Risky Hack Could Double Access To Ventilators As Coronavirus Peaks 77
An anonymous reader quotes a report from Motherboard: An emergency medicine physician says she and a colleague invented a way to connect four patients to a single ventilator, a hack that could significantly increase the capacity of overburdened hospitals during the coronavirus pandemic. Doctors Greg Neyman and Charelene Irvin Babcock published a pilot study of the technique in Academic Emergency Medicine in 2006. Babock is now an emergency medicine physician at a hospital in Detroit, Michigan and posted a YouTube video on March 14 describing the technique.
The technique is remarkably simple. "Four sets of standard ventilator tubing were connected to a single ventilator via two flow splitters," the study said. "Each flow splitter was constructed of three Briggs T-Tubes which included connection adapters with the valves removed." In Babock's video, she said the adapters were 22mm in size. Basically, any kind of T-shaped tube can be adapted to extend the ventilator to more than one patient. Babock's video has gone viral, and she told Motherboard in a phone interview that she put together the four way adapter set in her YouTube video in 15 minutes using supplies her hospital already had. In an interview with Motherboard, Babcock said that actually using it on coronavirus patients is a tough call, but a potentially life-saving one in a last-resort situation. "It's only been done in test lungs," she said over the phone. "But it's probably better than nothing in dire circumstances. We don't know how bad it's gonna get. [Italy] is so overwhelmed with people that will die without ventilators and they don't have enough ventilators. Sometimes trying something almost MacGyverish is better than doing nothing."
The technique is remarkably simple. "Four sets of standard ventilator tubing were connected to a single ventilator via two flow splitters," the study said. "Each flow splitter was constructed of three Briggs T-Tubes which included connection adapters with the valves removed." In Babock's video, she said the adapters were 22mm in size. Basically, any kind of T-shaped tube can be adapted to extend the ventilator to more than one patient. Babock's video has gone viral, and she told Motherboard in a phone interview that she put together the four way adapter set in her YouTube video in 15 minutes using supplies her hospital already had. In an interview with Motherboard, Babcock said that actually using it on coronavirus patients is a tough call, but a potentially life-saving one in a last-resort situation. "It's only been done in test lungs," she said over the phone. "But it's probably better than nothing in dire circumstances. We don't know how bad it's gonna get. [Italy] is so overwhelmed with people that will die without ventilators and they don't have enough ventilators. Sometimes trying something almost MacGyverish is better than doing nothing."
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There's a few ventilitor manufacturers (Score:5, Informative)
The hospitals, for their part, don't want to spend the money on them since they'll be mothballed as soon as a vaccine's out in 6 months.
Market forces don't really work for short term spikes when the manufacturers can see that the spike will be short term. Toilet Paper is the same way. They can't really ramp up production because people aren't using more, they're hoarding it. Meaning once this mess is over they'll start to work their way through it, and won't buy any more for months and months.
TL;DR, humans are dumb.
Capitalism is dumb (Score:5, Insightful)
Then the government should just step in and guarantee orders for xyz units. They can always be mothballed and used for the next plague, or donated to developing nations.
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Re:Capitalism is dumb (Score:4, Insightful)
I've worked with the government. It can move quickly when a fire is lit under it, but it's got to take the problem seriously otherwise the money gets funneled to politically connected contractors.
Not gonna happen (Score:3)
The libertarians and right wing is worried that if there is a strong government response to the Corona Virus then people will get used to government helping them. The belief is that the pain and death we experience now is better than the risk of Big Government.
Art Laffer and a bunch of his Libertarian fri
I should add (Score:2)
The former will change their tune real fast if their Social Security checks stop coming and latter when they get laid off as the general economic malaise makes their way to them.
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The Great Depression was the main catalyst to WWI & II. We can't stay on lock down like this, our society isn't built for it.
I really don't think the 1929 depression caused the 1914 World War.
From a simple perspective, WWI was caused by the arrogance of old empires, who suddenly found themselves facing an industrialized world of global interaction. The old notion of having a war confined to border zones and perpetrated by individual soldiers really didn't apply now that global logistics and mechanized weapons were a reality.
WWII (in Europe, at least) was caused by a number of unresolved issues from WWI, primarily the issue of hum
This time it's different (Score:2)
In the collapse of the 2008 housing bubble, only the proles were affected. The little people. The donor class and their servants (politicians in office) could not care less what was going on outside their own little world. A little (or a big) recession was just a time for the oligarchs to take more resources and gain more power. Well, they'll still do that latter part anyway, but this time their own butts and economic models are also on the line.
If Trump hadn't blown off the corona virus the way Bush blew o
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People in public health have been expecting something like this to happen, and the conditions that produced the pandemic aren't going away, so yes. Stockpiling is a good idea.
