FRC Helping the COVID-19 Situation, Automating Ambu Breathing Bags

FIRST General Forum
#1

Hello all, I hope this post finds you in good health and spirits!

Within the US & other countries as the situation gets worse, ventilators will become in very short supply. (Source)

My dad has been speaking with a friend who is a doctor, and the working theory is that if we run out of automatic ventilators hospitals and caretakers will have to turn to Ambu Breathing Bags. (Click Here to See the Bag) These bags require a manual squeeze roughly every 3 seconds. This means if ventilators run out, people will be required to manually work these bags for loved ones or hospital patients.

It was suggested by the friend that our robotics team work on a solution that automates this process, and my immediate reaction was to open this up to the FRC community. If there is any way for us to make this a 3D-Printable, or actual product to be given to hospitals, it could help the situation immensely.

I don’t have an immediate answer on how to automate this process, or get this to market/distribute it, but here are some of my thoughts-

  • A 3D-Printable piece may be very useful, as the community could print and donate assemblies/pieces.
  • This could most likely be done with a servo, or some other actuator. If we end up working with a 3D-Print, we’ll have to provide some sort of bill of materials of what else is needed to buy, and a instruction set on how to assemble.
  • If there is any way to get STRYKER involved that may help get a product to the market. (I know they work with lots of FRC Alumni, thanks FUN)

I hope we can all come together, and help solve this issue. Please use this thread to share any ideas, 3D models, etc. If there is enough interest we can also organize via Discord or something else and work on this project a little more intimately.

#2
#3

This is a terrible idea. I understand that you mean well, but FRC teams are not capable of designing and building medical devices that will kill someone if they fail. And no, it’s not better than nothing, because a homemade untested device that someone trusts and doesn’t monitor is going to be much worse than a manual bag because people are going to wander off and not monitor it.

If the solution is as easy as whipping together some 3d printed parts and hooking them up to an arduino, I assure you that the medical devices companies are going to be all over that.

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#4

Look at that, had looked around and couldn’t find anything. That’s awesome.

Nevermind then.

#5

Someone has already found a solution so we no longer had to. You never know if we had come up with something and actually gotten in vetted by professionals. Just wanted to help. I see what you mean tho.

#6

Alright before a fifth of these threads go down the rabbit hole again. Please keep in mind that 3d printing by its nature is not sterile, especially not without any form of post-processing, and random individuals (or frc teams) simply do not have this equipment.

Numerous people have been reaching out to hospitals about helping 3d print, and the answers have basically had to be a no because there’s no easy way to guarantee sterility

However working with a professional company is different because they can implement steps and post print processes to make it so and one can rely on them that it is.

Which is why hospitals are turning to companies like hp, flashforge, etc etc etc etc to donate their 3d printer hours and not individuals.

Edit: Kevin sniped me

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3D Printers vs. Coronavirus
#7

PPE is more important than ventilators. Donate & Build PPE. Anyone who’s sewn a bumper can sew a mask.

In SF, there are groups working on coordinating PPE donation & crowd-manufacturing masks gowns and shields.

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#8

Makes sense, I hadn’t looked into that at all.

There’s already one made and being produced so, nevermind!

#9

I just read the statement of the OSCMS, and stand corrected on what I posted below. Here is OSCMS’s current position on ventilators:

This does not mean that no one should be working to increase ventilator supply, but it does mean that other supplies (e.g. PPE) may be of more direct use to those who are treating patients. If you do not have knowledge or experience of mechanical ventilation and are not working with someone who does, you may be better off focusing on other projects.

My original reply (OBE):

It was a generous, innovative, and proactive thought and attempt to reach out, @Brayden4388. I’m sorry that others here were so quick to jump on your proposal and point out the challenges as though they were impossibilities.

The spirit of FIRST, the spirit of innovation, is to solve problems, not shy from them. Proper vetting of a design, if an ‘amateur’ came up with one is a problem to be solved, not a reason to abandon hope. Likewise, large scale production and sterilization are problems to be solved, not reasons to give up and leave it to industry or the ‘experts,’ but rather to engage them in defining requirements and reviewing novel concepts.

Innovation can come from anywhere, definitely not least from FIRST teams. Any impediments to implementation are just additional multi-disciplinary challenges to be solved. Open sourcing ventilator designs that are faster to manufacture with existing distributed capacity is still an open issue, and I encourage this community to think of ways to organize and focus creative energies toward addressing the shortages, which are about to become staggering in the U.S. and elsewhere.

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#10

Thought I had while listening to 60 Minutes - is DEKA looking to help make ventilators or parts for them? They seem well suited as a medical supply company.

#11

This seems like a nice concept that eliminates the need for sterile printed components. Given a pandemic scenario, shouldn’t liability concerns about a home brew medical device go out the window? I’d rather have a prototype ventilator than none at all - especially one based on actuating existing commercial medical equipment. Typically I err far on the side of existing standards and regulation, but if there aren’t enough devices to keep people who need them alive, isn’t a gamble better than a certainty?

