Help Elon with the ventilators

[Buckminster]

Not sure if Elon will be buying parts and building to a manufacturers design or building to a new design.

Random thoughts for if a new design is appropriate:

1. 1 ventilator to 4 or more patients. Match the individual's need to the ventilator - same pressure and timings.
2. Ask Dyson or similar to provide the air pump and motor electronics
3. Build for existing ventilator masks with extension tubes

I am sure someone will actually be able to help here...

How about @TrendTrader007 ? @KarenRei can turn her hand to anything.

 

[Buckminster]

PulmCrit - Splitting ventilators to provide titrated support to a large group of patients
Article on splitting ventilators.

 

[Tam]

...
Article on splitting ventilators.

As the article mentioned, each patient has individual needs and settings, not just oxygen level but also others such as volume, pressure, rate, modes...

It can solve that problem by grouping patients who can have the same settings.

However, it doesn't talk about infection controls, cross-contamination when sharing the same tubings.

Patients may potentially have more than Covid-19 and can transmit other germs by sharing the same tubings.

 

[Buckminster]

As the article mentioned, each patient has individual needs and settings, not just oxygen level but also others such as volume, pressure, rate, modes...

It can solve that problem by grouping patients who can have the same settings.

However, it doesn't talk about infection controls, cross-contamination when sharing the same tubings.

Patients may potentially have more than Covid-19 and can transmit other germs by sharing the same tubings.

Elon is all over this stuff:

Twitter
One ventilator being used by 9 patients!

 

[Buckminster]

More from Elon on sharing:
Twitter

 

[Xd85]

one problem is that ARDS (the supposed mechanism of COVID) is such a dynamic condition. critical settings such as oxygen concentration, respiratory pressures, and respiratory rate are often changed. While it may be easy to group in the beginning, they can become easily dysynchronous and incredibly difficult to manage. Not tenable at all even for short durations. It also might be that the multiple patient demonstration is more of a bridge-to-treatment (which might be effective for just hours), rather than a definitive source of ventilation.

 

[wipster]

So I've heard that there was a lot of talk about using the New York GF for building ventilators. Would Cuomo's action this morning prohibit that or would it be counted as an essential function? That would make sense to me, but who knows?

 

[printf42]

CyberVentilator avatar already exist:

 

[TrendTrader007]

Not sure if Elon will be buying parts and building to a manufacturers design or building to a new design.

Random thoughts for if a new design is appropriate:

1. 1 ventilator to 4 or more patients. Match the individual's need to the ventilator - same pressure and timings.
2. Ask Dyson or similar to provide the air pump and motor electronics
3. Build for existing ventilator masks with extension tubes

I am sure someone will actually be able to help here...

How about @TrendTrader007 ? @KarenRei can turn her hand to anything.

i am a board certified Psychiatrist with 22 years post-residency experience and Medical Director of a rapidly growing private practice in Mid-west. i used to be the only consulting Psychiatrist for a tertiary level hospital and dealt with critically ill psychiatric patients for 17 years and on a daily basis rounded in medical ICU AND Neurotrauma ICU . i used to work 7 days a week and saw numerous cases of critically ill patients ranging from overdoses to serotonin syndrome or neuroleptic syndrome to self-inflicted GSWs etc . while i know very little about ventilators ( last time i dealt with ventilator settings was in my residency back in 1994) i can tell you that for a critically ill patient in an ICU setting you have got to have a single ventilator assigned with a full time ICU nurse who can only cover 2 patients at a time . the whole idea of having more than 1 patient on a single ventilator is ridiculous because beside the unique settings etc you can not house more than 1 patient in a single ICU room. ICU / NTICU is not a place where you can have over-crowding- you have got patients who are extremely sick with grave prognosis.
as an aside, i am really worried about the economic and health implications of this global shut-down. i see mass-paranoia and severe over-reaction to COVID-19 the likes of which i have never seen. we are losing sight of the big picture here - what is the point of reducing transmission of this specific virus if by the end of it we will lose tons of businesses and jobs and untold human suffering in the form of increased # of deaths due to exacerbation of chronic illnesses like diabetes, heart disease, strokes, suicides etc. i deal with actively suicidal patients on a daily basis as well as chronic medical illnesses and i can tell you straight-up that trying to clamp down transmission of a viral illness with maybe 1 to 2% (if not much lower mortality rate because of severe underdiagnosis and gross underestimate of actual prevalence ) while neglecting treatment of much more serious life-threatening conditions is illogical. as an example the risk of suicide with untreated Major depression is 10%.
i totally agree with Elon Musk that there is a huge panic in society and in retrospect COVID-19 may be categorized as a huge bubble of mass panic and mass paranoia with great deal of damage done to society. this is a rather contrarian and not a PC view but me and my partner are the only business in town that are fully open and seeing numerous patients every single day while observing all the safety recommendations but at the same time doing our best to serve the needs of our community. in fact starting tomorrow we are even opening our Clinic for walk-in patients on saturdays to attempt to reduce the burden of local ERs and Urgent cares