Think of it this way: we as a country operate 11 naval carrier strike groups. We do this on the off chance we might someday need to have two or three carriers fighting a multi-front war, and if you start with a three front war and deduct the percentage of supercarriers that must be undergoing maintenance or training missions, you end
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I've been told that ventilators are hard to stockpile as the various seals and gaskets tend to deteriorate over time.
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I've been told that ventilators are hard to stockpile as the various seals and gaskets tend to deteriorate over time.
That is not a problem beyond the scope of human ingenuity.
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It is merely beyond the scope of patent law.
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Which patents would prevent storing a machine properly, or stockpiling spare seals and gaskets?
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True enough, but it is hard to create a stockpile during a crisis while things are in demand. You'd have to do it during more normal times.
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Possibly - but it would be cheaper and easier to whip up a new batch of seals and gaskets than a whole new ventilator.
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who've been interviewed concerned that they're not getting an increase in orders. They're not going to make them if nobody agrees to buy them. The hospitals, for their part, don't want to spend the money on them since they'll be mothballed as soon as a vaccine's out in 6 months. Market forces don't really work for short term spikes when the manufacturers can see that the spike will be short term. Toilet Paper is the same way. They can't really ramp up production because people aren't using more, they're hoarding it. Meaning once this mess is over they'll start to work their way through it, and won't buy any more for months and months. TL;DR, humans are dumb.
That's a factor, but another factor is that production doesn't ramp up because we don't allow prices to be elastic. Government and social pressure mostly (yes, not completely) prevent toilet paper prices from shooting up. Ebay bans profiteers, etc. So we can all feel good about ourselves for preventing profiteering, at the expense of empty shelves. The price is the same, but we can't buy it.
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Sigh. Production of most items can't suddenly "ramp up", and it's not because of price elasticity.
It's because product A depends on components B and C and D, and each one of those has its own set of dependencies. Those dependencies make up the supply chain for product A, and over time the supply chain tends to stabilize at normal market consumption rates. That's free market pricing and efficiencies at work.
When demand suddenly spikes I usually can't just start producing more A's because in order to do so I
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I don't think the O2 supply is the bottleneck. At the manufacturing end, it's all produced and distributed as LOX. Bottle fillers often fill both welding as well as medical bottles from the same LOX supply. In fact, I suspect that larger hospitals might just have LOX deliveries and feed their distribution network from that.
What hospitals need are the ventilators plus qualified operators (therapists, doctors) needed to set them up and monitor the patients.
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Problem with software monitoring (Score:1)
The problem I see is just what is being monitored? Besides sensors hooked up to gauges, a skilled human can monitor by sight, sound, even smell.
Replacing those senses with sensors and automating everything is not an easy task. So as you note, if it was easy the functionality would already exist.
Even if it was possible, I figure that we'd face a bottleneck in deploying additional sensors and training on how to use them, when to trust them, when not to, etc...
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Do not mess with Oxygen unless you know what you are doing! Lubricants, oil and gaskets can explode!
Re:What happened to the discussion about CPAP (Score:5, Informative)
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Well, I imagine intubation likely to be necessary regardless, and so long as you have a second tube into the lungs to release the pressure that should be fine. Big question - will a CPAP detect dangerous pressure levels in case a blockage forms?
As for enriching, that's a pretty easy hack so long as you have access to concentrated oxygen to bleed into the intake, which shouldn't be a problem. Accuracy might be a challenge, but "much better than nothing" should be a relatively easy target to hit.
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I'm not remotely surprised. Seems like the hard part would be interfacing with the human body, not mixing gasses.
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Because slashcode assigns a UID of 666 to all AC's, so who knows what would break on the back end if they changed that.
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While vents can run in CPAP mode, CPAPs cannot function as a ventilator. This would work so long as all of those patients had the same needs from the vent. Even then, you may have four patients capable of setting off those vent alarms, coughing against it, etc.
Cross contamination? (Score:3)
"You will be sharing this ventilator with Mr. Goatlung. You'll be getting to know each other well."
Comment removed (Score:5, Insightful)
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Just use facemask connected to compressed air cylinders, with an electronically controlled valve. A large cylinder will last quite a while. Turn on the valve, fill those lungs and turn off the valve and let the lungs empty and you can mass fill the compressed air tanks. You need to use the right kind of electronically controlled valve to let the air out at the right flow and feet up and head down to drain the lungs as much as possible.
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Yes, that is how the water network works too, and the reason why it's rare for one person's lack of hygiene to affect their neighbours via the water supply.
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all four patients will already be extremely contaminated by the time this is done. It's the last chance effort, the alternative will be certain death.
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"You will be sharing this ventilator with Mr. Goatlung. You'll be getting to know each other well."
And unfortunately, even if this is utterly unlikely, lawsuits protecting the rights of the patients this technique valiantly attempted to salvage from near certain demise will diminish the likelihood it is available to those of us who need it most.
