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yrnkrn wrote: ↑

Tue Mar 17, 2020 3:47 pm

True, I can't put firmware on any ResMed machine as the firmware is closed source and unavailable to me.
For the S10 series, ResMed can update the relevant ventilator modes using over the existing air (cell) firmware distribution.
The update would not have to be free, they can charge for it and send it only to specified machines or countries.
Would make many more ventilators available immediately alleviating one of the bottlenecks.

Since the ventilators needed aren't NIV, again, no.

Hope this isn't to far off topic. This thread is way over my head, that said it raises a question in my mind. It seams highly probable that the medical system may become overwhelmed and only the sickest of the sick could have access medical care. In normal circumstances self treating would not be recommended, but if resources become stretched could CPAP, APAP, or the BiLevel machines be used at early onset of pneumonia to help with ventilation and reduce the probability of needing hospitalization and more invasive ventilation?

colomom wrote: ↑

Tue Mar 17, 2020 4:59 pm

Hope this isn't to far off topic. This thread is way over my head, that said it raises a question in my mind. It seams highly probable that the medical system may become overwhelmed and only the sickest of the sick could have access medical care. In normal circumstances self treating would not be recommended, but if resources become stretched could CPAP, APAP, or the BiLevel machines be used at early onset of pneumonia to help with ventilation and reduce the probability of needing hospitalization and more invasive ventilation?

It could just as easily give you a false sense of security and delay the time to intubation which is risky because after a certain point it can be too late to be useful. A bi-level would be for a last resort situation, meaning you aren't getting a vent, so might as well use it since it's better than nothing.

I do know some people who get over infections at home while on NIV, but those infections have actual treatments. COVID-19 does not.

Here is one such project to use a CPAP with additional hardware/sensors to make a DIY ventilator:

https://github.com/jcl5m1/ventilator

Saw it mentioned in this article:

https://www.vice.com/en_us/article/5dm4 ... rus-demand

I would say only feasible for someone with engineering background, or lots of experience & contacts at their local maker space

palerider wrote: ↑

Tue Mar 17, 2020 4:27 pm

Since the ventilators needed aren't NIV, again, no.

Isn't invasive or noninvasive a feature air delivery - tube inside body vs. tube to mask?
With appropriate software, why can't CPAP hardware (casing, electrnoics, pump & sensors) used for IV?

colomom wrote: ↑

Tue Mar 17, 2020 4:59 pm

...It seams highly probable that the medical system may become overwhelmed and only the sickest of the sick could have access medical care...

While the flu season this year has been complicated with the COVID19 strain in addition to the "regular" flu (if there is such a thing as "regular"), we are no where near having to "ration" care at any level and it is highly unlikely we will. To quote another article (https://theconversation.com/coronavirus ... nic-132941):

"...The 1918 flu pandemic caused more than 25 million deaths in less than 25 weeks. Could something similar happen now? Probably not; WE HAVE NEVER BEEN BETTER PREPARED TO FIGHT A PANDEMIC..." (emphasis added)

Here is current info I just copied off the CDC website (https://www.cdc.gov/flu/weekly/index.htm):

Key Points

-- Clinical laboratory data remain elevated but decreased for the fourth week in a row while ILI activity increased slightly. The largest increases in ILI activity occurred in areas of the country where COVID-19 is most prevalent. More people may be seeking care for respiratory illness than usual at this time.

-- Nationally, influenza A(H1N1)pdm09 viruses are now the most commonly reported influenza viruses this season. Previously, influenza B/Victoria viruses predominated nationally.

-- Laboratory confirmed influenza associated hospitalization rates for the overall U.S. population remain moderate compared to recent seasons, but rates for children 0-4 years and adults 18-49 years are now the highest CDC has on record for these age groups, surpassing rates reported during the 2009 H1N1 pandemic. Hospitalization rates for school-aged children (5-17 years) are higher than any recent regular season but remain lower than rates experienced by this age group during the pandemic.

-- Pneumonia and influenza mortality has been low, but 144 influenza-associated deaths in children have been reported so far this season. This number is higher for the same time period than in every season since reporting began in 2004-05, except for the 2009 pandemic.

-- CDC estimates that so far this season there have been at least 36 million flu illnesses, 370,000 hospitalizations and 22,000 deaths from flu.

-- Antiviral medications are an important adjunct to flu vaccine in the control of influenza. Almost all (>99%) of the influenza viruses tested this season are susceptible to the four FDA-approved influenza antiviral medications recommended for use in the U.S. this season.

You are talking right past each other. One of you is talking about, and quoting information concerning, the past and present. The other is discussing what all knowledgeable professionals say WILL happen soon unless widespread changes in behavior occur. Those are two different discussions.

The reason we are better prepared than preceding generations were for earlier pandemics is that science and information distribution about what needs to be done have advanced. That has absolutely nothing to do with the preparedness needed with equipment, infrastructure, and supplies for what WILL be needed soon unless the situation is drastically changed from where it is STILL headed. Can either scenario happen? Yes. Flattened curve OR the dreaded sudden peak curve. Those conflicting scenarios are dependent on response of the public not just the response of clinicians, researchers, equipment manufacturers, and administrators. The fact that the full disaster has not yet occurred is irrelevant when discussing what efforts are now to prevent it.

yrnkrn wrote: ↑

Wed Mar 18, 2020 1:05 am

palerider wrote: ↑

Tue Mar 17, 2020 4:27 pm

Since the ventilators needed aren't NIV, again, no.

Isn't invasive or noninvasive a feature air delivery - tube inside body vs. tube to mask?
With appropriate software, why can't CPAP hardware (casing, electrnoics, pump & sensors) used for IV?

I've got better things to do than waste my time on this.

Sure, you're right, happy now?

JayDee wrote: ↑

Wed Mar 18, 2020 9:36 am

colomom wrote: ↑

Tue Mar 17, 2020 4:59 pm

...It seams highly probable that the medical system may become overwhelmed and only the sickest of the sick could have access medical care...

While the flu season this year has been complicated with the COVID19 strain in addition to the "regular" flu (if there is such a thing as "regular"), we are no where near having to "ration" care at any level and it is highly unlikely we will. To quote another article (https://theconversation.com/coronavirus ... nic-132941)

History says what will happen is going to depend on what we do:

https://www.npr.org/sections/health-sho ... save-lives

palerider wrote: ↑

Wed Mar 18, 2020 12:31 pm

I've got better things to do than waste my time on this.
Sure, you're right, happy now?

I am looking for answers to these questions, not for a fight.
You are long time contributor to cpap forums and if you know the answers, please share.

Doesn't use any CPAP parts, but an open source ventilator design:

https://techcrunch.com/2020/03/19/open- ... -one-week/

Interesting article.
https://www.bbc.co.uk/news/amp/health-52087002

I know that these machines will be specially adapted for this purpose. Just wondering what settings you all would change on your own machines should you succumb to COVID-19, if you're not in need of medical assistance?
I'm thinking maximum humidity and maximum EPR

Why do you assume those? Only a doctor could say.