 

[MassPlay]

Elon is all over this stuff:

Elon is all over it, calling out reacting to it as "dumb"

Elon Musk on Twitter

 

[Beltsbear]

i am a board certified Psychiatrist with 22 years post-residency experience and Medical Director of a rapidly growing private practice in Mid-west. i used to be the only consulting Psychiatrist for a tertiary level hospital and dealt with critically ill psychiatric patients for 17 years and on a daily basis rounded in medical ICU AND Neurotrauma ICU . i used to work 7 days a week and saw numerous cases of critically ill patients ranging from overdoses to serotonin syndrome or neuroleptic syndrome to self-inflicted GSWs etc . while i know very little about ventilators ( last time i dealt with ventilator settings was in my residency back in 1994) i can tell you that for a critically ill patient in an ICU setting you have got to have a single ventilator assigned with a full time ICU nurse who can only cover 2 patients at a time . the whole idea of having more than 1 patient on a single ventilator is ridiculous because beside the unique settings etc you can not house more than 1 patient in a single ICU room. ICU / NTICU is not a place where you can have over-crowding- you have got patients who are extremely sick with grave prognosis.

Nothing you said is wrong under normal operations. Doing different long term in the normal conditions would result in lawsuits and death But take one look at videos from Italy now and you can see that is not what is going on there. Patients are on vents in the hallways without dedicated nurses, though more of them are on just oxygen. In this wartime like environment in a hospital you could indeed stack two patients on one vent if they were closely enough matched. Its not ideal. Its dangerous. But it is more likely to save people. There will be conditions where one dies on a split vent because it was split. But there will be more times when both survive. The problem in Italy is they are simply letting patients die unvented in the halls due to lack of vents.

If it was just Italy suffering with this, we could airlift people and supplies to them right now. But we have our own waves starting this week (or already like in NYC).

 

[Tam]

...essential function?...

Ventilator is a life support system and clearly needed in the Covid-19 crisis, so, it is definitely classified as an essential function.

 

[Tam]

...If it was just Italy suffering with this, we could airlift people and supplies to them right now. But we have our own waves starting this week (or already like in NYC).

Maybe we can also ask for help:

Italy requested doctors from China, Cuba, and Venezuela to contain the coronavirus

 

[user212_nr]

Nothing you said is wrong under normal operations. Doing different long term in the normal conditions would result in lawsuits and death But take one look at videos from Italy now and you can see that is not what is going on there. Patients are on vents in the hallways without dedicated nurses, though more of them are on just oxygen. In this wartime like environment in a hospital you could indeed stack two patients on one vent if they were closely enough matched. Its not ideal. Its dangerous. But it is more likely to save people. There will be conditions where one dies on a split vent because it was split. But there will be more times when both survive. The problem in Italy is they are simply letting patients die unvented in the halls due to lack of vents.

If it was just Italy suffering with this, we could airlift people and supplies to them right now. But we have our own waves starting this week (or already like in NYC).

Yes, but lets hope that they (doctors, nurses, Elon, government) are able to get around all the "red tape" or that many of them just start doing what is sensible.

The 10x ventilator is genius. Still not going to be enough, but if 7 survive and 3 die, that is better than 1 survive and 9 die, assuming they all needed the ventilator.

So I've heard that there was a lot of talk about using the New York GF for building ventilators. Would Cuomo's action this morning prohibit that or would it be counted as an essential function? That would make sense to me, but who knows?