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Re:Cross contamination? (Score:4, Informative)
https://emcrit.org/pulmcrit/sp... [emcrit.org]
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I expect that's the least of the challenges with this one weird trick (TM). It's not as if each patient is built identically, having identical requirements. [youtube.com] This is an act of desperation.
Yes, it is a desperate action, but if it means a couple less folks die per ventilator, then why not?
By all means, keep folks alive if you can. In this case, a bit of plumbing is all that you need to assist 3 people where you have equipment for one then I'd say use it. I'm sure the three folks who now have a better chance would approve.
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What's to keep them from having 1-way valves installed after the T-junctions? Do they make any that block sub-micron particles?
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This is not supposed to be your first choice of treatment.
Physician discovers this one weird trick (Score:5, Funny)
Ventilator makers hate her because of this simple trick!
Not sure how well this'll work (Score:2)
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Depend on the risk of getting contaminated, the advanced computer parts expecting to detect changes from 1 person while in use... and alarm to such changes... on one person.
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I was thinking along the same lines when I read this. However, I don't believe that medical grade devices are built so cheaply. I would think they would be designed and built with plenty of margin for failures. Still, you are now doubling the load on a single ventilator and, at the same time, doubling the harm done when it fails. It's a desperate measure, but I suppose it is better than not having the option.
I can imagine the liability lawsuit though when 4 people die instead of 2 and the doctor/hospital is
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Filter part of a mask (Score:3)
I have a question about masks. Does anyone know what materials can be used, for the filter part of a mask? Can any cloth be used, if it has a tight weave - for example, cut-up curtains or cloth towels? What about several layers of paper napkins, or several layers of paper towels?
An advantage of cloth is that it can be washed in hot water prior to use, in order to sanitize it.
An advantage of paper is that it's relatively cheap and plentiful, so it can be used and then discarded.
I'm wondering if doctors and nurses could remove the used filter part a mask, and replace it with a fresh, new filter that's made of common cloth or paper.
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You can use any material you want and it will still be much more useful for protecting others from you than for protecting you from others, because the virus can survive on almost every potential material.
Our health care professionals should all have forced air hoods with UV sterilization, but as societies we've all chosen to optimize for other things besides public health, some more than others.
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but as societies we've all chosen to optimize for other things besides public health, some more than others.
This is rampant in our society. Hence giant high school football stadiums instead of science labs. Make America Great Again my ass.
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Make America great for someone other than white males for the first time.
There have been other successful people here, but their success pales by comparison.
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... much more useful for protecting others from you than for protecting you from others, because the virus can survive on almost every potential material.
Why the difference in protecting others from me, vs. protecting me from others?
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It helps stop you from spraying, but if it traps droplets they will just be right on your face.
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Why the difference in protecting others from me, vs. protecting me from others?,
tl;dr: Because it won't protect you like you think it will.
Because (for the general population):
The virus enters most people via the surface->finger->face route. If you're not sick (yet) and wear a mask, you are not breaking this route. If the mask is actually in a virus aerosol environment, you're also keeping a virus-laden surface (the outside of the mask) right on your face, all the time, where an unconscious finger touch can transfer the virus from the mask to, e.g., your eyes, one of the best p
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... much more useful for protecting others from you than for protecting you from others, because the virus can survive on almost every potential material.
Why the difference in protecting others from me, vs. protecting me from others?
Because.. There are more ways for the virus to get IN than OUT..
It can get in through your eyes, nose and mouth, and it's really hard to protect your eyes.
OUT is a different story.. It comes out your nose and mouth when you cough and sneeze, so your mask can stop that (or at least slow it down).
However, masks are not very effective under any circumstances and may only reduce your chances by about 25% on the inbound side, and a bit more than that on the outbound. The problem is that masks are only good
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"CDC is not currently recommending that except for cases where secretions are spewing all over a room. Some of their recommendations do consider the nationwide scarcity of PPE in the USA."
Right, that's exactly my point. There's a nationwide scarcity of important things because we've been focused on bullshit.
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Cambridge university did a study of DIY mask materials [researchgate.net] during the 2009 swine flu epidemic. The results are that a wide variety of materials around the home are capable of providing at least some protection, some nearly as good as a surgical mask. The very best alternative they found was a vacuum cleaner bag.
Note that this study only relates to the material's filtration capabilities while dry. A mask's real world performance depends on its design and how it is used. In general surgical masks aren't a g
Animal ventilators? (Score:3, Interesting)
OMG! They alarm like crazy with just one patient. (Score:1)
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Yea, and there are differences in resistance between patients which might cause patient A to be getting too much "help" at the expense of patient B who isn't getting enough and there would be no way to tell.
But, if this was the only way to bridge over and keep more folks alive until they either got better or equipment could be found, I suppose we cannot let the perfect be the enemy of the good and just let somebody die because everything isn't perfect. If we can get it close enough, folks can live.
Add an O2 concentrator (Score:2)
They are quite cheap, you just need new nitrogen scrubber filters from time to time.