Author Topic: Open Source Ventilator  (Read 6422 times)

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Offline NiHaoMike

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Re: Open Source Ventilator
« Reply #25 on: March 30, 2020, 03:45:49 am »
I'm thinking something more like a neon sign transformer, using the UV and ozone as the primary means of sterilization.
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Offline blacksheeplogic

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Re: Open Source Ventilator
« Reply #26 on: March 30, 2020, 03:49:20 am »
If I have to choose between maybe dyeing from a janky ventilator and definitely dyeing, I am going to choose the janky ventilator.

Medical's not one of those fields you can rock up to with your 'device/cure' and expect they take whatever you have cause 'they die anyway'.What you do in your own home that's different, but trialing it on others won't fly.
 

Offline james_s

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Re: Open Source Ventilator
« Reply #27 on: March 30, 2020, 03:58:27 am »
If I have to choose between maybe dyeing from a janky ventilator and definitely dyeing, I am going to choose the janky ventilator.

Medical's not one of those fields you can rock up to with your 'device/cure' and expect they take whatever you have cause 'they die anyway'.What you do in your own home that's different, but trialing it on others won't fly.

Trial it on me then if I found myself in a position of needing one when a proper device is not available. In that position I'd be perfectly willing to kill someone who stood in the way, though physically incapable of doing so at that point. Rules and regulations be damned, turning down any possible available cure for a dying patient is morally reprehensible.
 

Offline blacksheeplogic

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Re: Open Source Ventilator
« Reply #28 on: March 30, 2020, 04:17:13 am »
If I have to choose between maybe dyeing from a janky ventilator and definitely dyeing, I am going to choose the janky ventilator.

Medical's not one of those fields you can rock up to with your 'device/cure' and expect they take whatever you have cause 'they die anyway'.What you do in your own home that's different, but trialing it on others won't fly.

Trial it on me then if I found myself in a position of needing one when a proper device is not available. In that position I'd be perfectly willing to kill someone who stood in the way, though physically incapable of doing so at that point. Rules and regulations be damned, turning down any possible available cure for a dying patient is morally reprehensible.

You might be, but your asking someone else to take the responsibility for this decision.
 

Offline Domagoj T

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Re: Open Source Ventilator
« Reply #29 on: March 30, 2020, 06:32:08 am »
And again you bring in this false dichotomy of "DIY or death". The situation is not such that we have only those two options, not nearly.
The situation is such that the governments (in coordination with manufacturers) need to decide when and how to increase the production of tested and proven designs in existing manufacturing facilities. That can be done in matter of days, and in fact has already been done.

This and all others open source ventilator movements (and I've seen several in the last few days) is exactly the same story as with every other open source project - multiple different designs, every one different, not compatible with each other, and not a single one a complete solution. All that is needed is for them to be offered as "some assembly required" and for the ICU nurses to figure out how to compile the firmware through the command line.

But even if you do manage to come up with a decent, cheap and safe design, who is going to make it? The world needs thousands of ventilators per week. You expect to have distributed manufacturing of stuff like this? Everybody pieces something together from odd bits they find laying around their garage and then present their work to the nearest hospital?

There is a problem, but the solution already exists.
 

Offline Canis Dirus Leidy

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Re: Open Source Ventilator
« Reply #30 on: March 30, 2020, 07:56:36 am »
I would like to draw attention to one more thing. All these wundergerätes  without a qualified doctor are useless and simply dangerous.  Because (AFAIK) humans have several mechanisms for breathing regulation, and by the time when artificial lung ventilation is required, these regulators work and interact in non-standard mode. And now we have threaded a tube into the patient and we are driving into the lungs a non-standard mixture with pressure profiles other than atmospheric.
 

