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References:
[1] https://www.jto.org/article/S1556-0864(20)30132-5/pdf
[2] https://www.medtronic.com/us-en/about/news/increased-ventilator-manufacture.html
[3] https://www.ncbi.nlm.nih.gov/books/NBK545226/
[4] https://opentextbc.ca/anatomyandphysiology/chapter/22-3-the-process-of-breathing/
[5] https://emedicine.medscape.com/article/296625-overview
[6] https://books.google.com/books?id=oUNxDwAAQBAJ
[7] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5594148/
[8]https://e-vent.mit.edu/mechanical/
[9] https://books.google.com/books?id=oUNxDwAAQBAJ
[10] https://www.agvahealthcare.com/models
[11] https://www.agvahealthcare.com/covid-19
Thank you to AP Archive for access to their archival footage.
Music by Epidemic Sound: http://epidemicsound.com/creator
Songs:
Migratory Birds – Curved Mirror
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Huge thanks to Rohin from Medlifecrisis: https://www.youtube.com/c/medlifecrisis. Helped me tremendously in the direction this video took and fact-checked my script. This was a team effort with our sister channel https://www.youtube.com/c/realscience. Wouldn’t have been able to make this video so quickly without their help.
George Costarica First of all, what the hell kind of xenophobic attitude is that? Why does it matter to you where people are from? Secondly, he didn’t reveal his face… you didn’t pay attention to the video (which given your prejudices isn’t surprising). So, not only are you a bigoted idiot, you got things wrong as well.
@jannmutube Oh for sure, there is an urgent need to dispel the false class consciousness which is so deeply rooted in contemporary US society. It’s not a country of middle class comfortables, it’s a country of the working poor. The culture needs bottom up change to reflect this.
@Craving Hibiscus —- > I don’t dispute what you say. I’m just saying, people should be reminded that they voted against their own self-interests.
@jannmutube yeah, and why was that? Maybe because for profit health care is a massive part of the capital that owns the media which is, you know, who tells americans who to vote for? There is not real democracy with that kind of media, corporate and political consolidation, cmon be real.
@Craving Hibiscus —- > Bernie Sanders would have ended for profit health care and for profit prisons but people didn’t vote for him..
Robin,thanks for sharing video,kindly let us know how much tidal volume and pip range us accepted as we are going to design new thing soon,pls reply
Brian, Thank you very much for this video, I’m one of those engineers trying to figure out the needs and use cases of this machine to try to come up with something useful for the most vulnerable people. I have found more PR as you say than real engineering and science, but you make a huge difference with your timely and clear explanations. Please keep up with the good work. One of the main issues that I’ve found when it comes to the final design is to create the BOM and find suppliers for all the medical grade components (sensors, valves, filters, etc). It would be very useful if you could post a video with some indications for component characteristics, ranges, etc, that would save us a lot of time in this learning curve. Thanks again.
I’ve been in a lockdown for the past 24days. I have scavenged around and put together stuff that may help developing medical equipment. Could you please look at them and share your thoughts?
I’ll be happy to share details if it helps.
Development stage-1
https://youtu.be/WCPoa5GEUNw
Development stage-2
https://youtu.be/Auzl59fpLs4
Development stage-3
https://youtu.be/ZwpansG9Xhc
Development stage-4
https://youtu.be/ev20Ik8KZ5Y
[email protected]
from Czech Republik https://www.corovent.com/
An easy way to design a ventilator:
https://www.youtube.com/watch?v=AS2yOaWTp7U
Thanks for sharing! An alternative ultra-simple domestic ventilator by Prof. Jian
https://www.youtube.com/watch?v=AS2yOaWTp7U
To all Front Liners … Especially my mother 🙌🙌🙌
Didn’t know you were a bio-centered engineer, it was a very inspiring video indeed; especially on the listen to the user lesson.
TU Delft is woprking on this one, and it is at the stage where it is checked for medical usage: https://www.operationair.org/
They also have a similar design that works purely mechanical, with a pumping device and lots of one-way valves that just “aid” the patient in breathing extra oxygen (settable overpressure and speed on the pump), instead of forcing them to breathe. Really good insight in how a simple device does not have to be a “bag pusher”.
👏🏽👏🏽👏🏽💚
Just … woooow , the best explaination ever
keep going man
Great explanation starting at 5:02 where we need to be careful what’s being built
could things like this work? https://www.ufpb.br/ufpb/contents/noticias/respirador-pulmonar-da-ufpb-tem-licenca-liberada-para-producao-por-empresas . it’s a brazilian college prototype
An alternative approach that may be preferable for some patients is an non-invasive Negative Pressure Ventilator device described here: https://www.theengineer.co.uk/exovent-covid-19-ventilator/
I wish brilliant was free
Assist 8:19
Hi , we have designed a new mechanical ventilator . I think this will be helpful for people infected with COVID-19 .
and this video is very much informative . Thank you.
our design: https://www.youtube.com/watch?v=ATHOFcDAXlA&t=2s
Great video! We are launching a new development kit with all the necessary elements to design this application. Please find it here… @t
Who do you think you are Tesla?!
There also needs to be a filter or sterilizer for the exhaust so aerosolized virus isn’t released from exhalations.
The MIT ventilator has a pressure sensor and assist control, you are wrong about that. BTW I designed the original prototype in 2010 at MIT so I would know.
Thanks for your video it has helped me a lot with the thinking for my design going forward (see my design here if interested https://youtu.be/J70Sm0zX9ig ). I am about to begin MkII which will incorporate microprocessing control and more accurately control flow pressure and tidal volume. I too am using the Ambu style bag, mainly because it is made of approved materials for delivering air to patients. Do you think there is a better alternative to the Ambu bag available. for instance would you favour using medical air (50-55psi) and reducing the delivered pressure, which would mean all components in the airway circuit would need to be approved.
Take a look at https://www.helpfulengineering.org/ we are working hard on this problem.
What happened to Iron Lungs? They make the lungs work the correct way without over-pressuring? Just saying.
Fantastic video. Will be sharing.
Real Helpful. Summarizes a lot of things. Thanks a lot.
The radiograph was upside down.
Well explained, Thanks
#ChinaMustPay
E
Which software you use ?? To make videos
Take a look at the ventilator project coming out of Brown University: https://www.brown.edu/news/2020-04-13/bruno2
It is a low cost easily manufacturable open sourced device taking much of this into account. It does not use a BVM.
Would a lot of the barotrauma be negated by a kind of blow-off valve with programmable sensitivity? Instead of having to fine-tune the volume blown out of the BVM, you just dial-in the “not to exceed” pressure. Obviously not a perfect solution but maybe it would relax the demands on the vent designers, allowing them to produce higher numbers and faster. just a thought
Engineering for delusion or solution…
What about a thin metal reed valve that makes contact under the patients own low psi breath and that contact sets up 1 cycle of the pump for that 1 breath?
So to date NY has needed 1550 vents. The so called experts predicted 30k. Now President Trump is making a 100K in 90 days. We will have so many excesses it’s not even funny.
Please learn to ask from engineers, because they don’t have medical degrees too.
love the indian accent
Trying to imagine the horror of plastic all the way down my throat while having to breathe when the machine says.
Looking forward to your design.
Anyone else started breathing weirdly when they explained how lugs work?
What about a diver’s demand valve? no computing needed. It triggers on initial pressure drop then supplies gas at a fraction over ambient until demand ceases. With a full face type mask positive pressure could be set and maintained.
I’ll suck on my girls hair drier just take a plastic tube – attach it to a low heat or dismantle the heat coil – make a long plastic tube and suck on the end / now let’s think about moisture – how about putting a sponge in it or a plumber trap maybe put Back the heat if you have a plumbers trap – that will cool the air – Just give me credit!!!!!
I cannot understand why a CPAP machine cannot be the bases of a ventilator machine. CPAP as far as I know has a content non-adjustable (fixed by mask) PEEP. I was thinking that a software / firmware update to existing CPAP machines would be easier to design since it has many of the parts and systems needed are already on the CPAP? What I am not sure of is if they can attain the cm of h2o pressure needed to force inspiration? I believe they are in the 5~20cmH2O and not sure what a patient would be set at on a ventilator, I assume higher then this since a CPAP machine only maintains a constant pressure during inspiration/expiration cycles. Also the control over the expiration valve is not present on the CPAP and would have to be added via an unassigned GPIO pin from the CPU in the CPAP machine, this would be for example part of the hardware conversion kit.
Using the smartphone or some other common computer as the control interface is a great idea to simplify the design.
I am looking for a project such as this or thinking of perhaps starting it myself. Need to reverse-engineer some machine , including the firmware on a very common ubiquitous machine.
What’s the point? Ventilators kill nearly every covid patient anyway
Virgin wants to know your location
Getting bad air out, is harder than it is to get good air in….the rate is not the same….1:1.6 inhale: exhale, as any athsme sufferer will attest….1:1 causes hyperventilation….1:1.6 is common in nature.
This should have well over a million views.
Thanks for sharing very important info about respirators.
👏 Bravo 👏 Great video for all of us that prefer to think creatively, outside the box!
Has any engineer looked at the both respirator a low cost low tech variant of the iron lung used in Australia during polio outbreaks in 20th century https://en.wikipedia.org/wiki/Both_respirator
I need some help in understanding how will we detect if the PEEP is to be activated. We are currently using Proportional flow and pressure control valves for controlled inhalation. And are thinking of using a proportional valve with the exipratory valve as well. But not sure as to when / or on what feedback should the valve be triggered to maintain PEEP?
In the leading open-source ventilator, AmboVent, a pressure sensor was connected to monitor and change profile while too high pressure is detected.
https://www.youtube.com/watch?v=jgKKV1BeUI8&t=16s
How knowledgeable. Thanks to all the medical and Engineering professional helping in the fight of Covid -19
I knew those pump machines won’t met standards required for patients.
Thanks for explaining but can you provide more information.
So developers like us find out way to solve.
Thank you very much .
ecmo for the win then
It looks like the Tesla variant takes a lot of those tips you gave into consideration. Even a humidifier! /watch?v=zZbDg24dfN0
that is so true no Tidal Volume adjustment on those design. or PEEP either
This is fucking great. Great work.
Is all ventilator uses BVM to supply air
Why not start with a scuba regulator?
Save everyone some trouble https://youtu.be/IgAR4yWDsg0
So a couple of the key takeaways here are that this requires a thorough understanding of human physiology, and the medical context in which the device is used. And that it takes a lot more time and money to train up respiratory technicians and ICU nurses than it takes to make a ventilator.
At the level of DIY/hobbyist stuff, I can imagine someone trying to get more functionality out of a simple design by adding some control via Arduino and some pressure sensors and the like. Such a design wouldn’t be scalable but might be a bit more functional. The other thing that I think is really missing in the DIY approach is testing for reliability over hundreds of thousands or millions of cycles. And of course the piece about the skilled people to operate the thing!
Check out what the Kenyatta university in Kenya
Your talking style is that body language drama YouTuber who suddenly disappeared with his channel…..
Just use old iron lungs
Being able to breathe..is already a great gift in these trying times..who could have imagined it..
Nice video – I have shared it in Our COVID 19 Technology initiative in FB group. Nice information, usefull information very well documented. Congrats! (I worked in the medical /biomedical field for years)
great resource to show people that explains it perfectly. Thank you!
Why do MIT lead in everything
They stopped exporting because we in Indian lack a good number of ventilators
I love how virgin galactic, after trying to throw together some PR stunt that just a day’s research would show actually hurts the patients it treats, actively tries to take down a video pointing it out. Sad thing is, I have seen people say the ventilator shortage is a myth and point to designs such as virgin galactic’s, saying “look how easily they produced that one! If they REALLY needed ventilators, why aren’t they mass-producing these?” Virgin galactic is just fanning the flames of that myth by trying to take down videos that explain the real requirements of ventilators. Not only are they not helping, they are actively hurting the situation because all the engineers are just designing “puff-puff machines” instead of ventilators.
Although, in all honesty, that’s one of the things engineers do that drive me crazy; they design something without talking to the people who will be using it or working on it. I work on aircraft for a living, and sometimes I just want to punch the engineers who designed something in the face. Like a vent that has 20 screws, and every 2 screws have a slightly different length. (Not exaggerating). Or making an access panel so small I can’t fit my hand through it. Ah yes, I will install an autopilot roll servo through a hole that I can’t even fit the servo through. Forget square peg in a round hole, try fitting a large servo that is 5” at it’s smallest through a hole 4” wide. Any of these situations, if the engineers had just gone to a mechanic, would not happen, because the mechanic would explain that he is not a wizard, and cannot phase a servo THROUGH THE AIRCRAFT.
salute from a physician !