That's partly were all this came from - factory is closed but they can make ventilators. The rest is Elon wanting to help out like with his scuba sub.

as an aside, i am really worried about the economic and health implications of this global shut-down. i see mass-paranoia and severe over-reaction to COVID-19 the likes of which i have never seen. we are losing sight of the big picture here - what is the point of reducing transmission of this specific virus if by the end of it we will lose tons of businesses and jobs and untold human suffering in the form of increased # of deaths due to exacerbation of chronic illnesses like diabetes, heart disease, strokes, suicides etc. i deal with actively suicidal patients on a daily basis as well as chronic medical illnesses and i can tell you straight-up that trying to clamp down transmission of a viral illness with maybe 1 to 2% (if not much lower mortality rate because of severe underdiagnosis and gross underestimate of actual prevalence ) while neglecting treatment of much more serious life-threatening conditions is illogical. as an example the risk of suicide with untreated Major depression is 10%.

Very much "an aside" (we don't want every thread turning into corono-thread). I agree, depending on what the numbers are, we maybe ought to have toughed it out. On the other hand, remember that China is lying about their numbers and our government knows the truth of what happened there and hasn't officially told us. You see numbers from china in the 1,000 deaths range, but numbers from CDC projections in the million range. Italy has already surpassed China in a few weeks, and with full quarantine measures.

 

[Tam]

Ford, GM, Tesla getting 'go ahead' to make ventilators: Trump

The question is whether Tesla will start producing it or is it still waiting because Elon Musk sounds like a non-believer about the PPE (Personal Protection Equipments like gowns, gloves, masks...) and ventilator shortage when he tweeted: "We will make ventilators if there is a shortage,"

 

[FlatSix911]

More information from Electrek... https://electrek.co/2020/03/19/gm-t...-ventilators-to-soothe-coronavirus-shortages/

Wednesday afternoon, GM CEO Mary Barra offered to use empty factory space in a “WWII-style mobilization” to make ventilators for hospitals that are running short. That idea made its way to Tesla CEO Elon Musk tonight, who stated that Tesla “will make ventilators if there is a shortage.” When prodded further, he elaborated:

Tesla makes cars with sophisticated HVAC systems. SpaceX makes spacecraft with life support systems. Ventilators are not difficult, but cannot be produced instantly. Which hospitals have these shortages you speak of right now? Update: Since the offer, New York City Mayor Bill de Blasio reached out to Musk to discuss their urgent need for ventilators. The city reportedly has not yet heard back from Musk.

Ford also offered their help, stating: As America’s largest producer of vehicles and top employer of autoworkers, Ford stands ready to help the administration in any way we can, including the possibility of producing ventilators and other equipment. Similar events have transpired in the UK, with the British government asking automakers to help build ventilators there. Ford is considering how it could help, and Jaguar and Toyota have both offered help in response to the UK’s request.

 

[Buckminster]

Dyson have gone much further than I predicted in my first post:

Airbus and Dyson among firms expecting green light to make ventilators

 

[defc0n]

Nothing you said is wrong under normal operations. Doing different long term in the normal conditions would result in lawsuits and death But take one look at videos from Italy now and you can see that is not what is going on there. Patients are on vents in the hallways without dedicated nurses, though more of them are on just oxygen. In this wartime like environment in a hospital you could indeed stack two patients on one vent if they were closely enough matched. Its not ideal. Its dangerous. But it is more likely to save people. There will be conditions where one dies on a split vent because it was split. But there will be more times when both survive. The problem in Italy is they are simply letting patients die unvented in the halls due to lack of vents.

If it was just Italy suffering with this, we could airlift people and supplies to them right now. But we have our own waves starting this week (or already like in NYC).

“don’t let perfect be the enemy of good”

 

[Buckminster]

Did a lack of appreciation for their efforts on ventilators contribute to Elon's twitter storm?

 

[Tam]

Did a lack of appreciation for their efforts on ventilators contribute to Elon's twitter storm?

GM got the contract on 4/8/2020 and it started shipping its ventilators on 4/17/2020 or 9 days later.

Tesla's ventilator prototype looks nice (not the bought on the market CPAP/BiPAP scandal) but there's no shipping date planned just yet and there's no mention of the money yet.

To clarify, there's a scandal about the "ventilators" that Tesla delivered to the hospitals which were very much appreciated by the healthcare workers.

However, the workers leaked the photo on social media for the sake of thanking Tesla and Elon but it also shows they are BiPAP machines which the press promptly corrected the falsely assumed traditional ventilators. These CPAP/BiPAP are great for sleep apnea and for those Covid-19 patients who can still take their own breaths without the need for traditional ventilators.

After that, the Tesla Ventilator prototype was displayed on Youtube and most people and the press love it!

So no, it's not about the ventilators or otherwise, the twitter storm would happen between the CPAP/BiPAP photo and Tesla Ventilator prototype video.