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A call for teamwork.
This another long read, but please share with anyone you know working on potential solutions for #covid19 pandemic crisis #Covid19ventilators.
If this isn't your circle, carry on, and have a nice day! 1/17
This another long read, but please share with anyone you know working on potential solutions for #covid19 pandemic crisis #Covid19ventilators.
If this isn't your circle, carry on, and have a nice day! 1/17
In the last week I've been having a look at designs for pandemic ventilators able to save patients with ARDS.
Even excellent teams in universities, such Oxford, MIT and Uni of Florida, aren't making adequately specified ventilators. Sorry folk. But there is a solution. 2/17
Even excellent teams in universities, such Oxford, MIT and Uni of Florida, aren't making adequately specified ventilators. Sorry folk. But there is a solution. 2/17
This biggest single challenge I have concluded, having spent about a week scouring the internet, is cross-team teamwork.
This is leading to smallish teams making inadequately specified machines. 3/17
This is leading to smallish teams making inadequately specified machines. 3/17
Many teams are working on solutions that would have been considered adequate in the 1990s. Sorry. Not good enough. We need a 2005 level ventilator. This means it needs to be smart and responsive to the patient.
Don't believe me? https://dx.doi.org/10.1513%2FAnnalsATS.201512-841OC 4/17
Don't believe me? https://dx.doi.org/10.1513%2FAnnalsATS.201512-841OC 4/17
Even though it is tempting to argue "but we did have ARDS survivors in the 1990s", this misses the context of the current pandemic. The problem is, it is not just ventilators that some centres will be desperately short of, it will be staff. 5/17
A substandard ventilator that merely keeps someone alive for two weeks until they die is going to consume more precious resources than these centres will have. 6/17
So, these centres need fully functional ventilators so patients get in and out of ICU as quickly as possible.
This means light sedation, and allowing the patient to breath so their respiratory muscles do not waste away to the point of never breathing for themselves again. 7/17
This means light sedation, and allowing the patient to breath so their respiratory muscles do not waste away to the point of never breathing for themselves again. 7/17
Connecting someone to a bag squeezer and using paralysing drugs so they don't fight against it will, too often, be a prolonged and one-way journey.
So ventilators need to assist patients' breathing, not completely take over. 8/17
So ventilators need to assist patients' breathing, not completely take over. 8/17
Paradoxically the means ventilators need to be more powerful, not less.
Modern ICU ventilators can deliver pulses of pressurised gas at up to 120 litres/min. 9/17
Modern ICU ventilators can deliver pulses of pressurised gas at up to 120 litres/min. 9/17
In 2020, we are talking about under $50 dollars of components, coupled with an ordinary laptop, to make a ventilator smart enough.
So let's do that. 10/17
So let's do that. 10/17
Fully functional ICU ventilators are moderately complicated bits of equipment, but they break down into very simple components. I've done that here: 11/17 https://docs.google.com/drawings/d/1zwdmMs51Ko0eA8pqKSBo57S2Gl6XpH20xNFU3kfC9e4/edit?usp=sharing
As part of surveying the requirements, and to provide:
* an index to related resources,
* examples,
* alternatives, and
* links to promising designs,
I have started discussing each component here (very much baby steps):
https://docs.google.com/document/d/1SBT8auegsJCKCVMBHFLWaVo8rKbs0zsJc3dDVAqeADE/edit?usp=sharing 12/17
* an index to related resources,
* examples,
* alternatives, and
* links to promising designs,
I have started discussing each component here (very much baby steps):
https://docs.google.com/document/d/1SBT8auegsJCKCVMBHFLWaVo8rKbs0zsJc3dDVAqeADE/edit?usp=sharing 12/17
I've also written a reasonably detailed briefing for engineers here, which includes links to more specific resources
https://docs.google.com/document/d/1sdrKYQ0mDOu4bJum6Fx6piRutIJovo7UqFKYHHxUD5A/edit?usp=sharing
13/17
https://docs.google.com/document/d/1sdrKYQ0mDOu4bJum6Fx6piRutIJovo7UqFKYHHxUD5A/edit?usp=sharing
13/17
All around the world there are over 80 teams and projects all working on essentially the same problem. The issue is that none of them (except @tesla who are very clever and using proprietary car parts) have the resources to deliver a solution that will actually save lives. 14/17
If each team focuses on an individual component and coordinates with other teams for the balance then we've got a chance of getting a design that would actually work.
Speed is of the essence. 15/17
Speed is of the essence. 15/17
@RobertLeeRead has compiled a list of the open source projects here, which gives a sense of scale to the problem of failure to collaborate:
https://docs.google.com/spreadsheets/d/1inYw5H4RiL0AC_J9vPWzJxXCdlkMLPBRdPgEVKF8DZw/edit?usp=sharing
16/17
https://docs.google.com/spreadsheets/d/1inYw5H4RiL0AC_J9vPWzJxXCdlkMLPBRdPgEVKF8DZw/edit?usp=sharing
16/17
I'm going to spend time over the next day or two thinking about how to get all the teams out there to level up their collaboration using a component based strategy. If you know anyone on these teams, you can help me by sharing this thread with them.
Thanks and stay safe. 17/17
Thanks and stay safe. 17/17