Offline BlitzschnitzelTopic starter

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Re: Open Source Ventilator
« Reply #31 on: March 30, 2020, 10:21:37 am »
This and all others open source ventilator movements (and I've seen several in the last few days) is exactly the same story as with every other open source project - multiple different designs, every one different, not compatible with each other, and not a single one a complete solution. All that is needed is for them to be offered as "some assembly required" and for the ICU nurses to figure out how to compile the firmware through the command line.
Dude those hand operated ventilators are standardised, come with all the connectors and are approved. If you put a nurse next to a patient’s bed and let her or him hand pump the thing full time, that would be a legally approved way to ventilate a patient. The peak pressures and minimum pressures are regulated by the valves in the Ambubag and you can rout in the correct oxygen mix.
All the machine has to do is squeeze a bag at a set rate and make a lot of noise if it fails. This way you can free up the more sophisticated machines for the complicated and more severe cases.
The reason those projects you've seen in the last few days look unfinished is because they are unfinished. They started in the last few days.
We are working on a sheet metal box which squeezes a bag and you turn the dial how often you want that to happen per minute. No firmware compiling required by the nurse.
 
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Offline Domagoj T

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Re: Open Source Ventilator
« Reply #32 on: March 30, 2020, 10:42:52 am »
Those things are for temporary usage. Device for long term usage are considerably more complicated (for a reason).
You have also not addressed the main criticism I brought up - there are existing, better solutions. Use them.
 

Offline jogri

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Re: Open Source Ventilator
« Reply #33 on: March 30, 2020, 11:22:31 am »
Hmm.  My current thought is passing the exhaled air through a filter and illuminating one or both sides of the filter with UVC.  Provided the light penetrates deep enough on/in the filter to reach trapped viruses, the exposure time would be significantly increased since the virus is trapped and you might not need as intense a UVC source.  I'm not sure if generated heat from the lamp would help keep the filter dry, or extend the useful period of the filter itself.  I only mentioned the air purifier thing since it's an off the shelf product that includes some type of filtration with UVC.  Plus a fan providing a little negative air pressure helps make sure contaminated air gets where you intend it to go.

Bad idea, that won't work for a number of reasons:

1) UVC doesn't penetrate filters as they are designed to act like labyrinths for incoming air-> extremely high surface area without line of sight to the UV source
2) UVC degrades plastic at an alarming rate, your filter is not going to last long
4) heat+oxygen can also degrade plastic -- Why is that important? They are going to be used as a last resort, and at that time the hospital will probably only have critical patients. Straßburg is nearing this stage, and everyone they have on ventilation needs 50-100% O2 in the air to survive. A O2 level that high (combined with heat) will just melt your filter, as soon as one tiny hole starts to form inside your filter more air is going to rush through that hole as it is the past of least resistance ->more air ->bigger hole->filter gone


Btw, the same problems apply for ozone: That stuff is extremely reactive and toxic as hell. And it stinks like crazy, so you just can't vent the filtered air outside without giving everyone inside the hospital a headache (lovely stuff, isn't it?).

But lets come back to the UVC idea: Hospitals already have UVC sources in the kW range, they are used for sterilizing operating rooms. Basically just a very big lightbulb (mercury vapour lamp) on wheels. Might be usefull, but you could also use the Straßburg approach to have a negative pressure inside the rooms and have your vent system deal with the contaminated air.
 

Offline BlitzschnitzelTopic starter

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Re: Open Source Ventilator
« Reply #34 on: March 30, 2020, 11:25:46 am »
Those things are for temporary usage. Device for long term usage are considerably more complicated (for a reason).
You have also not addressed the main criticism I brought up - there are existing, better solutions. Use them.
They are more complicated for versatility and a simple forced ventilation system can free up sophisticated machines where versatility is needed, like assisted ventilation. We are following the UK's "Rapidly Manufactured Ventilation System" requirements and are getting advised by health professionals. Yes there are better machines, but if you follow the news there aren't enough and it is going to get worse before it becomes better.
 

Offline BlitzschnitzelTopic starter

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Re: Open Source Ventilator
« Reply #35 on: March 30, 2020, 11:34:35 am »
@Jorgi
You could off course get a glass blower to make a glass spiral around a UVC lamp. Are there cheaper UVC resistant and transparent materials than glass made by craftsmen? It might also be a good idea to make the worlds stockpiles of military ABC filters compatible with medical use.
 

Offline jogri

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Re: Open Source Ventilator
« Reply #36 on: March 30, 2020, 11:44:03 am »
@Jorgi
You could off course get a glass blower to make a glass spiral around a UVC lamp. Are there cheaper UVC resistant and transparent materials than glass made by craftsmen? It might also be a good idea to make the worlds stockpiles of military ABC filters compatible with medical use.

