medical staff may actually work out here.
Re:Staff and beds, not vents (Score:4, Interesting)
Sucks to be in a for profit healthcare system with no coordinated response.
When will Americans rise up against the corporate stranglehold on government?
Maybe COVID will be USAs awakening?
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I'm just hearing this now, I don't know the right answer: offer our protective gear to hospitals? I have 10 N95 masks in my garage I don't really need.
In any case, if you can support a nurse or a doctor somehow, please do, they are the frontline.
Just a quick google shows that they're looking in to using out of date n95 masks: https://www.cdc.gov/coronaviru... [cdc.gov] So yes, check what you have (like brand, date) then look at the web page of your local hospital to see if there's any information concerning donating equipment before you contact them.
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Indeed. You cannot just hook a person up to some air pump and think that is it. There is a lot more to it and most of that comes from the clinical staff in the trenches. These DIY devices would probably do much more harm than good. Remember, the people proposing these designs are _makers_. Most of them are not even engineers and basically none are biomedical engineers. My take is that these are people that a) have no clue about the complexities involved in ventilating somebody for more than a few minutes bu
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Is there a way to 3d print these things? (Score:3)
Anyone know of such an effort?
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We don't need to 3d print filters, just like we don't need to 3d print the actual fan motors or electronics or anything else. If it needs a filter, include a spot for the filter to be held. A quick google search shows some ventilators use flat cotton filters that are washable and held in a flat plastic frame, easy for manufacturing with a 3d printer.
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Forget it. There is a lot of complexity here not accessible to non-experts. Also, the machine itself is only a small part of the problem of caring for a ventilated patient.
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Yes, there is [google.com].
Italian 3D Printing Startup Creates Replacement Respirator Valves for COVID-19 Patients [extremetech.com]
Coronavirus: 3D printers save hospital with valves [bbc.com]
Italian Hospital 3D Prints Medical Valves for COVID-19 Patients [plasticstoday.com]
No idea about published data files.
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It's a valve - one part of an entire system.
Not a ventilator.
No problem (Score:2)
I can just sit and huff the O2 from my welding rig.
Understand a ventilator before you build one (Score:1)
Here is an over-simplified version of how to program and use a ventilator: https://www.youtube.com/watch?... [youtube.com]
If you followed that, some of the parts you need to assemble before trying to build a DIY ventilator include:
* oxygen supply
* pressure sensor
* flow sensor
* digital pulse oximeter
Then you can tie it all together.
Good luck.
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Also keep in mind that it is pretty easy to blow yourself up or set yourself on fire when tinkering with pure Oxygen. That stuff is dangerous.
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Oh you rebel! I bet you push the full flush button every time.
That's really sticking it to the man.
You're my rugged individualist super-hero!
Hospitals will not touch this stuff (Score:2)
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Indeed. And a lot of that is not just red tape, but needed. Ventilating somebody is a tricky thing and lots of things can go wrong.
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Not that simple. People will die if these things were used. Possibly more than if not.
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Furthermore, when I've been hospitalized, I've had to bring my CPAP with me, and it undergoes some sort of testing before they'll let me use it there. (There aren't any "loaners" available.)
I'd love to be able to sell/donate my old machines, but the gov't won't let me. Oh well they paid 75% of its cost.
What really pisses me off is that the gov't won't let me buy medical oxygen except on Rx, even if I'm willing to do it out-of-pocket. There are some downsides to gov't medicine, but having lived under both s
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I think that's sort of the point of this. If your country has a sharp rise in cases, then there won't be any hospitals available for you to go to. You may get a triage in the car park and be told to go home and take paracetamol.
What we know of Covid is that you can have respiratory failure, which will obviously kill you if not handled. In a choice between lying in bed at home facing imminent respiratory failure and telling your family you love them and are sorry you have to leave them, or using a DIY ventil
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Everything you need to know is right here! (Score:2)
N1000, here we come:
http://www.sorgonet.com/xtreme/gas-mask/
These types of vents are almost useless for covid- (Score:4, Informative)
Every paper and release in medical journals to date on the use of noninvasive ventilation for the present Covid-19 outbreak shows it is useless for all but a thin sliver of patients, and has a high potential to kill people rather than save their life.
Every one of the papers. Not a single one in favor of emergency therapy with nonincasive vents compared to high flow O2.
In addition, the lack of expiration filtering typical of them has been a realized infection threat for medical personal- it infected lots of Chinese medical personnel.
The bottom line: high flow oxygen (cannulas more than masks), and intubation with aspiration and full mechanical ventilation is the only therapy that improves outcomes for easily 90% of patients, despite an overall continued use of 30% to 40% in the field of noninvasive ventilation.
This is what the data says. Nonincasive vents dont aspirate fluids from the lungs, and can cause damage, and present infection risks greater than intubatiom and generally greater than benefits at all for ARDS (acute respiratory distress syndrome) patients.
These DIY units are laudable but largely useless even in a worst case scenario, as much as it would be nice to be otherwise.
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I think it's close to a fact that if you're intubated you're done. It's just a matter of a short time.
Re: These types of vents are almost useless for co (Score:2)
The survival rates after intubation range widely by demographics between 10% and 60%, averaging closer to 50%.
That's a lot better at both ends than without.
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Not that I doubt you, however I'd love to know where you're getting your numbers. The feeds that I have don't show that.
What I can tell you is in Italy the people dying if I'm not mistaken 100% of them already had something else wrong with them.
I hear if you're in Iran, in jail - bend over and kiss your butt goodbye. They're not helping them.
I found a site that had WHO situation data and it used to have percentages. That seems to be gone shortly after I pointed out that this is no worse than what happened i
Iron lungs (Score:1)
A thought.
Negative pressure ventilators (i.e. old style iron lungs) are simpler and might possibly be easier to produce as a stopgap solution.