Just submitting a suggestion. Probably wrong. Just trying to help. Using commonly available cheap components.
1. Why not use a standard air compressor with filtered input to supply a bank of ventilators say 20 or more.
2. Route the air through a tank of temperature controlled water with a level control with an oxygen input with
a control valve coupled to an oxygen tank input and an internal fan to mix air and oxygen to a preset amount.
3. Moist oxygenated air is then made available to to the individual lines.
4. Wrap a strain gauge line around each patient. A control valve opens as the chest cavity expands via sensor with
a baffle so as not to abruptly change pressure. The prressue valve then opens until strain gauge feedback indicates lung capacity reached and then closed. A one way valve opens and expelled air is routed to a ulta violet treatment (standard component) and released to atmosphere. Negative pressure for exhalation is provided
via a control valve with a standard ulta violet lamp treatment and released to the atmosphere. As I said these are
all standard commonly available of components. And much more cost effiecient.
On it, we engineers are on a race. GrabCAD is offering 10000$ to the one Winner Design who achieve this goal, myself included trying to be the one as a mechanical engineer student, this is really exhalarating, i reached this becouse of it and thanks a lot it really was a punch in the brain. if someone would like to help me, reach out to me and we will form a team, the more we are the more probable of a good solution will be made. we can meet up online and try to come to a solution.
This is fucking great. Great work.
Add a variable clutch to the part that adds pressure to the bag. Tune it to activate at a certain psi. You can then put a sensor on the clutch that switches the in hailing to exhaling
mmmm I dunno a low cost ventelator does not have the monitoring and self regulation. Ppl have their lungs burst by those machines
Nevermind I found the info, thank you for keeping your video up in spite of pressure to do otherwise, it is really in keeping with the spirit of science for all
Great constructive criticism and bringing awareness to a problem.
Medtronic has even made available ALL the design and manufacturing documents and software for one of their older models, the PB 560. It seems to be a good move, because not only anybody can start producing the thing itself, engineers can probably get any idea or two from how the PB 560 operates.
good job! medical devices had been carefully studied and designed before operating, any new design should be based on a scientific and approved thesis and then can be used in hospitals regardless of a pandemic happened or not. thank you for your video and I hope you keep it up!
Thank you very much for the valuable information
I am trying to find a funder to manufacture this product line
Thanks for going to the next level of understanding ventilators. I can always count on learning something new with each video
I think the concerns raised about the BVM based ventilators are not accurate. I have made a video response to the concerns raised. Check it out below, I look forward to hearing all your comments and suggestions.
https://youtu.be/h0GnTkgKtZw
The Tesla ventilator looks very promising. It has the sensors and the processing power to do it properly. BTW a link to a news report about the Indian ventilator from Agva Healthcare: https://youtu.be/YfIhQ231S7g The cost works out about USD2K (INR 1.5lahks = R150,000).
They stopped exporting because we in Indian lack a good number of ventilators
This is the thing I was searching for. Nowadays everyone seems to built ventilators.
How about we just let the 80 year old fat smokers DIE, instead of wasting 1/2 mill $ on them, instead of giving a REAL education to a couple of young people?
Anyone else have a minor PTSD episode to that periodic beep from the medical equipment?
Polio machines would help.
Why not use a check valve to increase peek.
this video was necessary. Thank You <3
Plannedemic!
bru, I’m interning as a repair and servicing engineer at Medtronic, it CRAZY to hear my company out of nowhere!
Like others are saying, this is the definition of constructive criticism. Thank you
love how that first ventilator we see is called a Covidien
I joined a project of making emergency ventilators along with several professors and engineers of my uni. Needless to say, it’s waayyyy more, more harder than just creating a pump and breath apparatus. We even barely create one that works.
Here’s the video of the Indian engineer’s ventilator from a year ago..
https://youtu.be/IgAR4yWDsg0
take a look at oxvent = rapid collaboration of anaesstetists + BME PhDs at oxford. the only one which looks any good
8:37 As an electrical engineer let me chip in that it does NOT require ‘very fast microprocessors’. Pretty much the cheapest on the market would do. Neither would it be very complex of implementing the hardware. It is the software that is more complicated, but still not incredibly complex. There are however, two problems.
Firstly, the problem with microprocessors is that the software needs to be verified for life critical applications, because otherwise you are going to have a lawsuit on your hands if the device does something wrong that results in a patients death. Software is not easily verifiable if complex.
Next to this, the software needs to be fully tested before you can ever put it on a patient of course. How else are you going to know it is working? I assume in the industry they do this with simulators and maybe even live animals, but these testing cycles take long to fix and iron out problems and definitely out of reach for most people.
In my professional opinion it makes far more sense to turn out and scale up production of verified and tested designs already in use. But we all know how tightly arsed medical companies are about their intellectual property and letting others produce it.
Me personally wish there will be design of sterile bagging of open plan individual rooms. To be able to enclose individuals inside cloth roofs and walls or other material so that everything around each patient can get changed /sterilised when they leave that spot and possibly ozone inside that compartment and allow it to neutralise before the next patient enters.
The risk of handling that barrier will then be better. Ps … ozone tends to weaken plastics over continuous exposure over a long term.
I discovered last year in amongst a crowded area that isoproponal vapour kills unowned awful flatulence almost immediately ( not useful amongst sick people though )
As a doctor I really have to commend you guys on this excellent video. Factual, detailed and clearly presented, nice job
hello, this is really helpfull, now as a follow up could you make a video on how a actual ventilator works?
Thank you
Fantastic video. As always, you address each topic thoroughly and accessibly. Thank you sir!
I have a CPAP machine I have to use. I’m told that’s kinda half a ventilator.
From all health professional thanks you! You are awesome!
Hope they don’t make people die like the current ones.
Outstanding video. I didn’t realize how complex this was and this was a fascinating watch. Thanks for making it.
THANK YOU!!!!!! It’s nice to see that someone is actually paying attention to the facts.
The E-Vent analysis is not correct, it has pressure sensors and does not exclusively operate on a Mandatory Breath operation. More research should have been done by the channel before making such a claim. The design of the system is available online and such a mistake should not have taken place.
love how that first ventilator we see is called a Covidien
Thank you
Bro this Video made me love this channel more it was really very informative…. I was surprised by the fact that lot of people who do not possess the knowledge of medical equipments are making this ventilators but your video made it very clear that it’s not just a mechanical pump…. And also i want to know where are the sensors which detects the air pressure drop in the lungs located in the ventilator system… Also exactly before watching your video i was watching the Indian ventilator… I am from india
So I can’t make a ventilator using an IKEA drawer testing machine.
“this topic needs no introduction!” proceeds with introduction
Just a link to an open source well documented emergency ventilator from a danish university https://github.com/CoRescue for anyone not going for the too cheap stuff.
https://www.respiradores3d.es/
We are all in this together except for the US government. Unfortunately.
not so simple, is it?
Awful how the press is crying out for production as tho ventilators can be made by a toddler, when in fact a lot of these companies are just fraudulent/incompetent— thank you for informing me!
My former University has posted this “Recipe”. Approved by the Danish health authority:
https://github.com/CoRescue
CCP : *lets get some profits out of this pandemic*
As always – you are superb. Thank you for such thoroughly done research on a topic.
Is anyone really planing to mas produce those cheap ventilators? Horror!
what you need is ventilators that can handle more than one patient at a time independently. this means 500 menchies can teat 1,000 or even 2,000 patients at one time. That doesn’t fix the problem now but could in the future. It would really only take some hardware (CPU, pumps and connections) and software updates.
Grate work
I wonder why we can’t return to negative pressure machines? They would probably be cheaper and easier to convert machinery to/from. It’s basically a box and a vacuum pump.
More importantly, No Baro-Trauma and no esophageal damage.
And, yes, we have made negative pressure breathing aids before; like 1937 – 1960s. They were commonly known as Iron Lungs.
THIS IS IMPORTANT! PLEASE READ.
A Danish University has developed an emergency ventilator and it’s all open source.
The idea with this emergency ventilator is keeping people alive, its not quiet as sophisticated as the big expensive one. It is approved in the Danish health system as an emergency ventilator. It costs about a tenth to build this thing (40000kr = 6000 $)
It’s made of easy normal industrial things, so it should be easy to get hold of the parts.
In the article below (In Danish) they actually describe it as “very, very robust. You can drag it over a field and it will still work”.
It’s all free, no money involved.
I do hope you find this worthy to show in your channel. To get the message spread.
Link to article from Danish national broadcasting (Danmarks Radio), is in Danish, sry. https://www.dr.dk/nyheder/regionale/nordjylland/danske-forskere-har-brugt-blot-14-dage-paa-lave-en-simpel-respirator
Link to github: https://github.com/CoRescue (English)
Hope you will help spreading this around the world, as I see it this thingy can save lives.
Keep up your good work
A quick comment for YT algorithm ! Great video as always !
bru, I’m interning as a repair and servicing engineer at Medtronic, it CRAZY to hear my company out of nowhere!
you damn legend
VITAMIN C TO WUHAN: China Using Vitamin C against COVID http://orthomolecular.org/resources/omns/v16n13.shtml http://orthomolecular.org/resources/omns/index.shtml
I have a autopap device that I use to help me sleep every night. It seems to have a lot of the functions mentioned in your video. Could one of these be modified to be a ventilator?
Thank you for the information. It will really help my design process.
I would like to get your permission to translate your video to spanish and add subtitles to it. We are designing a blower ventilator with our own electronics in Ecuador for covid patients. We are trying to build awareness about the risk a DIY ambu ventilator might be.
I believe AvE’s design attempts to deal with peak pressure, PEEP, making sure the lungs don’t get overprsssurized. He’s had 3 iterations so far, doesn’t claim that it will work, but that it might be better than nothing, and has taken constructive criticism about his designs.
I am glad my brain called bullshit on those designs…I was thinking “if that was the case, why don’t they just have people on call pumping it by hand?”
raspberri pi for microprocessor.. get with it engineers.
Very clear, thanks.
Progress on COVID-19 treatment now points away from mechanical breathing being a good option. Turns out that it is more of a blood disease and not a respiratory one (AMS, altitude sickness, hypoxia). The blood is showing hemolyzation and Low O2 before pneumonia. Patients with moderate infections can show disseminated intravascular coagulation.
I have been wondering if the “iron lung” implementation of the Polio days might work more reliably or better? Trying to support the natural inhale/exhale process instead of pushing gas in which apparently requires the sedation. And — what happened to those “iron lungs” after the polio was conquered? Probably all of them sold to scrap…
I was hoping, you’d show Tesla’s approach to building a ventilator as an opposing example
It looks like Tesla has a rigorous ventilator design using car parts.
Huge props and respect on your channel.
Can you comment on the NYT story about Medtronic/Covidien burying the Newport Medical inexpensive ventilator project? Interesting that you are a former company employee and have some knowledge specifically of ventilator manufacture. Hope you can shed light on the feasibility of the project, and whether it was indeed buried, abandoned, or tested and found unachievable.
Please ask the Doctor
What portion of COVID-19 patients benefit by CPAP alone?
There is too much focus on ventilators. Ventilators are the hospice of this pandemic and are only keeping 16% of the people who need them alive through to recovery. There needs to be more focus on treating people before they get to the point of needing a ventilator.
The tittle is misleading… Not helping, at all… Maybe, one reason pandemic related videos got demonetized…
great!! but why was the chest x ray held upside down!!??
The infection must be stopped! Not pressing air into infected aveloi! High-dose Vitamin C ist the solution:
http://orthomolecular.org/resources/omns/index.shtml
50 TONS OF VITAMIN C TO WUHAN: China Using Vitamin C against COVID http://orthomolecular.org/resources/omns/v16n13.shtml
http://orthomolecular.org/resources/omns/index.shtml
https://www.anonymousnews.ru/2020/03/18/china-coronavirus-vitamin-c-covid/
https://vitamincfoundation.com/forum/index.php
08oo.wordpress.com/2020/03/23/unterdrueckte-heilung-des-coronavirus-covid-19/
Keep away from hospitals. They will kill you.
Brian, it’s good to see your coverage of AgVa Healthcare’s full-featured, low-cost, smartphone-controlled ventilator. Using ~$50,000 units as a baseline, a Grade A if you will, AgVa’s device range appear to be really good Grade B units.
AgVa have stuck an interesting partnership with Maruti Suzuki wherein the latter will provide it’s engineering, manufacturing, supply chain and logistics expertise and manpower to assist in rapidly ramping production to address the immediate ventilator shortage. Licensing their technology is another positive step.