I don't think so, and even normal glass sucks at letting UVC pass (it transmits 1-10% at most). You need fused quartz glass for that, and that stuff is rather pricey as it is more difficult to work with (higher melting point at almost 2000°C, compared to 1400°C for normal glass). If you go to UVB normal glass as well as acrylic glass kinda work, but UVB sucks at killing viruses/bacteria.
 

Offline MasterBuilder

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Re: Open Source Ventilator
« Reply #37 on: March 30, 2020, 05:02:27 pm »
Medtronic have released the source for the PB 560 ventilator,  :-+
https://apnews.com/Globe%20Newswire/471a4dfe92e9697ecf5e3e177803bb54

Source here, no firmware yet
http://www.medtronic.com/openventilator
 
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Offline pipe2null

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Re: Open Source Ventilator
« Reply #38 on: March 30, 2020, 07:40:24 pm »
@Nay-sayers:  There are valid points against DIY medical equipment, but these are extreme times:

In the count-y I live in (a "county" = a small collection of towns), we have as many confirmed COVID-19 cases as all of New Zealand and Croatia combined.  And we are not even the worst hit county in my state.  And my state is an order of magnitude better off than New York.  In the past 7 days, the number of confirmed positive cases in the US has QUAD-rupled, almost QUINT-upled.  Just over the weekend, like 2 days, the number of cases increased by almost 50% of China's total cases over the entire pandemic.  And we still have problems with availability and lag time of testing.

2 days in the US = 50ish % * 3 months in China.
https://www.who.int/emergencies/diseases/novel-coronavirus-2019/situation-reports/
(Note: There is roughly 24 hour lag time in the numbers published by W.H.O.)

No matter how fast manufacturing of ventilators and other medical devices ramp up, and no matter how fast those devices get distributed, there WILL be lag time and a period where people will die due to unavailability of equipment.  This is already true in Italy, and I think Spain as well.  If there are reproducible DIY designs, someone from the maker community can build a device within a day or two, and even if those devices are essentially single-use-disposable, that is one less body bag.  And the maker community is much larger than a single person.  Getting a patient to sign a waiver to use DIY equipment when nothing else is available, and getting medical professionals to consider the DIY equipment in the first place, is a different issue.  We need reproducible designs first, and some coordination of those efforts.

SO:  Please contribute if you are able to.  Please be critical of design ideas when appropriate to help avoid unforeseen problems.  And please do not assume that idiot politicians will set aside personal interests and reelection campaigns for the greater health and well-being of their country's citizens, in a timely manner.  I'll stop there since I do not want to devolve into a rant.

Medtronic have released the source for the PB 560 ventilator,  :-+
https://apnews.com/Globe%20Newswire/471a4dfe92e9697ecf5e3e177803bb54

Source here, no firmware yet
http://www.medtronic.com/openventilator

That's freakin awesome!
 
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Offline pipe2null

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Re: Open Source Ventilator
« Reply #39 on: March 30, 2020, 11:54:52 pm »
Adding some tangible numbers for ballpark estimation.  Excerpt from the study on virus inactivation of SARS I posted earlier:
2.3. UV light treatment
Ultraviolet light (UV) treatment was performed on 2 ml aliquots of virus (volume depth = 1 cm) in 24-well plates (Corning Inc., Corning, NY). The UV light source (Spectronics Corporation, Westbury, NY) was placed above the plate, at a distance of 3 cm from the bottom of the wells containing the virus samples. At 3 cm our UVC light source (254 nm) emitted 4016 μW/cm2 (where μW = 10−6 J/s)...
3.1. Effect of radiation on the infectivity of SARS-CoV
... Exposure of virus to UVC light resulted in partial inactivation at 1 min with increasing efficiency up to 6 min (Fig. 1A), resulting in a 400-fold decrease in infectious virus. No additional inactivation was observed from 6 to 10 min. After 15 min the virus was completely inactivated to the limit of detection of the assay, which is ≤1.0 TCID50 (log10) per ml.