#12

If you want to help with 3D printing, check this site that’s organizing 3D printing for face shield/masks: https://budmen.com

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#13

You’d think they would go out the window, but the problem is that if something goes wrong, the lawyers get involved. They will ask the following questions, in about this order:

  • What went wrong?
  • Was this part to blame?
  • If it is, why isn’t it certified by [appropriate bodies here]?
  • You let a homemade device into this facility to provide medical care? INSURANCE!!!

This is then followed by the hospital or medical facility having to pay out of pocket for whatever went wrong.

Now, if the answer to the second question is “No”, then the lawyers will be asking similar questions to 3 and 4. If the regulators/insurance folks agree that it’s not an issue, then you’re home free. If either one says it is, then you’re toast.

Now, when I say the medical facility pays out of pocket–if it was YOUR device that failed, they’ll be paying their lawyers out of their pocket to take the “what went wrong” damages out of your pocket instead (minus whatever regulatory fines they have to deal with).

In this case, though, and remember I’m not a lawyer, you might be able to argue “Good Samaritan” depending on your location, and that would give some partial liability shielding. But that’s a gamble.

#14

I’ll take the jury trial in this suit: big insurance versus a private citizen trying to save someone’s grandmother due to a shortage of critical medical infrastructure.

It’s fascinating and disturbing to me that our culture still values things like legal liability in a time where it really doesn’t matter for a sizable cohort of our society. Make no mistake - I believe in responsible engineering practice. Very soon there could be people that need rapid innovation regardless of its vetting by dubiously effective agencies like the FDA.

Anyway, there might not be too many tort lawyers to litigate once this is all over with.

#15

I’ve started to hear stories like this one about printing masks for hospitals. https://www.ktvq.com/news/coronavirus/billings-doctor-finds-inventive-way-to-help-with-shortage-of-medical-masks?fbclid=IwAR3VOGiv8LPBXd2yESzKtNQPbGNhBg1nPyS292Yh7vfgrLyFyLDaVs1BbzU

My wife is a nurse and their management has been very stingy with handing the N95 masks out because their supplies are so low, even to more at risk staff (my wife is pregnant). Basically she has to have a patient with a confirmed case before they give her one. if 3d printed masks like these, from the story i shared, could be made and donated from robotics teams i know they’d greatly appreciate them… they’d be much better than scarfs or bandanas as I’ve heard recommended.

links to directions and files for masks can be found here: https://www.billingsclinic.com/foundation/

#16

I’m gonna go out on a limb and say that the FDA is a pretty effective (and essential) “agency”. While in a world inhabited entirely by moral and upstanding people, a free market of sorts would be tremendous. Unfortunately, we don’t. The FDA and many bodies like it worldwide provide the checks and balances to keep deadly snake oil medical devices (and drugs, etc) off shelves.

While the intentions here are good, the potential ramifications of a failure are heartbreaking. Please consider helping out one of the already existing efforts to produce PPE responsibly.

1 Like
#17

It’s just like, my opinion man, but ok: https://en.m.wikipedia.org/wiki/Criticism_of_the_Food_and_Drug_Administration

Apparently I’m not the only one that sees potential issues with federal agencies staffed by former industry insiders with massive incentive to support said industries (FAA/Boeing cough cough).

My basic point has been completely overlooked. Let people help people that are most certainly likely to die without help.

1 Like
#18

Depends on what the gamble is.

I keep seeing proposals for hobbyists to 3d print valves, which sounds like a great way to feed bacteria stuck in FDM layer lines from the hobbyist’s non-sterile lab directly into the lungs of a critical-condition patient.
(Give medical device companies three weeks to ramp up and they’ll get this covered, 100k pieces is still medium volume.)

What I appreciate are folks sewing cloth over-masks right now so that existing N95 respirators can get used for multiple patients and supply stretches farther to keep our healthcare providers from getting sick, and so that patients have something to put over their mouths while theyre coughing and reduce aerosol counts without using up the surgical masks.

Relief Crafters of America is a particularly tightly focused and organized group https://www.facebook.com/groups/reliefcraftersofamerica
Mask Makers is a more classically American “blunderbuss” approach
https://www.facebook.com/groups/2228975397397815/?fref=nf

If you must 3D print, visors for plastic shields are a good option. This is another measure that allows a worker to use a single N95 respirator for longer. Bethmo’s link above is valid, and outside CNY there’s a tree of options listed in the OSCMS doc I linked above.

I’m glad that surgeon trusts their dentist buddy to produce good equipment. It’s very easy for FDM layer lines & voids to harbor microbe growth (or leak). Many common cleaners will damage them. Most worryingly - a significant number of HEPA-type furnace filters are made with fiberglass or plastic fibers that (after cutting to size) can get free to irritate lungs. Trade one pneumonia for another. I hope to God they’re using a safe design & procedure.

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HELP the COVID-19 Situation: Pretend to be a doctor!
#19

Looks like someone’s involved in FRC


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MIT ventilator E-Vent project
#20

I suspected that the heat of a 3D extruder was pretty good at sterilization. I found and article to back that up. https://www.authorea.com/users/4381/articles/4634/_show_article
Your other statements that porous objects being hard to sterilize and our workshop being terrible places for producing sterile items are spot on. But the 3d prints themselves might be good for one time use medical items.