Beyond that, a team from Cambridge University and Kings College have created a very promising Grade C design that would be suitable during the initial emergency period referenced in which the patient is fully sedated. The oxvent (oxvent.org) is an Arduino-controlled, BVM bladder-based solution with settings for frequency, volume and pressure. This design doesn’t rely on motors, gears, levers, linkages, etc. Instead, the BMV bladder is suspended in a sealed chamber into which compressed is supplied/exhausted to squeeze the bladder.
Made of readily available, off-the-shelf components, costing less than $100 and requiring only minutes to assemble, the oxvent could be a game changer in emergency settings. As with AgVa in India, the NHS are working closely with the team to deploy this solution.
Lastly, a team coordinated by 3D printing service provider Materialise are developing a non-invasive PEEP connector as an alternative to mechanical ventilation where appropriate. This device connects an oxygen supply with a PEEP valve, a filter and a mask. Information on this innovation is here: t.ly/lZdrq
Thanks for the excellent video on a complex subject and for your contribution addressing the coronavirus pandemic.
@John Coloe oh ok that clears my doubt , i will check out that ARMEE one , i feel that in such lockdown situation every engineer should brainstorm in creating such life saving equipments
@saurabh_k_ Different patients require different levels of treatment. The idea of having various graded if equipment allows the proper machine to be employed to address specific patient requirements.
Additionally, the low-cost, easy and fast to manufacture designs can fill the gap while awaiting the arrival of units will a longer delivery timeframe.
It could mean the difference between having ventilators, or not, in which case people will die. It may mean that some patients may suffer some barotrauma that the more expensive machines might have prevented, but their lives could be saved.
Another promising initiative I just came across is resurrecting a 1965 Army design that goes by the acronym ARMEE.
@John Coloe thanks , that was a pretty nice explanation . As you mentioned about the feature wise grades, can you tell me which features are required for the covid-19 patients ? and does grade b and c have them ?
@saurabh_k_ Surely, “Grade A” is meant to indicate the most feature-rich (and most expensive) devices, such as those described in the video by Dr. Robin Francis.
“Grade B”, then, is meant to indicate a device of some lesser capability, though, any limitations are by design to comport with some set of market requirements. In the case of AgVa’s ventilators, firstly, these are in a “good, better, best” range, and have pricing to match. Secondly, it’s all about suitability for purpose. A less feature-rich device may suffice at various points along a treatment regimen. If this were to the case, the most expensive, high-end ventilators could be freed up for patients who need some specific feature, while others’ needs could be easily met with one of AgVa’s devices that are much less expensive, as well as easier and quicker to manufacture.
“Grade C” devices would be used in emergency situations, as well as in the event of ventilator unavailability. In these cases, saving lives takes precedence.
As for AgVa’s devices, while medical oxygen isn’t _required,_ it is supported.
can you explain grade a,b,c that you mentioned , also are there any drawbacks to agva ventilator as theyre not connected to o2 cylinders and portable too
Amazing video. You explained the mechanical and biological mechanisms behind COVID-19 ventilators clearly, and in just the right amount of detail. I practically never “thumb up” a video but this more than deserved one.
I’m a long time subscriber and it appears you learned a lot from your recent discussion post. This is the type of content that got me to click that subscribe button all those years ago. Thank you for the great video.
There are/were ventilators that work with negative pressure (outside the patient). Those are called iron lung and are kind of outdated. However it might be possible to bring those designs back as a ventilator alternative that is less harmfull to the lungs. However weening patients of that might be even harder than of a basic ventilator.
How about making one using that wafting pc cooler & a corkscrew instead of the complicated motor system
I have a B-PAP machine to help me sleep. I wonder if something like that would be useful for people who aren’t bad enough to need a tube in the throat, but could still benefit from having air pushed in (gently). If it does (and I have NO idea if it would) it might alleviate some of the need for ventilators.
🔥🔥 12:00 For training clinicians with no previous experience with ventilators (or lung ultrasound scans), there are 2 free courses at MedCram that address this issue: https://www.medcram.com/collections?category=covid-19-SARS-CoV-2
I understand a video tutorial is probably not ideal, but it’s still better than nothing.
Very valuable advice. Well spoken. 👍👍👍
Thank you for this! Well said and much needed.
excellent vid. thanks.
MIT´s e-vent does have “volume control” AND “assist control” modes. Excellent video by the way. MIT developed AGC, the computer that took humans to the moon, maybe they are capable of developing a functional ventilator.
Medtronic has opened up its design: https://techcrunch.com/2020/03/30/medtronic-is-sharing-its-portable-ventilator-design-specifications-and-code-for-free-to-all/
Please make a video on aero spike engine…
Not long ago people used to move to iphones because android was crashing too often and now you want to trust it to keep someone breathing. Nice
Nice video.
For me as mech engineer working in medical world for 10 years looks good and useful.
Thanks
Great Video, thanks for sharing…
Why is there not something like a dialysis machine used for lung bypass?
Question:
From what I am hearing here;
-the BVM style that people are making is low cost.
-they also don’t provide the pressure and rate controls required
-many of them (besides the straight circular motor styles I am seeing) seem to be designed with servos, which I would assume have a position feedback and accept an analog signal (4-20, 2-10, etc).
So, my question is, what is stopping someone from adding the sensors to the end air output and completing an automated loop?
Just as a shoot from the hip example;
-trigger the stroke off of a drop in pressure (from the breath in).
-then, either the length of stroke or an analog controlled vent valve could regulate the volume given off of the pressure increase.
A PLC or other controller capable big digital and analog I/O could handle this complete loop. Design wise, given the output parameters needed, it seems just as doable as any other closed loop control system. It may not be AS cheap as some of the BVM compressors are, but still a viable possibility in a pandemic. Just throwing it out there, to anyone who has access to the answers to the end user specs.
Totally doable, infact many or doing this right now.
Indian railways developed a low cost ventilator and added some sensors and their machine has been approved by ICMR top medical body in India handling this crisis.
Big corporates have capabilities they just need some will.
Any thoughts you on have free radicals and destructive 02 on lung tissue in humidification systems in the 02 feed input present in modern high end vents would be appreciated, Awesome video thanks. PEEP is hard to DIY build but possible, a good PEEP system I would say impossible but someone will no doubt prove me wrong the amount of collaboration and innovation being unleashed against COV2 is awe inspiring ,however I did not realise people were actually making BAROTRAUMA euthanasia machines in so much abundance, I am little disappointing in Virgin.
bollocks
Very good! I’m going to translate the subtitles to brazilian portuguese.
People can do the same to another languages.
Thank you!
This turned out great!
Here, my very cheap version – with most of required features same time
https://www.youtube.com/watch?v=gHQG8CW-Rgg
@Joanna yea, i know, i tried to emphasize on seriousness of these things and that they should not be miss used 🙁
shots/2020/04/02/826105278/ventilators-are-no-panacea-for-critically-ill-covid-19-patients And they have a troubling history of being misused, especially in the treatment of
Don’t capitulate to Corporate bullying. Keep this video up, stuff like this is needed.
love u real engineering
33k vs 257
1000:1
perfectly balanced just like everything
I think maybe it’s matter of setting a more realistic goal, I don’t see these DIY devices replacing the ones on the ICUs anytime soon (they’d need to get intensive testing, overcome legal issues, get permissions, etc.) but instead being used at patients’ homes, when they start having the first symptoms of respiratory problems they could use them coupled with an oxymeter to raise their oxygen and lower carbon dioxide levels, but if it doesn’t work they’d need to get to an hospital and be treated with a profesional certified machine operated by trained and experienced professionals.
A CPAP machine notices when you breath by flow… And could be programed for a respirator… It’s not about cheap as much as options for different levels of breath assistance, so that they aren’t getting so exhausted as to need ventilators.
CPAP and bypap machines also have humidity control and you could easily add an o2 sensor and o2 flow control pretty simple there…
So far the only team/company I saw implementing this is Tesla. But I don’t think that their design is low cost though.
By today’s standards, the microprocessors used to detect triggers do not need to be particularly fast.
Thanks man
This video is going to blow up because of all the charlatans making “ventilators” that are no use to anybody. It’s just PR.
Thanks 😊
Why is the chest X-ray upside down ? 😂
since you like to dish out critasism without coming up with any alternatives yourself, here’s some critasism if your video. You say “every single design I’ve come across uses BVMs”
You obviously have done much research because plenty of designs I’ve found don’t use BVMs but rather use compressed air. That was a day or two after your video.
You say “They would likely do more harm than good” Well if a patient is exhausted can no longer breathe at all some mechanical breathing would be better than none because none would equal death so unless these ventilators harm them in the afterlife they can’t do more harm than the death the are already facing.
You say they don’t incorporate PEEP when I’ve found plenty that do using a simpler tube and bucket of water.
You explain how vital it is to have moisture but how does that small Indian device that you recommended add moisture?
You’re tearing down others without doing enough research and without coming up with any alternatives (oh yeah besides the one from India that we can’t get). Instead make a video of all the good diy ventilator that use circuit boards and pressure valves and PEEP and then criticize those INCLUDING possible ideas to improve them.
All this video is you tearing down good people’s work, bringing nothing to the table, AND profiting from it at that with sponsorships and medical device company’s that you happen to leave near. Looks like a giant advertisement to me.
****Please read and answer****
For controlling the airflow rate could you generate a sound wave with a specific wave attribute and turn that to electricity like a speaker does and control the flow of electricity by that sound wave? if possible it solves the airflow rate and humidification could be solved by passing the air through a water container or using the mechanism in a cigar humidifier to inject humidity to the airflow.
Thank you so much Real Engineering. This was the most informative and very much motivating on how people can give in their part by first doing their research right so that the effort doesn’t go to waste during these crucial times.
Great vid have shared but 3:12 is an upside down chest X-ray and 2:40 is some terrible bagging
https://en.wikipedia.org/wiki/Nonthermal_plasma
https://www.youtube.com/watch?v=vDcQhkt3-L0
https://www.youtube.com/watch?v=GLzjJNhMgwU
https://news.umich.edu/cold-plasma-can-kill-99-9-of-airborne-viruses-u-m-study-shows/
https://www.youtube.com/watch?v=VquomoGn4zk
That immediate dip into advertising Brilliant was a jarring end to a fantastic video.
I’ve recently started wondering about the use of ventilators, especially amongst the elderly. They’re not just a benign treatment. Here’s an article from the Washington Post recently:
https://www.washingtonpost.com/health/2020/04/03/coronavirus-survivors-recovery/
And they’re not very effective either:
https://www.npr.org/sections/health-shots/2020/04/02/826105278/ventilators-are-no-panacea-for-critically-ill-covid-19-patients
And they have a troubling history of being misused, especially in the treatment of patients with dementia:
https://www.reuters.com/article/us-health-dementia-ventilators/ventilator-use-surges-for-nursing-home-residents-with-dementia-idUSKCN12A29M
Tell your family not to put you on one of these!
I think the Tesla design I saw takes this into account, it would be interesting to hear your take
What do you think of Tesla trying to make Ventilators?
A very much needed video on the awareness of the covid19 outbreak. learned so much from this video from your channel as usual.
Mercedes are producing 10k simple(their size) ventilators, are they implementing their design shown in this video? @real engineering
I am starting a science and engineering channel my first video will be up soon I will comment on my comment when it is up, if you would like to subscribe please do
Oh so many problem… i have have difficulty breathing as i watch this 😭
Ignore any criticism, your always on point and educating the general public about how these machines need to work will help massively. Now is not the time for gimmicks or hollow words. Keep up the great work as always, fact over fiction every time.
breathing mode : manual
Thank you. This was very interesting.
As a doctor with 1.5 years of ICU experience right now, I sincerely thank you for this clear explanation. The fact that you also took the time to bring in an expert and explain the medical side of the story is respectful and can hopefully explain things even better to citizens. Thank you for this effort!
So could an electrode be placed over the diaphragm and hooked up to an arduino or raspberry pi type microcomputer to control one of the cheap variable volume/speed ventilators? Those are only around $20-$50
Interesting video. BTW, the CXR beginning at 3:11 is upside down (rotated 180 degrees).
What is your opinion on AVE’s channel version 2?
How about CPAP plus surfactant replacement therapy like for premies?
Why can’t APAP/CPAP machines be used for the less critical or in case of a shortage of ventilators? When my APAP machine acts up, it puts out an extremme amount of pressure which then drops, at a regular breathing pace.
