COVID 19, CPAP, Ventilator MEGA THREAD...everything go here please

[jimsp1]

I see NY ordered 3000 biPAP machines from Philips. They have received 750 of them so far.

[raisedfist]

Hopefully other states get their sh*t together so they don't end up like NY. Ordering PR BiPAP in mass means they expect supply of vents to be less than the demand, if it's not already there it's gotta be close.

2 weeks ago the idiot nyc mayor was going to the gym and telling everyone to keep living their lives. Then he spent a week arguing with the governor about issuing a shelter in place order. And you s till have people doing non essential activities outside in groups, with a moving population of 10-12 million during the day. Recipe for disaster.

I lived in the city for a decade and I would not be able to handle being there right now.

[prodigyplace]

How about faux ventilators? Tesla donating BiPAP and calling them ventilators.


https://ftalphaville.ft.com/2020/04/01/ ... machines-/

[ChicagoGranny]

How about faux ventilators? Tesla donating BiPAP and calling them ventilators.


https://ftalphaville.ft.com/2020/04/01/ ... machines-/

These donations appear to mark a turn in Mr Musk's view of the coronavirus. In early March he tweeted that the panic over coronavirus was "dumb". In another tweet he suggested children were "essentially immune" to the virus - which is false.

https://www.bbc.com/news/technology-52071314

[Pugsy]

How about faux ventilators? Tesla donating BiPAP and calling them ventilators.


https://ftalphaville.ft.com/2020/04/01/ ... machines-/

The link requires a log in to see the document and I simply won't do that just to read articles.

Some BiPaps/bilevel machines are ventilators though...at least in the sense that they can force a breath if someone isn't breathing.
Not to mention there are several other models of bilevel machines being made that we don't see discussed here that have been used to help ventilate people for many, many years.

[jnk...]

Any device that changes something about breathing can be referred to as a ventilator broadly. Even straight CPAP. That is what causes confusion in specific contexts when some readers don't recognize from the context that specific machines are meant. The term is basically meaningless outside of context. It's like saying "the machine that helps that dude breathe." If your airway narrows at night, CPAP is often the right modality for that and other things. Many of them will be needed to help people after they are out of the woods with COVID-19, which will allow the more powerful machines to be freed up for others coming in.

[jnk...]

Not a good time to need EMS in NYC area:

Grim New Rules for NYC Paramedics: Don’t Bring Cardiac Arrests to ER for Revival--
https://www.nbcnewyork.com/news/coronav ... l/2356265/

[babydinosnoreless]

Good article:

A “cytokine storm” becomes an all-too-frequent phenomenon, particularly among the young. But treatments are being tested.

https://www.nytimes.com/2020/04/01/heal ... ystem.html

Very interesting. What it left out is what happens to those of us with an immune system already on high from autoimmune problems. My c reactive protein has been high for as long as they have been testing it 10+ years. They are taking away our immune suppressing drugs and using them for covid 19. Luckily they took me off hydroxychloroquine a few years ago because it wasn't helping but many are left without their meds.

[prodigyplace]

How about faux ventilators? Tesla donating BiPAP and calling them ventilators.


https://ftalphaville.ft.com/2020/04/01/ ... machines-/

The link requires a log in to see the document and I simply won't do that just to read articles.

Some BiPaps/bilevel machines are ventilators though...at least in the sense that they can force a breath if someone isn't breathing.
Not to mention there are several other models of bilevel machines being made that we don't see discussed here that have been used to help ventilate people for many, many years.

Sorry. It did not earlier. I believe they are S9 VPAP that Resmed said they bought in Asia.

Here is another link with the photo & tweet.

[raisedfist]

Not a good time to need EMS in NYC area:

Grim New Rules for NYC Paramedics: Don’t Bring Cardiac Arrests to ER for Revival--
https://www.nbcnewyork.com/news/coronav ... l/2356265/

As someone who is clueless: what are the odds of being revived by the time you get to the hospital, if you can't be revived at the scene?

[jnk...]

Not a good time to need EMS in NYC area:

Grim New Rules for NYC Paramedics: Don’t Bring Cardiac Arrests to ER for Revival--
https://www.nbcnewyork.com/news/coronav ... l/2356265/

As someone who is clueless: what are the odds of being revived by the time you get to the hospital, if you can't be revived at the scene?

Normally, as I understand it, you attempted it on the way to ER, which is only a few minutes away in much of NYC. Now you don't even load them into the back. Not so much traumatic for the unconscious patient, but devastating pressure on the EMT.

[timbalionguy]

I haven't posted here for a while, and I haven't read this entire thread through. But a few thoughts on trying to turn CPAP machines into ventilators.

Back in 2010, when I was prescribed an Adaptive Servo Ventilator machine, there were two on the marked-- The ResMed VPAP and the Respironics AutoSV machine, which by then had an 'advanced' model. Both of these were adaptive servo ventilators, designed to deal with complex sleep apnea issues and related problems. In my case, I was diagnosed with Complex Sleep Apnea Syndrome, or CompSAS. This means I experienced both obstructive and central sleep apnea in a unpredictable combination.

