Rewriting the software on CPAP AIR RAMP to turn then into ventilators/ respirators. Saving carvers lives.

[John Gilmour]

Odd topic for a snowboard forum but our members  are quite resourceful .

I already I configured my Airsense 10 CPAP with humidifier to run on dual lithium ion batteries for 10 hours and retrofitted the filter with a N95 mask, and encased the entire machine in a HEPA  filter and then surrounded by more filter material In a back pack.  This now allows for safe air travel from Covid-19 , and as a mobile facemask /gas mask that is considerably easier to breathe than an n-95 mask alone.

The resmed airsense 10 comes out of the box with A protocol for an adjustable “air ramp “ to make it gradual to adjust to the positive pressure ... so for instance you could sleep before the pressure increases. 
 

it occurred to me if you can control ramp via software (you can using the app that doctors use) you could prescribe a “repetitive air ramp” that would mimic the pressure ramp of a ventilator . This is IDEAL in the case of a ventilator shortage SO you won’t die waiting for a ventilator to become available . Given that the vast majority of carvers are not millennials and are likely to be tail end  baby boomers and Gen X  and are at risk for pneumonia complications. This is important . If you think there are few carvers on the snow this season ... wait until next season after a ventilatior shortage . Losing even 1 of our carvers is  huge loss .... even if they are an annoying troll (I know some of those), they are still a carving brother. 

 

why would there be a shortage ? OK let’s assume that the hospital has 10 ventilators. And the average initial patient needs to use a ventilator for two weeks before they can be safely taken off of it and they are on their way to recovery this is a relatively short estimate given the severity of the disease. Considering 7488 people in South Korea were infected, and that this class of infected people were younger women who are more likely to recover faster, even a month after the outbreak only 118 or if you do the math 1 in 63 has fully recovered.

Given that that’s the best case scenario with the majority young women, it’s likely that some people need chronically to use the respirator for an extended period of time. Maybe even several months, there also be some that don’t need it as long but still have an EXTENDED temporary need for it. 
 

Errr...so after a few weeks of statistical accumulation of a variety of longer term users the turn over if available ventilators will go DECREASE  to 1-2 every 2 weeks while huge lines begin to accumulate ( with many dying because of lack of the ability to breathe well enough on their own to improve their condition) .

 

so

If anyone wants to tackle hacking the softwares of an auto set or adjustable CPAP with built in heater, humidifier, and heated air hose best choose is the resmed airsense 10  (these greatly reduce the likelihood of respiratory infections EVEN WHEN USED AS A REGULAR CPAP. In part because of the heated moist air from the humidifier ) and hacking it into a respirator/ventilator that would be a huge help towards giving people a chance to Iive when these  scarce resources run out. Estimates are between 100,000 and 160,000 available respirators NATIONWIDE! 

NOW let’s put this into STARK perspective let’s assume that 1/4 of those over 65 who got infected need them to live. In New York City’s five boroughs alone there are 1.3 to 1.4 million people over the age of 65. That means the elderly residents of Brooklyn alone could consume the entire countries stock if for respirators and still over 1/2 would die .

Since we can’t snowboard now and have time off, anyone up for my little pet project ? We snowboarders and skaters AND like an “impossible challenge “ and I enjoy thinking outside the box.  Surely using 6 degrees of separation someone could refer the right person to me. 
 

and to keep this snowboard relevant - so

many of us live at higher altitudes that the need for this is even more likely amongst us carvers.

JG 347-263-7238

 

 

 

 

 

Edited March 18, 2020 by John Gilmour

[bobble]

jg

why not approach resmed with this idea? i *believe* these types of machines employ firmware. the original source code is compiled into firmware. 

without the original source code you're basically starting from zero. it might be possible to reverse compile the firmware but then you'd have figure out how it works. on top of that you'd have to reverse engineer the electrical circuits to figure out the port mapping. 

it would be helluva lot quicker for resmed to create software/firmware for the machine since they already have the source code. plus, resmed would sell moar machines.

just an idea... maybe search linkedin for resmed electrical or software engineers? maybe ex-resmeds?

[lowrider]

But what about the drugs necessary to suppress  your systems to allow the respirator  to function ? Or do you know a guy that know a  guy ?

[SunSurfer]

Wearing my anesthesiologist hat, non-invasive ventilation very effectively aerosolises the virus. Recommendations are for intubation earlier than usual to support patients but enable sealed systems to be used to minimise aerosol spread.

The other issue is not just the number of ventilators, but the number of people with the skills to operate them.

Lots of people thinking hard about ways to get us all through this. Keep thinking John.

[st_lupo]

Great ideas!  I wonder if Fin is thinking about this as well?  Seems like there is a fairly active community trying to open-source a ventilator design with printable components.

https://www.forbes.com/sites/alexandrasternlicht/2020/03/18/theres-a-shortage-of-ventilators-for-coronavirus-patients-so-this-international-group-invented-an-open-source-alternative-thats-being-tested-next-week/#1211f03b3ba0

 

[lowrider]

Ontario Provincial gov't has  today publically asked for input from anyone with skills and ideas to source and build respirators.

[ursle]

56 minutes ago, lowrider said:

Ontario Provincial gov't has  today publically asked for input from anyone with skills and ideas to source and build respirators.

I don't think the medical world needs gilmore bias

Ventilators have a  endotracheal and an oxygen supply.

Although gilmore bias after recovery may help, partying.

Edited March 22, 2020 by ursle

[BobD]

Modified CPAPs were used in Italy apparently. Now being modified in the UK

 

https://www.bbc.com/news/health-52087002?fbclid=IwAR0bNygBC2FCJVViLhKLV7cAL5eqg6W7EpME4PusCslZa23TNwW5rTkrgXE

Edited March 30, 2020 by BobD

[ursle]

Except

 

In the U.S., emergency plans developed by states for a shortage of ventilators include using positive airway pressure machines—like those used to treat sleep apnea—to help hospitalized people with less severe breathing issues.

While that measure could stretch the supply of ventilators and save lives, it has a major drawback. Officials and scientists have known for years that when used with a face mask such alternative devices can possibly increase the spread of infectious disease by aerosolizing the virus, whether used in the hospital or at home.

Indeed, that very scenario may have contributed to the spread of COVID-19 within a Washington state nursing home that became ground zero in the U.S. early on. First responders called to the Life Care Center of Kirkland starting Feb. 24 initially used continuous positive airway pressure machines, often known as CPAPs, to treat residents before it was known the patients were infected with the COVID-19 virus.

“It’s best practice for us for people with respiratory illnesses,” said Jim Whitney, medical services administrator for the Redmond Fire Department, whose crews responded to the nursing home’s 911 calls. “We had no idea that we potentially had COVID patients there.”

It was only later that King County public health officials advised Redmond Fire and other first responders in the region not to use those machines for patients suspected of having COVID-19 illness. Whitney said responders were using the machines with specialized filters, which can reduce the amount of virus released. But county public health authorities recommend that first responders avoid using CPAP altogether. Redmond Fire has now discontinued the use of CPAPs for COVID-19 patients.