Thanks for calling out Virgin Orbit for their PR gimmick
Fantastic video. You can’t solve the problem until you understand its parameters. It was good to see the collaboration with MedLife Crisis as well. JB
Very important info. Thank you
Virgin AND YouTube… Disgusting companies…
the efforts done by engineers to make cheap & fast ventilators or “bag squeezers” as you put it,really immoral of you to make an example of engineering failure by taking clips of someone doing their best to offer an alternative to death when there are no proper ventilators available , everyone knows they are the last resort option,what is the fast alternative to death you offered in the video ?, these things can NOT do more harm than good because they are only used instead of death ,if these machines end up not working on 99999 people and saving 1 human life then its all worth it , and far more important than your video which offers nothing new to anyone working on this, only entertainment , its’ only message is “look everyone i am smarter than engineers working on this, just wait people …someday some company will solve this for us..dont know when but soon”
This is an awesome video. More people need to see this!
Nice explanation..Thank you
God,
Hasn’t ANYBODY ever heard of Nitinol ?
Have you seen the Mercedes model? What do you think about it?
Thanks for the information, I’m trying to develop a low cost fan here in Brazil, South America
good job sir, thank you very much !!
Engineered crisis, no pandemic. Shame engineering doesn’t teach you to think for yourself.
Tesla released a video of their ventilator design, please please please do a follow-up?
no one:
Fabius Tiro: *beep*
Clearly explained. I was attempting to make my own design, and after many talks with specialist I’ve realized that it is not just a “pump”. Even without these consultations I’ve realized that some designs is closer to heavy construction machine tires pumps, than a precisions medical stuff.
This is a DAMN good video with very well done research. !!!!!
I have seen all of these DIY videos., I thought the same thing. All of these BAGs will not work.
Options are SIMV or Asstist Control. and Volume Control or Pressure control. Sedation, PEEP, Rate, i:e ratio, etc. You need to consider ARDS and pathology. A BVM cannot do this.
You are soo right. They are so much missing the boat …. Virgin and Tesla. All BS videos for PR.
My school is doing this right now!
Do a video on the US hospital ships!! I would love to see your take on it
Any thoughts on the new Tesla Ventilator??
Positive
Thank you @real Engineering for bringing light to some important topics on Ventilation Design. I was thinking the same, if designing of ventilation was so simple then why would industries design such a complex machine.
I was wondering if you could do a video on the engineering of the planes that can do the cobra maneuver
I would be interested to understand, what kind of ventilators is the Chrysler company going to build, after they were pushed to change their production by Trumps law?
why werent teslas ventilators mentioned?
good info, actually to design a ventilator, atleast a details of what is required to the end user is needed which your video has done reasonable justice, thank you.
“Needs no introduction” : *proceed to introduce*
That is called an attention catcher
Recently watched a video by AvE where he cobbled together a ventilator concept that could integrate oxygen out of common, cheap, off the shelf parts
I have a bipap machine that seems pretty fancy. I am wondering if it could be used or modified to be used as a ventilator.
Thoughts on whether or not the Tesla built ventilator will be able to adequately function as a ventilator?
well done
@realEngineering take a look on the one projected by the USP (University of Sao Paulo) it was made by a Brazilian group and seems to be easy to manufacture and low cost
A student team of the Dutch Technical University Delft is working on developing a safe and relatively easy producible ventilator that can be used when a shortage occurs due to the coronavirus pandemic. The first protoype is currently under review of the government to get autorization for clinical tests. The clinically approved design will be publicly available on the website, so other countries can make use of it as well.. https://www.operationair.org/en
Fantastic, thank you! As a part of a large multinational MedTech company that is in contact with and supporting many of these initiatives around the globe, please spread the word that they ALSO need to be concerned about the expiratory valves as a source of contamination for healthcare workers. As you said, they are a more precious resource in this fight than the equipment, and without proper engineering controls these makeshift machines can turn into COVID sprinklers. Traditional ICU ventilators address this issue with filters that connect to the patient circuits, e.g. HMEFs (protecting the machine and healthcare workers, as well as future patients from cross-contamination), and/or connect to the expiratory valve of the ventilator (protects healthcare workers). These consumable medical devices are standard of care and available through dozens of manufacturers – including all the major ventilator manufacturers, as well as several specialized MedTech manufacturers such the company I work for – but our supply chains are stretched to support the scale up of traditional ventilators, so any help these initiatives can receive to help mitigate the problem in novel ways would be amazing.
Absolutely amazing! Thank you very much for taking the time to make this.
Then why do doctors use the manual ventilator
Because when no automatic ventilators are readily available (which is the case in the current situation), slightly damaging the lungs is still better than a nasty case of the deads.
Then, patients weened off artificial breathings free up a machine, which can be used to ventilate a patient who was previously using a manual ventilator.
You sound like some F&$#+& punks trying to hold people back on coming up with anything that can help
https://youtu.be/IgAR4yWDsg0. The portable indian ventilator mentioned in the end
Thank you for a fantastic video. As an experienced EMT, I have also been wondering how a BVM with a basic motor drive and no sensors could ventilate a patient for days without injuring the patient.
In addition to the inability to modulate the pressure, volume, and timing of the ventilations to match changes in the patient’s requirements, newly designed devices are prone to failure, exspecially when rushed into service. Without proper testing cycles, simple failure of the devices could contribute to the harm they do.
Thank you for leaving this video up, lots good info that the regular person doesnt realize about ventilators, hopefully this will spur someone to create an ingenious cheap solution correctly!
I talked to a nurse about an idea I had and he brought up a big component you kind of under emphasized: medical professionals need numbers in order to make decisions on what care to give. You can use something as simple as a scuba regulator combined with a constant PEEP if all you need to do is provide air. However, you need the $30k ventilator to provide the data to understand what configuration of pressures/ airflow to use.
I wonder if the tesla ventilator is smarter than this?
it is really annoying seeing that all those tech start-ups don’t take the required steps of R in their respirator R&D! No one cares if “insert_company_name” wants to put their name all over twitter. From now on, I want every CEO to try their homebuilt respirators in public for 5 minutes before they ship them.
The design you’re talking about sounds very similar to a CPAP machine.
After all of this, I have a feeling that when anyone have successfully created a cheap and effective ventilator design it would be a lot of beneficial to the rest of the world after the pandemic. Imagine having the most remote hospital or medical facilities from a poor country acquiring ventilators because there is already a cheap option available for them to use.
3:15 why are people looking at an upside-down chest xray?
Here’s a mass ventilator project but by people who actually know what they’re doing: http://massventil.org/en/massventil-project/
*YOUR BREATHING IS SET TO MANUAL*
Was this video censored or something? I didn’t see it in my feed
Hi there, great video. Consider a follow up with discussion on high frequency oscillatory ventilation, Which has been used in ARDS patients successfully, though we are still trying to figure out which conditions are best models for the lung injury and respiratory failure observed in covid. Just a thought. Great work.
An Indian engineer developed a pocket ventilator years ago, priced at ~170$
Sir Donald Trump, i salute
i haven’t seen hospital ships since the documentaries of the second world war, and these are super freighters! if it wasn’t for this pandemic i’d be gushing over the idea of exploring such a cool super-ship! i can imagine small fleets of frigates or coast guard ships escorting those beautiful floating mobile hospitals! (sry i cant help it, medical background)
We need more bagpipe players in the world
https://www.youtube.com/watch?v=zZbDg24dfN0
Yes! This is the content I want to see
12:37 “Will come to light soon”
Next day: Tesla😃 https://youtu.be/zZbDg24dfN0
A better person to talk to would be a respiratory therapist….
Compelling presentation. This is a brilliant contribution at an optimum moment.
Hi awesome video, thanks for details information , i myself working on the ventilator and it is very helpful in understanding working of ventilator
I luve your irish accent !
I’ve built one at home using an aerator (air pump for fish tanks) and modified gas and water valves to get the PEEP between 1-10cm H2O and limit the pressure between 20-40 cm H2O. If you wish to check it, below is the link to my YouTube post. Pls mind it is in my native language, but you should be able to guess what I speak.
https://youtu.be/zH8lHUFjkVM
Take a look at Prof. Diwakar Vaish (@diwakarvaish): https://twitter.com/diwakarvaish?s=09.
He’s the founder of the Indian company that designed that cheap , portable and fully functional ventilator. You could contact him for more questions . The most basic version of their ventilator costs less than 300 dollars , while a top of line ICU ventilator costs about 2000 dollars . They were having trouble sourcing components recently and if your someone in the business of electronics , help would be appreciated .
Your home town is called “Go away”? That is amazing!
eu amo demais um canal HAHAHAH fiquei na pira de estudar controle de pressão agora usando ventoinhas de computador.
I’d be interested in a serious video about PPEs and what makes a good one or a bad one. Lots of people are making DIY masks and I’d be reassured to know what an engineer recommends.
Please make a content about the development of V1 and V2 racket by Nazi.
Due to my background, I am more than qualified to design low cost ventilators. I have a strong history of designing products that use microprocessors and microcontrollers. For example, back in the 80’s, I designed the first American commercial SONAR unit that used a color LCD.
Anyhow, when COVID-19 started infecting people, I read about ventilators and watched instructional videos about them… volume, pressure, CPAP, BIPAP, etc…. I consumed all information about ventilators that I could get.
Since I am an Apple person, I would use an iPad for the user interface OR a 7” or larger touchscreen connected to a Raspberry Pi 3 or 4. No Android. Yes Android is cheap, but they have too many security issues to be trusted in life or death situations.
One of the most important factors no one seems to have talked about yet in ventilators, is redundancy. To oversimplify things, a ventilator can be viewed as a series of valves all working together in synchronization. Almost like a conductor conducting a symphony.
Back to redundancy… redundancy is needed with the sensors. These sensors can mean the difference between life and death for a patient. No one should die because a sensor fails. Same thing for valves. Valves are mechanical and can fail. So redundant valves are also needed. This also means twice as many sensors and valves are needed…. so immediately doubling the supply requirements for those.
A low cost system can be built with redundant Raspberry Pi’s. This is so that if one Raspberry Pi fails (overheating, etc…), the other Raspberry Pi can takeover and send and emergency failure notice. Raspberry Pi’s also have an Ethernet connection so they can be attached and monitored on a network. Raspberry Pi’s also have a GPIO (General Purpose Input/Output) connector that can be used to interface (with simple circuitry) to the sensors and halves.
What would a low cost ventilator consist of? #1 – Medical grade tubes and valves. A small air compressor… the kind that can fit in a shoebox. A minimum humidifier and water tank (with redundant water level sensors) or a connection to a water source. The water should be filtered. That means a water purifying filter. The software can be written, or ported from existing ventilators. Of course the two Raspberry Pi’s mentioned above. An Uninterrupted Power Supply (big battery with inverter) world also be needed … mostly to power the air compressor and valves. The Raspberry Pi’s use very little power and an iPad has it’s own battery.
That leaves two main problems: parts and trained personnel.
Parts – This is medical grade equipment. Especially the tubing going into a patient’s throat. No one should be subjected to a brand new tube if it gives off toxic fumes that make breathing difficult. It also needs to be sterile. That means UV light or chemicals in liquid or gas form. 3D printers can be used to make parts…. but… they… are… slow.
Training – Training people how to adjust the ventilators. One incorrect setting can literally kill a patient.
Believe me when I say I have put a LOT of thought into this during the past few weeks. It can be done… the biggest challenge is obtaining and/or making the parts.
Is there a way you can send me the script of this video??? I’m from Paraguay and we only have 700 beds of ICU in the whole country, and 80% of those beds are already occupied by other type of patients, we are 7.000.000 people, currently we’re working on low cost respirators, and I need to show this information to our engineers and policy makers asap.
Therefore, I need to translate your script, I’m a lawyer so that makes more vital for me to have your script since I don’t have the knowledge for others to believe me.
Great video, I learned a lot.
Great video. Good explanation about a topic which balances the need for expertise in the industry together with detailing how stuff works.
Here you have the answer: https://www.corovent.com/
Great video, and cleary an area you are familiar with. Nothing about project pitlane?
Thank god for this video. Some of those home ventilator designs were scarring me.
I’m in ICU doc in Boston and a biomedical engineer. thanks for posting this, it’s the first video on vent design that starts to get it right
Would an iron lung design be useful? It doesn’t work with PPV.
You should check out the Tesla ventilator
thank you so much
What have you studied ?