2.5. Heat treatment of virus
We incubated 320μl aliquots of virus in 1.5 ml polypropylene cryotubes using a heating block to achieve three different temperatures (56, 65 and 75 ◦C).
3.2. Effect of heat treatment on the infectivity of SARS-CoV...
... At 65 ◦C, most of the virus was inactivated if incubated for longer than 4 min (Fig. 2B). Again, some infectious virus could still be detected close to the limit of detection for the assay, after 20 min at 65 ◦C. While virus was incompletely inactivated at 56 and 65 ◦C even at 60 min, it was completely inactivated at 75 ◦C in 45 min (Fig. 2C). Surprisingly, at both 56 and 65 ◦C the virus was inactivated at early time points but at 60 min a small amount of virus was detected.
 

Offline BlitzschnitzelTopic starter

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Re: Open Source Ventilator
« Reply #40 on: March 31, 2020, 07:23:28 am »
Hi, so I saw the news that ford is making face shields:
https://www.wired.com/story/tinkerers-created-face-shield-being-used-hospitals/
Apparently, they are gluing and stapling those by hand. I made a stamping design which you can assemble in the field in seconds. And the big advantage is that you can send them flat pack with an equal number of headbands in the box. You could send these out as fast as you can stamp them. Does someone know the right contact path to get the idea to Ford? Art supplies are closed due to Corona So I can’t make a transparent version.
 
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Offline pipe2null

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Re: Open Source Ventilator
« Reply #41 on: March 31, 2020, 08:10:42 am »
That's a pretty effective design.   :-+  Perhaps it merits its own thread to get a bit more exposure and hopefully someone will know someone?  I fear my ranting today has scared away some viewers...  Sorry about that.

On the UVC side of things, if I'm reading the numbers right from the study, it might be completely feasible to stick an off the shelf UVC lamp in an opaque can and pipe exhaled air through it without much need of anything else.  Geometries and seals will be important, but need to figure out the UVC source first.  Even if the can is 3d printed or made from chunks of PVC pipe, the plastic should probably hold up against photo degradation long enough for short term use.  I haven't found any good source of info on how long it takes UVC to kill plastic.  Also, from looking at other info, 254nm UV-C apparently eliminates ozone and does not actually create it (lower nm UV generates ozone).  I'm currently trying to find UVC lamps that might work for an in-line virus killer for CPAP/BiPAP/etc exhaled air exhaust.
 

Offline BlitzschnitzelTopic starter

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Re: Open Source Ventilator
« Reply #42 on: March 31, 2020, 09:33:21 am »
Thanks. Will do. :)
 

Offline jogri

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Re: Open Source Ventilator
« Reply #43 on: March 31, 2020, 11:20:48 am »
On the UVC side of things, if I'm reading the numbers right from the study, it might be completely feasible to stick an off the shelf UVC lamp in an opaque can and pipe exhaled air through it without much need of anything else.  Geometries and seals will be important, but need to figure out the UVC source first.  Even if the can is 3d printed or made from chunks of PVC pipe, the plastic should probably hold up against photo degradation long enough for short term use.  I haven't found any good source of info on how long it takes UVC to kill plastic.  Also, from looking at other info, 254nm UV-C apparently eliminates ozone and does not actually create it (lower nm UV generates ozone).  I'm currently trying to find UVC lamps that might work for an in-line virus killer for CPAP/BiPAP/etc exhaled air exhaust.

Let's say we have a system of two bags where each bag can contain the exhaled air of 15min ventilation (that's roughly 20l). When a bag is full the UVC source kicks in for 15min, disinfecting the contaminated air while the other bag fills up. We could either use fully collapsable bags to use their full capacity (bag gets squeezed->no remaining air) or we have to apply some sort of pressure to get the 20l of air into a container that is already filled with air at ambient pressure (having a pressurized container of airborne viruses kinda sounds like a bad idea).
A 20l cylinder (20cm diameter, 65cm height) has a surface area of 0.4m^2 (or 4000cm^2), that means we would need a 16W UVC source if we assume that the intensity for UV radiation of water samples is also viable for an aerosol (probably not). Yeah, that could work. I'd use a 50W source just to be on the safe side and some bigger containers to minimize the required pressure (a 20l canister would sit at 2bar when loaded with the 20l of residual air+ 20l of exhaled air), but it sounds feasible.
 