The Respironics and the ResMed machines did the same thing different ways. I got a Respironics machine, which was more suitable for my condition. It is a do-everything machine that most of the time, functions like an APAP machine. It only attempts to ventilate under certain specific conditions. The ResMed machine OTOH, from how users described it, actually veltilated you a little. to train you how to breathe better. Both machines will do that, given time, and my Resiproncs machine has taught me how to breathe better when I sleep. But users who have used both machines tend to prefer the ResMed machine. Once you got used to it's somewhat forceful approach, people seemed to really like it.

Enter COVID-19, where severe cases require invasive ventilation. This kind of therapy is beyond any CPAP machine, no matter how sophisticated. That said, I believe ResMed does make full ventilators. But for milder cases, I bet the VPAP machine would be helpful. Thus you see Elon Musk managed to come up with 1,000 of them. I am sure this will be helpful to some patients, and they certainly are a lot less expensive than a full blown ventilator. If it works, it might be easier for ResMed to ramp up production of their current ASV machine, than it might be to ramp up the production of full ventilators. They probably sell a lot more VPAP machines than ventilators, and being a consumer product, can probably ramp up production quicker. We'll wait and see.

The question was asked about converting a CPAP or an APAP machine into an ASV or ventilator machine. Could it be done with a software/firmware upgrade? I would bet not. Due to the rapid response of the ASV machines, at least the ones made when I was prescribed, had special parts not normally found in CPAPs or APAPs. In the case of the Respironics machine, they had an 'air dump valve' that used essentially a speaker voice coil type mechanism to quickly open and close a shutter, perhaps as fast as on every breath. The blower motor, which could only change speed slowly, would always be going a little faster than necessary for the pressure needed, and the air dump valve would regulate the pressure down to what was needed at the moment. For a CPAP or APAP machine, motor speed regulation alone was enough. Does with work well? My Respironica AutoSV Advanced is still going strong nearly ten years later. Because it can respond so flexibly, I have not needed to adjust it since correcting an error on the original prescription the first night I had it. Newer machines might use a lighter blower motor that turns faster, and can regulate fast enough to obviate the need for a dump valve. Maybe hanging around here again will allow me to learn from other users who self service their own machines (Something I can do, too but thankfully never have had to!). So, it may be possible to do a firmware upgrade on a newer machine to get an ASV. But I still bet there are hardware differences, especially when you see the difference in price between a CPAP/APAP and an ASV machine. At least in the last ten years, the prices have come down. And the therapies have almost certainly improved.

In any case, I think hoseheads are lucky in a way. CPAP therapy is wonderful when you have a bad head cold, or even a chest cold. It clears out the head almost immediately, and I cough a lot less while on therapy. I suspect that if you are unfortunate enough to come down with COVID-19, that your CPAP therapy, even just basic therapy, will help make it less severe, and offer you a quicker recovery.

[DreamDiver]

I wonder if extending the time outside of intubation with XPAP may actually reduce the response window for when it actually becomes clear that intubation is necessary, increasing patient risk.

...
In any case, I think hoseheads are lucky in a way. CPAP therapy is wonderful when you have a bad head cold, or even a chest cold. It clears out the head almost immediately, and I cough a lot less while on therapy. I suspect that if you are unfortunate enough to come down with COVID-19, that your CPAP therapy, even just basic therapy, will help make it less severe, and offer you a quicker recovery.

[raisedfist]

Not a good time to need EMS in NYC area:

Grim New Rules for NYC Paramedics: Don’t Bring Cardiac Arrests to ER for Revival--
https://www.nbcnewyork.com/news/coronav ... l/2356265/

As someone who is clueless: what are the odds of being revived by the time you get to the hospital, if you can't be revived at the scene?

Normally, as I understand it, you attempted it on the way to ER, which is only a few minutes away in much of NYC. Now you don't even load them into the back. Not so much traumatic for the unconscious patient, but devastating pressure on the EMT.

Ah I see what your saying. I wonder if they will have to lug a portable defib into every cardiac related house call.

Hospitals are close indeed, but arriving by ambulance doesn't get you the instant attention now that it normally would.

I've heard many rants from EMTs about having to transport the worried well who are literally ambulatory and able to walk into the ambulance to be taken in. By demanding treatment for a fever and cough, they are unfortunately indirectly killing other people...calls for seriously ill people can be backlogged over an hour now. More call volume than on 9/11.

I've had a few days recently I did not feel well, including some shortness of breath. I refuse to waste any resources unless I truly feel myself circling the drain.

[palerider]

Ah I see what your saying. I wonder if they will have to lug a portable defib into every cardiac related house call.

They already do. it's part of the standard loadout. they're not very big these days