Look at the AgVa ventilator which runs with a smartphone. An amazing design from Indian neurosurgeon and robotics engineer. Agvahealthcare.com
meanwhile china selling respiarators to EU and do huge pr stunt but then doctors say they are worthless
Tesla is doing a really good job then, https://www.youtube.com/watch?v=zZbDg24dfN0 they are using their existing parts(like touchscreen, infotainment computer & vehicle controller) & have taken almost everything mentioned into account.
True
Great video. I’m a respiratory therapist and you hit on so many crucial points. There is one critical one you left out though: Triage.
We’re focusing on building vents for COVID patients — but that’s only a subset of all of the people who need vents in a hospital. Most of them don’t need +14 of PEEP or APRV. They’re on basic settings.
I need a basic vent so I can triage my equipment. Give me a bunch of Servo 900s for the PACU and I can save all my PB 980s for my ARDS patients. Build me a quick, cheap vent that meets the needs of the bottom half of my ICU and I can use the gee-whiz vents I already have for the worst half.
At 9:35, you can actually see the Real Engineering logo to the right of Dr. Rohin Francis head.
Excellent and useful video for refining the current maker level designs. Thanks for this!
Iorn lung
That Indian startup’s ventilator costs around $800 but the bulky ones shown in this video costs above $8000. Watch this video to know more about it… https://youtu.be/IgAR4yWDsg0
There are increasing reports from doctors that ventilation does more harm than good, because inflamed lung tissue can’t take the oxygen at the pressure delivered by the machine! Symptoms indicate the disease is closer to altitude sickness instead of typical ARDS and providing oxygen through a mask would help instead.
Here you have the answer: https://www.corovent.com/
I went and looked at the Virgin Orbit ventilator after this video, and it looks nothing like it did in that announcement. Looks like they worked on it some more
Biomed engineer here and you have no idea how people hate me because I’ve been against those devices from the beginning. Thanks for a great video!!! I will share it everywhere.
Smarter every day was also building the mechanical ventilator..
Wouldn’t an iron lung solves all the problems? Simple, effective, kept people alive for decades in their own home. https://en.wikipedia.org/wiki/Iron_lung
can you render your videos in 4k
Call them out boy!
Finally something I love Real Engineering for 🥰
Question, cause I’m no doctor. A patient needing ventilation assistance, are they always unconscious? You mention the “mandatory breath”. If a patient is or could be conscious during portions of the required ventilation could these machines be triggered by the patient themselves? I know from time to time I certainly consciously take a big breath and also consciously slow my breathing, even though for the most part breathing is a subconscious act. Just throwing it out there.
Have you seen the Tesla one? I think this one is a proper ventilation system
In USA very hard to find to talk to doctor.
Doctor always busy to talk to inventor engineer etc.
Before change situation as it today. Nothing will help
11:46 🙂
Is there any way to bypass the lungs and use oxygenated fluids directly into the bloodstream? I know liquid breathing has been studied for some time now and there are chemicals like perflurocarbons that can bind oxygen – yet are smaller than red blood cells so the molecules can get past blockages. (simple overview: https://en.wikipedia.org/wiki/Liquid_breathing) Of course this won’t be any sort of panacea – but the concept has been around for a few decades now – there has to be some way it can help.
can a c-pap machine be adapted for use?
What if there was a two bag system that worked in phase to ensure that there is a phase difference in the output of the air pressure to compensate for the PEEP issue?
It came from C H I N A
Does this faker do any engineering or he just click baits?
Person at 8:40 has a death wish. Scratching their mask *screams internally*.
What about iron lung technology? Those things were purely mechanical, fixed step ventilators working on vacuum arround the whole thorax.
I mean, it basically takes a Barrel, some gaskets, pressure switches and something like a vacuum cleaner to produce the negative Pressure. This is definitely easier to construct.
I already thought of this idea as well. Might be worth investigating. It surely has some disadvantages to modern positive pressure ventilation, but may be a better Option than these Ambu-Bag DIY Ventilators.
You have mentioned state of the art Ventilator that has thousands of parts which unfortunately, after all these years, cannot be mass produced. You said your old firm can only ramp up to produce 500 units/week, the entire China can only produce 2200 units a week according to news. That’s life. You have also mentioned garage-graded ventilator which probably does more harm than good at the moment. What about other noninvasive ventilators such as Continuous Positive Airwave Pressure (CPAP) or PEEP, which can be mass produced and perhaps more affordable?
What are the keys the machine looks for to adjust ventilation? Question. Can they inhale, and how much can they inhale?
Why google demonitized this?????????
How many people who require ventilators end up recovering?
I don’t really understand how to build ventilators, the sensors, coding, calculations, valves are all perplexing, I do have 5 3D printers I don’t really know what to do with right now, more of a CNC building/fixing person, not a biomedical/mechanical designer or marketing person even though I should focus on making money at this point of my life, if anyone knows what I should be doing, feel free to point me in a direction, thanks
I just want to say the Medtronic already keep mes alive 24/7. They deliver insulin to me, which has kept me alive ( I am a T1D, and an engineer, btw).
i would trust them over some crazy PR stunt – just me saying as a person who already relies on medtronic.
Hey, what do you think about using Helmet based ventilation? It basically removes every problem that you talked about. I also would like to know how intensive is its consumption of oxygen compared to traditional ones?
Why not just giving oxigen to the patient? perhaps it is not so helpful but it is better than nothing. If patient can still breathe by himself, oxigen will help to reduce the effort by increasing the gas exchange in the alveoli that still work. It can be even generated from electrolysis if there are no oxigen tanks.
Could we bring back the old iron lungs?
Great Video during this needy days/weeks/probably a month or two. It presents a great inputs for someone not so much into medical developing a ventilator for the current crisis. Key takeaway are 1. Ambu Bag mechanization cannot have a CPAP. and 2. It can only force someone to breathe at its own cycle not the patient’s natural one. 3. More controls like Humidification and Oxygen demand over natural is not possible.
I think 2. can be taken care by intelligently using a pressure sensor.
What do you think about the Tesla Ventilator? It has sensors to measure and adjust flowrate, pressure, and etc.
Just get a plumber or a car mechanic to fix your problem.
Thank you for this crucial information.
Wonder if it would be easier to oxidize the blood. I was also wondering If 132 degrees kills this virus why are we not putting patients under for a minute and raising their lung temperature to 132 degrees for that minute? That’s not hot enough to damage the lungs at all. Some of these saunas get hotter than that. So does that temperature really kill this virus or not? I’ll tell you my story. Last week I started having severe lung issues but it could have been bronchitis although I haven’t had bronchitis it 8 years. I was really having a hard time breathing and I could not get nothing out. Out of desperation I took a countertop steamer filled it up and stepped back about 2 to 3 ft. put a towel over my head and let the steam bounce off my chest and I breathe it in. I did it three times at five minute intervals. Other words I breathed the steam in for 5 minutes took a break and did it again a total of three times. I’m not going to lie it didn’t immediately get better however my little finger oxygen monitor raised from 85 to 96%. The next day the breathing started getting a little easier. My oxygen monitor was steady between 96 and 98%. On the second day I was breathing easy again. I would love to say that is help me with the corona 19 virus. Unfortunately I can’t because I don’t know how to get a test to see if I even had it or if I just had some other issue. However if you’re having bronchitis I know this helps. it’s not a surprise though we’ve been using steam for years. I took the hottest temperatures as I could take. I simply adjusted the temperature by backing up or moving closer.
*talks about how breathing works*
manual breathing activated
why aren’t we delivering this right now? we could deliver this triggering system with trivial ml on data collected from the pacients on ventilators now (even if we there is no data available now) basically we need to measure or the eletrical charge from the intercostal and diafragm muscles, or somekind of initial more sensitive change in positive or negative pressure, signing the will to expire or inspire
Had planned to watch the video later but that got pushed forward when virgin orbit started to cry. They are a danger to others and probably don’t care that they got it wrong
I am glad someone has finally made a video that explained some additional information about ventilators. I wish there was a video that explains more specifics, so that qualified engineers can try to design and create a ventilator that meets the required specifications.
(i.e. Positive Pressure range, Humidity control, Sensor levels for correct state detection, etc)
Why not use manual ambubag to patient whose under weaning and patient with no spontaneous breathing?
Then a regular monitoring of SPO2 shall be made to sustain the need… a continous physical assessment by the nurse is vital to this design….
Richard Branson is mad.
“A topic that needs no introduction” *introduces topic*
Awesome video! Another way to understand the equalizing pressure of the external pressure to the lung and the internal pressure applied by the respirator is to look at how a regulator on a s.c.u.b.a. Breathing equipment works. Trying to breath under water with a very long pipe as you get deeper in the water is a very nice way to experience first hand what happen if there is an imbalance between the external pressure on your lungs and the internal pressure of the air coming in. A good ventilator requires to constantly get feed back from the patient which is a living thing. 😁😁😁 Humans à not machines or robots! 😁😁😁😁
2:34 As a first responder I can say that no self respecting first responder would use a BVM like this. Wouldn’t seal on the patient. Also squeezing the bag too fast and not squeezing the bag enough. Clip before this scene is much better 👍
Always an amazing channel!
From what was being said, it sounds like one of the biggest problems is a low, consistent pressure. Couldn’t that be achieved with a radial pump designed to move a low mass of air consistently through a mask? You could connect it to a hobby motor and control the speed of the pump that way and “breathing” can be achieved by spinning the radial pump faster to move a larger volume of air. The pump could be 3d printed, though this doesn’t solve the problem of WHEN to breath, it would provide a means of consistent air flow through the mask.
If you haven’t seen it, AVE has a few videos about using off the shelf parts to make a ventilator that meet all the requirements you talk about. An interesting take to use off the shelf parts that are plentiful in industry to make a high tech device. Would be interesting to know what your thoughts are on the approach.
تعالوا للعراق
https://www.appareo.com/emergency-ventilator-project/
Thanks for the detailed explanation, I had no idea how complicated these things are.
Your video used one key word for me, “surfactant.” I ask, might the same surfactant therapy given premature infants help to lessen the need for ventilators in COVID-19 patients? Might surfactant agents in metered inhalers like the ones I use for my asthma also help noncritical patients avoid the need for ventilation? See, https://medical-dictionary.thefreedictionary.com/surfactant Please, let me know your thoughts. Thank you. Maybe a chemical background can help.
What encourages this problem is people like Elon Musk. He tweets about ventilators like he actually knows anything about them. Then he says he’s going to get hold of thousands of ventilators if the American people need them. He then buys some 5 year old CPAP machines that are useless for Covid-19 intensive care patients and donates them to a New York hospital as a PR stunt. What a Tool
Except he partnered with a ventilator company and is making using parts from teslas ventilators that have the sensors and computers needed to work properly
so what about Tesla’s ventilators?
I only practical way to deal with this ventilator supply problem I believe is to support existing manufacturers so they can massively upscale their existing supply line.
Hey! So i see you acquainted with this type of equipment. I have a question for someone like you. I saw that vibration causes concrete to become more fluid/liquid and flow able, this effect widely used in construction when pouring concrete, I wondered if that effect can help people to clean their lungs/alviolies of mucus, and I found that there is a therapy already exists, called oscillation lungs drainage (it might have different name in english). So vibration cases mucus to become more allowable and helps to push it out into bronchioles and from there person able to cough it out.
So if used together with nebulizer, inhaling moisture and medicine than draining lungs and than bringing medicine into your lungs using nebulizer again might help not to bring persons condition to a degree when ventilator needed. So I built a small device (I cough myself), used a mini amplifier with bluetooth connectivity and a so called bass shaker, a surface transducer speaker, I use smartphone app as a signal source. But I don’t know frequency and actually application of this therapy.
If you know about this can you share information about its effectiveness, procedure itself, specs, what dangers and side effects this therapy might cause?
oh thank fuck. I was worried from the title that this might be one of the types of videos you rip on! So glad you proved yourself again, and pointed out how ideas that occur to people quickly at home have deep flaws. It’s very easy for certain types of Online engineers to announce they’ve solved basically any topical problem with some proof of concept they built in a few days… and then never have to face any of the challenges of actually using them for real and at scale for a real end-use. Well done sir!
You need pressure in regulation pressure out regulation and determine a mean lung volume of the pt and do a full max and full min breath cycle every so many minutes which i forget the #
What do you think of Tesla‘s recent video about this?
Are they actually trying or is it just PR?
I am overcoming coronavirus. At the beginning, I was battling with mucus building up too fast in my lungs.
I did however take high dosages of vitamin C and that hugely helps boost immune system and builds white blood cells needed to fight viruses. Not only that, I took salted water in gargles and nasal rinses. I did that on one night when I had too much mucus in lungs. Next morning, I awoke with clear lungs. Salted water worked, but mucus kept coming back later. Then I discovered the advantages of sleeping with a *TILT,* roughly 30 degree from a waist up. Tilt reduces the problems by horizontally sleeping which only multiplies viruses that get trapped in tight spaces inside lungs, thus increasing mucus.