Offline Enginerding

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Re: Open Source Ventilator
« Reply #44 on: March 31, 2020, 02:13:51 pm »
Blitz and friends, would you gentleman like to join forces?  I have another thread going titled "Chapter 1...." in this same forum.

Your thread proceeds mine, but I have a ~20 years medical experience.  And I think that's part of what's missing here.

If you're willing to come over, I promise there will be fame, glory, land and titles.

Thank you.


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Offline pipe2null

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Re: Open Source Ventilator
« Reply #45 on: March 31, 2020, 06:37:57 pm »
@Enginerding:  Aw maaaaan.... But I'm so comfy here!  Hehe.  Sounds great, thank you for lending your medical experience!

On the UVC side of things, if I'm reading the numbers right from the study, it might be completely feasible to stick an off the shelf UVC lamp in an opaque can and pipe exhaled air through it without much need of anything else.  Geometries and seals will be important, but need to figure out the UVC source first.  Even if the can is 3d printed or made from chunks of PVC pipe, the plastic should probably hold up against photo degradation long enough for short term use.  I haven't found any good source of info on how long it takes UVC to kill plastic.  Also, from looking at other info, 254nm UV-C apparently eliminates ozone and does not actually create it (lower nm UV generates ozone).  I'm currently trying to find UVC lamps that might work for an in-line virus killer for CPAP/BiPAP/etc exhaled air exhaust.

Let's say we have a system of two bags where each bag can contain the exhaled air of 15min ventilation (that's roughly 20l). When a bag is full the UVC source kicks in for 15min, disinfecting the contaminated air while the other bag fills up. We could either use fully collapsable bags to use their full capacity (bag gets squeezed->no remaining air) or we have to apply some sort of pressure to get the 20l of air into a container that is already filled with air at ambient pressure (having a pressurized container of airborne viruses kinda sounds like a bad idea).
A 20l cylinder (20cm diameter, 65cm height) has a surface area of 0.4m^2 (or 4000cm^2), that means we would need a 16W UVC source if we assume that the intensity for UV radiation of water samples is also viable for an aerosol (probably not). Yeah, that could work. I'd use a 50W source just to be on the safe side and some bigger containers to minimize the required pressure (a 20l canister would sit at 2bar when loaded with the 20l of residual air+ 20l of exhaled air), but it sounds feasible.

Here goes my current thought:
(Potentially dangerous) Assumption #1:  The study only used a single intensity level "4016 μW/cm2 (where μW = 10−6 J/s)" which resulted in "400-fold decrease in infectious virus" in 6 min, and total eradication to detectable limit in 15min.  There is no data on the relationship between UVC intensity and required exposure time in this specific study.  If someone knows, please provide info!   ;D  Using the study's exposure intensity as the MINIMUM and if we (potentially dangerously) assume the relationship between intensity and required exposure time is somewhat linear, then increasing UVC intensity to somewhere around 900x (into the W/cm2 range, which is still do-able), the required exposure time would reduce to around 1 second compared to 15 minutes.

(Potentially dangerous) Assumption #2:  The whole "social distancing" recommendation of 6ft/2 meters (please correct if better rec's available) is because of gravity's affect on virus transmission.  If the output port of a virus killing device is piped down to the floor where a mop and bucket can periodically finish the job, then the targeted virus killing result could potentially get moved to a less conservative ~99% instead of 100% reduction in detectable virus infectivity.  So, if we went with this (potentially dangerous) assumption, then the targeted exposure time required for the lower intensity UVC used in the study reduces to their 6 minute value.

(Potentially dangerous) Combination of both assumptions:  You might be able to make an in-line virus killer that maintains enough UVC intensity for the designed geometry of the "can" to kill viruses at or above the peak air-flow rate of a patient's exhale.  Basically, kill the suckers in real-time.  You probably won't kill every single one of them, but depositing a few active viruses under a massive pile of dead virus carcasses on the floor is a major reduction in risk for anyone around a patient, whether at a hospital or at home.

Big open ended question of the unknown: Is UVC more/less/same as effective on water/air/aerosol/surface dwelling viruses?
 