Operating a stupid breating machine does not take 7 years of training, GTFO, Mr Doctor. Sad music cue out.
Get to the point! Breathing machines that do not harm the longues are intricate and difficult to produce! What the fuck is that movig car analogy?
When I build something that isn’t fit for a given task, I want you to be the one to tell me. Also, holy crap that was a good video. Thank you!
By the way… there is this ball thing in the end of your throat, and usualy the whole throat contracts and blocks the air-intake with that tiny hanging ball in extreme situations. As a doctor, I feel you should have felt / read about that as some time. The body is incredibly rescilient in adverse situations, you just have to not fight your instincts, Mr Doctor.
I love doctors btw, honestly.
What are your thoughts on the prototype shown by Tesla? It seems to address many of your concerns.
https://youtu.be/zZbDg24dfN0
Why would I not stick my head out of a moving car? Are you for real? I’ve done it already. I’ll do it again without much harm at all. Keep your pointing finger somewhere else, and your advice pertinent to the topic, Doctor whatever.
Insects are not a big deal so long as you can keep them away from the air channel. Even then – there is this extraordinary phenomenon called COUGHING. It works. Try it.
I have also been accelerated by gravity towards the ground in free fall for periods of 5-45 seconds on numerous occasions. Keeping my mouth shut in those situation was one of my last concerns. At least a couple of those free falls were conducted with my mouth gaping open – no harm came as a result of those experiences. Just saying.
Have you seen this incredibly simple 3d printed device from a Japanese Doctor: https://www.youtube.com/watch?v=0fCl1uguMb0
Why don’t we bring back iron lungs?
TBH, they seem to be ‘Virgin’ with the concept of barotrauma.
People who are making The ventilators do have their heart in the right place . It’s good that you put this informative video out . I’m not an engineer or anything but I have watched a lot of cool scientific videos. I’ve come across videos showing prosthetic devices that can can receive signals from the brain to make prosthetics move. I was wondering if the ventilators could be hooked up to the brain’s natural signals to control the speed in which it provides the air. That way it would be the natural frequency in which the person would have taken a normal breath. And would that help?
What about Tesla’s design?
Excelent video. Educational, dissecting the problems of a engineering task
Absolutely disgusted that Virgin has asked you to remove this!
#Virgin
#Virginprstunt
Great video, thanks. The inclusion of the usual sponsor message at the end detracts from the authority of the content, which is unfortunate under the circumstances.
Using an iPad, is there a way to see if a video was demonetized ?
Great presentation! Many vids show (basically) bellows with mechanical linkages, but with no feedback regulators. Your vid shows how that simplistic approach is inadequate (at the least.) I wanted to see some implementations that used sensors for feedback — E.g., place an [ Arduino / ESP32 / STM32 ] – controlled pressure sensor between the patient and the actuator that is driving the AMBU – bag. This is nothing new… even my CPAP machine has a “smart” sensor that continually monitors and adjusts the air pressure that I receive. AFAIK one main difference is that CPAP will not FORCE me to breathe, unlike what one needs for a ventilator. Bottom line — THANK YOU for presenting what my field calls a “Survey Article” — letting people know the state of the art.
… and what if you don’t force the air into the lungs invasively but oscilate the presssure to the upper body from ouutside? Sort of a rigid swimsuit. So you have free airways for oxygen etc.
👍❤👍
What if the patient commands the breathing manually, rather then with sensors?
Or, sensors intervene only when no command has been given for a time.
Why not look at scuba regulators? Problem with scuba regulators is that it takes a bit of vacuum before it releases air but it is completely controlled by the person breathing. If made more sensitive, it might work as a ventilator.
This is your best work. Well done!
covid 19 turned China upside down in just a few weeks. Months later, it’s impacting most of America. Where did our time go?
Is it possible to use cheap pizoelectric Humidifier as humidifier for ventilator !
It’s a shame the world needs a crisis to trigger inovation like this.
cant we place the entire body except the head in a enclosed system which decreases the internal preasure?
this way we can suck the air inside
I dont know if there are other damaging effects for other organs
maybe enclose the chest only
Im sure this can be possible
implementation?
Iron lungs are where it’s at.
The past is the future.
It’s basically approaching medical grade complexity, which may or may not be a good thing.Everyone is looking into low cost mass production, if they can pull it off using parts that aren’t (going to be) in shortage it might be a good option.
What is your take on Teslas design? https://www.youtube.com/watch?v=zZbDg24dfN0 Would you say this takes all the stuff you mentioned into account, or is it a naive
Big thumbs up for this one!
This video was extremely informative. Thank you so much for producing it!
Excellent video, well researched and perfectly snarky!
And I got here thanks to Virgin Orbit complaining about it, and they are full of it! Lol
Thank you for this informative video. I have build a simple ventalator , but I am now adding features into it as recommended by your above video. I will be adding feedback sensing from the patients airflow and pressure over the next few days. Since i just started builting this on April 1st just 4 days ago , i didn’t have the details at the time and just quickly posted my progress last night . Here is mine below.
https://www.youtube.com/watch?v=1ClsSSpRRjY
Very good video, Still didn’t understand people that landed a man on moon 50 years back can do this simple task.
i) Oxygen concentration will be detected by an external pulsoximeter
ii) Humidity can be controlled externally by some mechanism (perhaps a humidifier placed at some distance to the air pump)
A 3-way connector connects the tracheal tube to 1) an air pump via a one-way valve with an adjustable absement leading in 2) a compliant, ‘isobaric chamber” of adjustable capacity with an adjustable check valve (calibrated to match the desired pressure inside the lungs) set up such that, when the release valve opens, “Event 1” is detected by an arduino and when the elastance of the compliant membrane returns to its zero point, “Event 2” is detected and 3) a one-way valve with an adjustable absement (meant to be lower than that of the inlet) leading out connected by a solenoid. The solenoid is connected to the arduino. When “Event 1” occurs, the arduino provides power to the solenoid allowing a decrease in pressure and subsequent exhale under positive pressure, and when “Event 2” occurs, forced inspiration starts again.
This would lead to a periodic swing in pressures with a maximum pressure set by the release valve (2), and minimum set by difference in flow rates of the inlet and outlet valves (allowing constant positive pressure). The compliance and volume of chamber (2), if adjusted to roughly match those of human lungs, ensures that the rates of inspiration and expiration are regulated and modulable.
The functionality looks similar to CPAP (AKA:snoring machine). What happens to exhaled air with the ventilators? I heard the exhaled air can carry the virus?
What about the Iron lungs from the Polio epidemics in the 1950s? Those are more expensive and complex but they use negative pressure to ventilate patients and won’t cause barotrauma over a long amount of time.
Actually, I would think they would be less expensive, as they are all analog and can possibly be fabricated by a company that can bend metal, it should be easier to manufacture. But the machine may not work for patients who are badly affected. Some coronavirus patients go from talking to the doctor to needing a ventilator in as little as 5 minutes.
This video misses the point. If/when there is a shortage of ventilators, the choice for patients will be between nothing (dying) and using a less-than-optimal ventilator solution.
So the real question is, what is the best alternative to a conventional ventilator? There is certainly a lot of room to debate this question, but any “best alternative” _must_ be able to be produced by the thousands within weeks.
Your video did an excellent job describing pulmonary function and some of the risks associated with manual ventilation. (In fact, we’re a big fan of your channel.)
But, respectfully, we think you should consider amending the video to not be dismissive of a solution that will save lives should the need for it arise.
The automated Ambu bag project that we’ve been involved in (shown in one of your video clips) was conceived by an anesthesiologist at the University of Minnesota, has now been thoroughly tested, and reviewed by many doctors and several respected medical schools. Boston Scientific, an experienced medical device manufacturer, will be producing these devices, in addition to other manufacturers.
All of these medical professionals have concluded that, unless ventilation by an Ambu bag is specifically contraindicated, this device is a reasonable alternative to a conventional ventilator when the latter is unavailable.
The simple “one-armed robot” that we’ve helped design is expressly not meant to take the place of a ventilator. It has many of the shortcomings you mention in your video (although there are mitigations for many of them, e.g., the use of an in-line PEEP valve, as one example).
But do we want to hope for the best, or plan for the worst? The Governor of North Dakota is one official who’s planning ahead; he’s ordered 2,000 units, and they start shipping tomorrow.
Our most sincere hope is that, for whatever reason, the projected shortage of ventilators does not come to pass, and our device is never needed. That would be ideal. But until we have enough conventional ventilators for everyone who needs one, we’re going to advocate for any reasonable solution (ours and/or others’) that can be produced fast enough to be helpful.
Love your channel and the video! There is actually a low cost initiative able to assist and/or control the breathing of the patient. It is based of a ’60 device used by the US army for emergency ventilation. There are several similar initiatives but here’s a nice example:
https://www.youtube.com/watch?v=fWIJwUU7BcA&feature=youtu.be
One of the nice features? It has no moving parts! It can be injection molded in just two pieces.
RE: slams Virgin Orbit for making a PR stunt machine.
VO: You are spreading dangerous misinformation
RE: no u (dab)
I’m an MD and this video is by far your apex.
Bravo !
Thank you!
What’s your thoughts on the Tesla prototype?
What is your take on Teslas design? https://www.youtube.com/watch?v=zZbDg24dfN0
Would you say this takes all the stuff you mentioned into account, or is it a naive implementation?
Dräger ♡
You have totally negative mentality. Everyone knows these low cost design are not very good but something is better then nothing .saves lives anyway.
India Rocks..
As a biomed equipment tech I have been struggling to explain (and frankly don’t have the time) To explain why building ventilators is a harder problem than it seems. This is a great resource to show people that explains it perfectly. Thank you!
I suppose you can start by telling people to read the free standards offered by http://www.iso.org/covid19 on ventilators.
If they get bored after 10 mins, then perhaps building ventilators isn’t for them.
Can you make an update to this video about the tesla ventilator? I really would like to see you break it down
Love the videos keep it up and the clear explanations from different channels. Good man
Have you seen the Tesla ventilators?
They actually seem to have done some real research into how a ventilator needs to operate.
Such a large disparity between Virgin and a company that actually cares to make a difference.
Virgin orbit are a bunch of scumbags. Using simple, old technology to get some good propaganda is as revolting as Trump and Jared fumbling around and preening. #boycottvirgin
When open source people use vacuum cleaners and valves to build a respirator….what’s PEEP again? lol Well people are trying which is nice.
Sounds a lot like a SCUBA regulator. Provides air at a slightly higher than ambient pressure.
I’m happy to know our team at our university (VUB, Brussels) included all of these features and is well educated thanks to good communication with doctors. Thank you for the nice video !
Thanks for this. I see a lot of praise on social media for these homemade devices from those who think doing anything is better than nothing. Virgin Orbit is like that guy from the seltzer commercial that says “I’m part of it.”
Very well explained.. with a race to make a low cost ventilator, many out there never really wanted to know the real features needed and the complexity involved. Kudos to u guys for making this video which I hope will reach the right people at the right time.. before its too late
Up front your video suggests there are no therapeutics currently in use for CoVD-19. This is not true. Many doctors are using chloroquine or hydroxy chloroquine in combination with anti-biotics. I think it’s great to help consider what we can do for worst case scenarios, but since there are therapeutics to help prevent these scenarios shouldn’t that also be included? I feel this opener to your video is misleading as it presents ventilators as the only real solution. It’s something I find tragic and exhausting that people who are trying to present important information about this topic don’t even seem to be following mainstream news about it. One might find reason to ask questions about how much bias you have towards more engineering rather than biochem/pharmaceutical solutions so much that you exclude even mentioning them from this video. Its disconcerting from my perspective.
@Real Engineering The mechanism for hydroxychloroquine is not yet clearly known but it is showing more than anecdotal evidence for helping treat the virus. The antibiotic is a supportive medicine for preventing secondary infection from pneumonia caused by CoVD-19. You’re debunking a claim I never made. Aside from these two drugs, a global survey of doctors suggests is working effectively together, South Korea is also suggesting plasma from recovered patients has some effect on the disease. This treatment has anecdotal evidence for MERS treatment, also tried in South Korea.
Blood plasma article:
https://www.channelnewsasia.com/news/asia/two-south-koreans-recover-from-covid-19-after-plasma-therapy-12618422
World survey of doctors:
https://www.washingtontimes.com/news/2020/apr/2/hydroxychloroquine-rated-most-effective-therapy-do/
Anti-biotics….for a virus. Right, you many want to stop listening to main stream news
Engineers are fantastic, problem is it’s quite easy to go down a rabbit hole and/or forget the end-user(s) and/or use cases. Granted complex projects have additional SQEPs to mitigate and manage this, it’s a shame the disciplines of Systems Design and requirements elicitation, gathering and management aren’t widely taught…
Excellent content and analysis once again. Extremely disappointed with Branson and co for asking you to take this down. The video is fair and constructive in it’s criticism
There’s a team of people in Czechia developing a ventilator that could actually be helpful. It will cost about $4k in parts to make one, so it’s not that low cost, but they really seem to know what they’re doing. They have already built a final prototype and once they’re done testing, they plan to give away free license for the entire thing (as well as making a few hundred units for Czech hospitals themselves) to anyone who has enough experience and funding to actually get them to hospitals in their country. https://www.corovent.com/
I really enjoy the stock footage at 3:12 of someone pointing at an x-ray that’s upside down
https://youtu.be/zZbDg24dfN0 – Tesla’s prototype of a ventilator using Tesla Model 3 parts.
Curious: isn’t Tesla’s ventilator supposed to solve the microprocessor issue?
What microprocessor issue? The electronics (Model 3 infotainment system) they are using is vastly oversized for the problem area they’re tackling. They’re more than capable of handling the sensor input and control loops required for a ventilator.
Thank you for mentioning the real hero’s, nurses and Tecs. Every mother is a nurse and the Tecs are amazing. I was lucky enough to work on many of the ventilators and my name is on some of the patents.
So few people even think about these issues. Last century more american s died from the flu, than have ever died in combat. Many people that die in a hospital, die on a ventilators and if you get on one, it is hard to get off.
One of the hardest things in the world to do is breath. It takes a very complicated machine and very talented people even to get close.
We need to start testing early. Before we get put on the ventilator. It has to be as easy as brushing your teeth or touching your phone. Everyone should test everyday and Mothers should have the tools to help her become even a better nurse.
Every person that watches this channel needs to help.
It is a big step but you are the best we have.
Thanks
Great video! Obviously, hospitals would have flooded long ago with homeowner-grade ventilators if it was just that easy.
Being forced to breathe at fixed interval gives me so much anxiety.
Thank you. I’m an engineering student and I’ve been trying to explain to the other students that if this could be done with squeezing a bag we wouldn’t have the complex ventilators. I’ll make sure spread it around.
The common goal of the designs that I have found on the Internet is to squeeze and release an Ambu bag model Spur II, based on 3 predefined parameters: Air volume, Breathing frequency and I / E ratio (inhalation-exhalation). Prototypes basically vary in the way they squeeze the bag. Given that these 3 parameters do not ensure synchronization in the event that the patient coughs or moves, I understand that these designs are only a last resort and the patient must be immobilized and sedated. Are there any additional parameters that allow the equipment to be synchronized with the patient’s natural breathing without risk of damaging their lungs? Greetings.
Wow, I had no idea how complex those ventilators were. I kept wondering why 1) they were so expensive and 2) why hadn’t companies been able to make something that just pumps air into people. From the negative pressure to O2 levels and humidity – very eye opening. Thank you for putting this together to educate the masses.
You need to sync your videos to LBRY. Unlike youtube, curiosity stream, or nebula when you post stuff it stays up.
https://lbry.com/youtube
I have a question for you, and i hope you can answer me. Can negative pressure ventilation, be useful in those cases? Iron lungs were massive used to treat polio. Maybe a lot of this devices still are somewhere, and can be reused to treat covid-19? Thank you for this video, no one in tv, or social media, is talking of this. A lot of people is creating false expectations with those DIY power ventilators.
They’re about to put the design out soon – I looked for a similar video on YT, but it seems they don’t publish to YT for now: https://www.facebook.com/VentilaTM/videos/223787758704756/
It’s a team including both engineers and medics. The machine is computer-driven. It’s led by the lead engineer of a local 3D bioprinting company and an experienced and technology-knowleadgable ICU medic from a local hospital. The designs will be completely free and open source.
They had the first prototype after a week or two – and called it a disaster. A few weeks later, the mark 4 prototype went into tests with medics, and it seems to be the right thing. It still lacks some functionality, compared to expensive, state of the art ventillators, but that’s simply because they couldn’t find widely available hardware for some functions.
The device does monitor pressure and oxygen levels in real time, ventilating the patient in accordance with a ventilation regime set up by the medic – in terms of pressure, not air volume and/or time. It does so by controlling the pumping via stepper motors based on feedback from pressure sensors, rather than having an oddly shaped pedal or other contraption repeat the same cycle over and over again. What they couldn’t find is some valves which could be controlled electronically to also regulate the influx of oxygen – that’s what medics have to adjust – but it notifies via cell phone when oxygen levels start to deviate from what’s prescribed. I assume that, given a few more weeks, they’ll build these valves themselves. Only, that’s a bit of a more critical piece of equipment – oxygen-related equipment requires extremely high industrial safety margins, because a leaky valve or one that incorrectly handles the flow can cause explosions.
They don’t have a web page yet. But they keep their facebook page pretty up to date.
Yes i agree with the video but designing solutions takes time and never think out of the box.
Corona virus
In the 50’s it was the iron lung that helped people breath with polio using pressure and then the rocking bed. Old style solutions although the rocking bed principle is not that far fetched. This could be implemented and also mass produced to fit hospital bed as an add on with in days.
Gravity then helps to keep the patient alive and it’s cheaper by tilting back and forth.
You get pneumonia so it’s gravity that’s the enemy as well so why are people put into a position where gravity is winning surely putting people at an angle so the feet are above the level of the head would allow the lungs to drain quicker?.
Ventilator with a hollow tube and uses it until he or she can breathe on his or her own. So two tubes instead of one is inserted one 3/4 of the length of the other so one ( full length ) is oxygen and the 3/4 is mild suction and the patient is tilted so the head is downward ( You’d have to calculate the angle. ) so the tilted angle is using gravity to aid the patient instead of working against them.
Mon 6th april 20 2.45pm
Shout out to that Indian manufacturer and their innovation to come up with a cheaper but functional alternate for expensive ventilators..
What do you think of the new ventilator prototype Tesla put out?
I didn’t know you studied BME! Hello fellow!
I switched to manual breathing while watching this
So how did a ventilator work in the 1950’s & 60’s before microprocessors were an option? I assume people ventilators worked ‘properly’ back then for people on them for days & weeks. Can we produce old designs without needing the sophisticated components found today.
could a diaphragm be forced to move via an external electrical pulse?
Can anyone give us more details about the Indian startup at the end of the video that is making low cost ventilators ??
You are doing a great job. Your efforts are very much appreciated. Thank you for doing your bit to your society.
What about reviving Bird Mark 7? https://www.mark-19.com/ It’s all mechanical but has the main features mentioned in the video, and is simple enough to produce in volume. Even iron lungs (negative pressure ventilators used for poliomyelitis patients in the 1950s ) can have some use here.
Have you seen the latest Tesla video? What is your thought on it? Their new ventilator design seems rather sophisticated and seems to take care of your points… including sensors, processors, a touchscreen, humidifier, …
You have the best channel your episodes are the best, keep up the amazing work!
covid 19 is kinda scary
Proud of this video and india
This video shows how much we don’t know about our amazingly created human body
all you need s an attachment to a vacuum cleaner that can convert it to a home PAP machine – lol
I’m disappointed that the reaction from the majority of govts around the world was so slow.
They should have known that the virus was coming back in January, and started preparing back then.
It’s comical how a country as rich as Ireland only just a few days ago flew in PPE equipment. How on earth did they not realise months ago that we will need an adequate stockpile of this equipment? When did the company who produces the ventilators start to increase production? I hope they didn’t back in January.
Thanks for helping us understand the real problems in a humble way. Your research is award worthy!
DO NOT BOW TO CORPORATE PRESSURE FROM ANYONE TELLING YOU TO TAKE DOWN THIS VIDEO. Brilliant job.
Feel low key betrayed, something you said in a past vid made me think you were an aerospace engineer 😔 real talk though, it was great to see a video by someone who knows what they’re talking about on this. Amazing content as usual
Finally….someone with a brain has explained how the virus kills people. You are brilliant!!!
A great down to earth video.
The only flaw I would point is the interpretation of the chest radiograph upside down at 03:17.
Since you are an engineer, you’re safe! 😀
Great video!
bumb for you up you go
What about something like a scuba regulator? It opens because off the drawn breath. Allowing the patient to breath on their own. Just a thought.
Video drops the next day. Tesla doing it properly? https://www.youtube.com/watch?v=zZbDg24dfN0
So like… would Iron Lungs not be a better “hack”?
i really had no clue of this, thank you for this video
Brian, since you literally worked on this for a living, can you tell me what you think of Tesla’s efforts? https://www.youtube.com/watch?v=zZbDg24dfN0
It looks like they’re avoiding most of the pitfalls you mention in the video, and are actually building a medical instrument, as opposed to a last-resort post-apocalyptic ventilator.
Well done. Great video 🙌
Good video. Thanks
Did Tesla do it better than Virgin?
https://youtu.be/zZbDg24dfN0
The Tesla ventilator has processors, screen, a lot of sensors and seems to be a lot more complex than the others. Maybe it can be set up to work as those professionally made?
https://www.youtube.com/watch?v=zZbDg24dfN0
What are your thoughts on the ventilator Tesla is developing
@Real Engineering: Tesla just released a video on their ventilator, it seems that they are adressing the point you raised https://www.youtube.com/watch?v=zZbDg24dfN0. Would love to get your take on it.
https://www.youtube.com/watch?v=zZbDg24dfN0 What do you think about this?
If anyone wants to help work on an open-source ventilator, a group of polish engineers started a project called VentilAid. The objective is to develop a “last resort” ventilator that can be 3D printed (some common parts are required, though). If you want to help, check out the ventilaid forums or, at the very least, let people know about the project!
I’m here cause I heard someone tried to take this video down. There’s not many things more evil than doing something like that. Especially for a video like this providing genuin information about a crisis. I know there’s really nothing I can do but if you need us I’m sure I’m not the only one willing to help.
We need iron lungs instead?
Excellent video. The world needs more people spreading good information like you do.
Hi, what do you think of Tesla’s prototype ventilator looks more thoroughly designed? A pretty decent effort
https://youtu.be/zZbDg24dfN0
This channel never fails to impress me, thought provoking sensible information.
Virgin never fail to depress me, I will be cancelling my media account with them shortly.
This was an incredible video. Thank you for clarifying such an important topic. Now, if someone would only apply this kind of deep analysis and reality check to the epidemiology of the virus itself, we might one day figure out what the hell is actually happening. 🙂
Which program do you use to create animation?
in·tu·bate
verb: intubate; 3rd person present: intubates; past tense: intubated; past participle: intubated; gerund or present participle: intubating
insert a tube into (a person or a body part, especially the trachea for ventilation).
You missed a great opportunity to do a Chubby Emu impression with your definition of Barotrauma! Great video tho!
Tesla is also working on ventilators but is going to many details https://youtu.be/zZbDg24dfN0. Have a look
Great video! Very interesting engineering perspective of this ventilator crisis.
I live in Galway although not Irish myself. Fair play to the private companies doing their best to supply these live saving devices.
This is basically the RE channel that I feel in love with. Solid video.
Hey virgin, if you stop learning from your mistakes then your money is not worth of anything. Times like these should towards positive engineering.
Trying to take down one video that makes sense just show your incompetence.
Well timed video!
i was designing this Ventiator since last 15 days and saw multiple designs online. I was really excited but My brother, a doctor, told me it’s not possible. I discarded him by calling him pessimist( Hate your older brother being right…aarggh). Afterwards, I talked with his intensivist doctor friend and had a long chat about medical stuff that goes inside a ventilator. I quickly realized that it is not as easy squeezing just BVM.
BTW, Another Indian company made a ventialtor which costs 1000USD.
News: https://www.thehindubusinessline.com/companies/rajkots-jyoti-cnc-makes-indigenous-ventilators-costing-1-lakh/article31259099.ece
What are your thoughts on the tesla ventilator they just showed off on their yt channel?
Respect+++
Love the video. Tesla made a video on a ventilator; “Tesla Ventilator”. Any comments on their design?
Tesla’s example is here: https://www.youtube.com/watch?v=zZbDg24dfN0
Very interesting video!!
I’m a doctor and I can safely say the entire medical community agrees; Trump has FAILED America and the world.