Offline jogri

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Re: Open Source Ventilator
« Reply #46 on: March 31, 2020, 08:16:18 pm »

(Potentially dangerous) Assumption #1:  The study only used a single intensity level "4016 μW/cm2 (where μW = 10−6 J/s)" which resulted in "400-fold decrease in infectious virus" in 6 min, and total eradication to detectable limit in 15min.  There is no data on the relationship between UVC intensity and required exposure time in this specific study.  If someone knows, please provide info!   ;D  Using the study's exposure intensity as the MINIMUM and if we (potentially dangerously) assume the relationship between intensity and required exposure time is somewhat linear, then increasing UVC intensity to somewhere around 900x (into the W/cm2 range, which is still do-able), the required exposure time would reduce to around 1 second compared to 15 minutes.

Well, seems like 30.000 uJ/cm2 is the required dose to kill spores (or anything else that could be a biohazard) that are sitting on a surface. If you want to disinfect a surface in 1 sec that would be 30 mW/cm2... Yeah, doable, but i wouldn't trust that number when it comes to airborne organisms as it comes down to statistics when you are using UV: You need to hit every organism with at least one photon (realistically 2-10 as not every impact induces an reaction). You can either drastically increase the number of photons or wait a bit.

And no, i don't recommend using UV sources in the W/cm2 range at all. Been there, done that. The problem with such light sources is that you don't know how bright they are as you just can't see them and you risk permanent eye damage when you look at them without proper eye protection (although you can feel your face getting hot which is quite scary when you realise that a skin cancer ray is warming you).

About your second point: Could be done as they need to wipe down the rooms anyway after any invasive procedure.

Effectiveness at different conditions: Water is the worst as the UV needs to penetrate it and gets attenuated (Beer-Lambert law).  Aerosol/Air: Dunno, but i'd guess that an aerosol is marginally worse as the light can also get absorbed by the water. A surface is the best option as the virus is stationary and you can control which area has gotten what amount of radiation. I could be wrong, that's just my 2ct on this topic.
 
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Offline bluey

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Offline Lord of nothing

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Re: Open Source Ventilator
« Reply #48 on: May 14, 2020, 11:32:45 pm »
Quote
http://www.medtronic.com/openventilator
When I rember right there was a Topic about them here in the Forum and I guess dave did make a Video to.
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Offline donotdespisethesnake

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Re: Open Source Ventilator FI5 released
« Reply #49 on: May 15, 2020, 11:47:27 am »
https://iit.it/iit-vs-covid-19/fi5-ventilator

https://multimedia.iit.it/asset-bank/assetfile/15783.pdf

Still trying to find completed price...

At least they have used an Open Source license, which is good. But they have based the design on an STM32F746 Discovery Evaluation Board. The terms of that board do not allow commercial use, nor use in a safety critical environment. https://www.st.com/resource/en/license_agreement/evaluationproductlicenseagreement.pdf

Quote
The Evaluation Board shall not be, in any case, directly or indirectly assembled as a part in any production of Yours as it is solely developed to serve evaluation and testing purposes and has no direct function and is not a finished product. 
 
If the Evaluation Board is incorporated in an evaluation system, the evaluation system may be used by You solely for Your evaluation and testing purposes. Such evaluation system may not be offered for sale or lease or sold, leased or otherwise distributed for commercial purposes and must be accompanied by a conspicuous notice as follows: “This device is not, and may not be, offered for sale or lease, or sold or leased or otherwise distributed for commercial purposes”.
 
You shall not use the Evaluation Board in any safety critical or functional safety testing, including but not limited to testing of life supporting, military or nuclear applications. ST expressly disclaims any responsibility for such usage which shall be made at Your sole risk, even if ST has been informed in writing of such usage. Unless expressly designated in writing by ST as suitable for use in testing automotive or aerospace applications, You shall not use the Evaluation Board in such testing.

The NHS has rejected PPE from Turkey, because it did not meet requirements. I mean, that is just cloth and plastic, hardly anything to go wrong. They have also rejected Chinese made ventilators as sub standard. Ventilators operate with oxygen, the last thing you want is for them to catch fire.

I very much doubt they are ever going to risk untested or unapproved ventilators. I still feel confident in saying that none of these "open source" ventilators will ever get used in a real hospital environment.
Bob
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