What do you think of Teslas attempt?
Might be a dumb question, but at what point / why don’t we just use artificial lungs? Don’t they have microfluidic oxygenators now? They seem easier to make and easier to run…
I really dont like what’s going on.
Regarding the virus? No one does
Hey, I know this video was made before hand, but you should check out the tesla ventilator. Addressed many of the issues you brought up.
And if a lay person, say an engineering student, had ideas about this, how would he be heard?
I would say that in the case of a student, they should contact their professor who will know how to network out their idea since most universities have the ability to prototype and the social network to get the idea out. As for other laypeople, I would get on places like reddit and find out if there are any tech incubators around where they live, design and prototype the design and then post to reddit or similar
Hey, what do you think of the Tesla approach of a ventilator?
https://www.youtube.com/watch?v=zZbDg24dfN0
From what it sounds like they do the things you criticised on other ventilators.
I think the Bag-Squeezing-Approach is a good thing. It just has to be more sophisticated than these simple designs. Ventilators in the German Rescue Service coudn’t do much more until they got replaced last year. They were able to control frequency and minute volume. On a pressure gauge you saw the loung pressure. Also there was a mechanical over pressure valve which was set to prevent damage. It wasn’t perfekt but ok to work with. (Medumat Standard 1, https://www.weinmann-emergency.com/products/medical-ventilators/medumat-standard-a)
I hope all of the would be inventors watch this and realize that a 5 dollar ventilator is not an option.
You can produce PEEP with these Ventilation Bags. There are Valves to stick on.
As a engineer, who investigated the ventilator design after this crisis started, I have to say excellent video. Ventilator is a last stop measure after the lungs have deteriorated
Excellent job!
2:35 What are they doing?? This looks like stock footage with actors who have no idea how to ventilate..
Yeah it is
What if a ventilator lowered (or raise, I’m running off little sleep can’t do basic theory) the atmospheric pressure. Wouldn’t that allow air to patient to breath easier as they don’t have to fight as hard to breath. This would be similar to the air force hypoxia chambers but instead of removing o2 would supply “easier” air? This would keep them breathing on their own thus the need for sedation wouldn’t be needed. Thoughts?
I was very much sure all this BVM designs will not work at all… Now your video made clear how they really don’t help
Great video man! Do not listen to Virgin Orbit, they simply wanted a quick PR to benefit them, great work unveiling their negligence.
Good thing Tesla are coming close to a breakthrough for their newest self made ventilator.
Introducing, Teslung!
Very cool
Can we trigger expansion and contraction of diaphragm by triggering muscle by mild shock???
@Robert Connor hmm…I thought virus affects function of diaphragm, and due to use of ventilator required moisture is not accomplished which damages tissue in lung area..
Actually, the diaphragm is not the issue here, it is working fine, the issue is that the virus damages the actual lung tissue, causing inflammation and fluid and creating resistance, not transferring oxygen to the blood and tissues.
There is one group out there producing an affordable ventilator that is also taking Pressure-support functionality into account, not using a BVM, and create an actually helpful ventilator for this pandemic. The Ventilator Project (www.theventilatorproject.org) is a non-profit start up working out of Mass Robotics in Boston with a full team of medical experts to create a mass-producible ventilator that conforms to the needs of the COVID-19 Patient
If you want to help either with donations or your technical expertise please reach out through our website (www.theventilatorproject.org) or to me directly by email – [email protected]
The manual squeeze type ventilators are low cost,each patient just squeezes their own manual ventilator or maybe two patients could squeeze each other’s taking turns?🤪
I came here because of the supposed scandal Virgin Orbit is starting.
Edmond Cristian Razmerita …check out the COMMUNITY section of Real Engineering’s YouTube channel.
@Edmond Cristian Razmerita watch the video??
Wait, what was going on? I keep reading that Virgin Galactic disliked this video in comments, yet I can’t find the source. Can anyone explain?
i was told there would be popcorn?
What about a mechanical valve regulated to allow up to a peak pressure ?
A diafragm like membrane that triggers the inbreathing/outbreathing. With a machanical trigger.
Plus a vapor producing section in the air compilation area of the breather. Maybe even the intake.
Also just watched a video about a ventilator that used phones, this way it would be far cheaper using cellphone processors to regulate the breather based on electronic barometers/electrodes in diafragma muscels and also regulate humidity with a vapor producer included in the design
Hold up, you live in Galway, Ireland? I loved that city
Holy crap, this is one of the best videos I have ever watched.
Quite a few of the things I knew in isolation but this video is one of those “ah ha” moments. So well made, so insightful. Something you only get from people experienced in the field. It has really got me thinking, and that doesnt happen often 🙂
Thanks and take care.
Do u have any suggestions for the ventilator that Tesla is working on? https://youtu.be/zZbDg24dfN0
Is it possible you could stimulate the muscles and diaphragm
with electricity to avoid barotrauma?
As a engineer, who investigated the ventilator design after this crisis started, I have to say excellent video.
Ventilator is a last stop measure after the lungs have deteriorated significantly. Too much emphasis on ventilators when the real focus should be on preventing that stage being reached.
LORDOceanus Yeah currently we don’t have wide spectrum anti-virals like we have for antibiotics.
This is just the reality of the pharma business. Very few invest in antivirals just because finding targets for viruses are very difficult.
@Samuel Tiffany The real problem in the countries which are running out of ventilators is TESTING! If you don’t do comprehensive testing you don’t know how or where the infection is spreading, so you are always playing catch-up. The countries which are having success in cutting down the spread are the ones who started testing early and are testing large numbers. If you are running out of ventilators you have failed. Just for information, today (10 April 2020) the total of confirmed cases in the USA had reached nearly ONE THIRD OF ALL THE CASES IN THE WORLD!
Priorities should be 1/ Quarantine, 2/ Testing, 3/ PPE for first responders, carers/medics, and key workers, 4/ Ventilators. Search for a vaccine in parallel to this. Not many national governments have got to grips, and the US is currently at bottom because they are actively hindering attempts to get control of the situation. The UK isn’t doing well, but at least we have the NHS. I am lucky, because as a Cancer survivor I have a care system in place that keeps an eye on me. My age and health also put me in the top category for danger, so I have a more immediate interest in how things are progressing!
Agreed, but fro now this is just a number’s game, and a time game. There is some ventilators number that will be needed and that number if somewhat built-in based on where the epidemic stands as of right now.
@LORDOceanus Apart this is the effectiveness of antivirals compared to antibiotics. Unfortunately, viruses are far harder to treat in the same manner as bacteria when it comes to drug treatments. This why we advocate mostly on preventative measures, such as vaccines, lifestyle changes, for example condoms for virus STDs, as well as surveillance programs such as China’s unknown pneumonia identification program. (other problems with the Chinese government aside, their program in that regard was effective in identifying it early, even if they again chose to suppress information about it.)
But you do have a point that an investment into antivirals would of likely brought us to a treatment, the economics of it dissuades people from pursuing this research. A scientist is less likely to get grants for such a low profile virus such as coronavirus, and up until recently coronavirus like SARS and MERS just were not prevalent enough to make a profit from those grants.
Hopefully, though I wont hold my breath, after this outbreak we’ll see a reimagining of global medical, and medical research systems. We live in an interconnected world, and we cannot keep pretending that the health of developing nations, or even other nations, dont effect everyone.
Quite frankly our investment in antivirals over the past 50 years has been crap. Focus has always been on flu and well known highly virulent diseases such as Ebola, HIV, and Herpes rather than viral families with the potential to cause pandemics. Had we invested in new research following SARS and MERS we would likely know of one or more antivirals that would do something against COVID-19 because unlike bacteria which rapidly develop resistance to antibiotics viruses struggle to do so for antivirals. This is because the viral genome is already very small and most of their genes cannot change much or they will no longer function. And its on those highly conserved DNA/RNA transcription and translation genes that most antivirals act. As a result an effective antiviral for SARS would almost certainly work on COVID-19 as they are very closely related and even one for the more distant relative MERS would likely work to an extent
Hi Virgin Orbit lawyer 😉
“Bot… me 3D printa…”
Finally someone talking sense!
Great video, glad this channel exists and shares information in a detailed but simple format
Pity we can’t develop some sort of dialysis machine that works on CO2 and O2, instead of kidney stuff.
So the mechanical part is relatively straightforward. It is the sensor feedback and doctor’s medical judgment that is hard. But we can do it! All the parts are there! Production ramp-up. It is not easy, it’s rocket science. So? We can build rockets- we can build these. Oh: AT COST.
https://youtu.be/zZbDg24dfN0
As a med student who has been following this channel for a while now, what a great video
This was so informative and beautifully explained
Question: what about mass producing CPAPs/BIPAPs for people who are still in a less drastic phase of the disease and are self-treating at home or in a non-ICU section of a hospital, so they can breathe more easily and not exhaust themselves?
Wouldn’t just getting constant ambiant pressure air with 40% oxygen instead of 20% oxygen already be helpful in recovery?
I was lead here to this video from your latest post. Its because of people like Virgin Orbit that got me being very skeptical about information on the internet. You did a really good job at educating me since I had no idea the human respiratory system was that complex. Very glad you refused their take-down request.
What about the Tesla ventilator? Is that also a PR stunt?
real engineering: *gives constructive criticism and really explains why the vast majority of designs won’t work*
virgin orbit: “tAkE tHiS vIdEo DoWn”
Any comments on tesla ventilator? https://www.youtube.com/watch?v=zZbDg24dfN0&t=136s
@real engineering, can you please give an estimate of how powerful the micro controllers needs to be to maintain all the functions?
Great video. Thanks for doing your research so thoroughly, the quality of your videos is always top notch.
PEEP is very important. We measure airway pressures in cm of H2O. Normal values of PEEP in an non-intubated person are around 0 to 5 based on the time of their airway muscles. We are using up to 22 cm H2O. If your vent can’t provide higher levels of PEEP for prolonged piriods of time then it won’t be helpful. A trick to providing PEEP for your patients is to carfuly controll their expiratory flow. When PEEP wax first being used by doctors like Dr. Tom Petty (not of the Heartbreakers) they called it the expiratory retard valve. Thank you everyone for for helping out all the support really does make a difference.
Tesla ventilators design… because of the valves and controls modes, seems to be legit!!! https://www.youtube.com/watch?v=zZbDg24dfN0
Tesla just released a footage of their own prototype. They are doing it the right way.
So to summarise, would this be a reasonable list of requirements for a DIY solution?
– a compression fan which can accurately apply a set amount of pressure to the mask
– a mechanism to gently release pressure after the inhalation period is complete to reduce pressure down to slightly above atmospheric levels
– a pressure sensor to regulate that fan, and to sense the patient starting to take their next breath
– a humidity sensor
– a mechanism to humidify air to a set level
– and a controller which has:
-> a clear interface which an operator can configure everything, and live charts of sensors and historical operation
-> adjustments for how much of a dip in pressure should trigger the pump to increase pressure
-> adjustments for maximum pressure and rate of increase
-> adjustments for maximum total volume in a breath
-> a maximum duration between breaths which triggers a mandatory breath
-> a configurable audio & visual alarm to alert operators if patient is recieving mandatory breaths, or if any part of the mechanism is failing (target pressure not reached: pump or mask seal failure, or humidity issues)
Is total volume an important thing to accurately measure in a last resort sort of device? if pressure is regulated so the device cannot apply too much pressure and burst lung structures, is that safe enough?
How about STOP Trying to design a ventilator and help exiting vent manufacturers get their parts. I am an Engineer that actually has helped design ventilators. It’s not something that can be done in your garage in a few weeks.
anyone else here because they saw the virgin orbit thing😂
Virgin Orbiter should name a craft “The Streisand Effect”.
I’m so sick of seeing all these comments, mainly on reddit, blasting engineering and pharmaceutical corporations for charging tens or hundreds of thousands of dollars for this equipment “that can be built for $50”.
Yeah, I’m so sorry that a team of engineers, doctors and their support staff had to dedicate at least a decade of each of their lives refining this piece of technology so it wouldn’t pop your lungs like a balloon. If you’re so confident that this equipment can be produced for $50, go use a $50 ventilator.
I am learning electrical engineering. Someone help me with how to learn it properly.
TESLA has released a video explaining their approach to building a ventilator: https://www.youtube.com/watch?v=zZbDg24dfN0
Seems to in the right directions in many areas.
They actually did their homework
Yes. They actually discussed things with Medtronic before going on with the design. IOW the took necessary care to educate themselves.
9:50 are there machines that spray artificial surfactant to keep the alveoli open?