Thursday | 02 April | 2020
By Reon Janse van Rensburg
With the spread of the Covid-19 virus globally, a drastic shortage of medical equipment including ventilators has emerged. A shortage of ventilators for serious Covid-19 cases is very problematic.
What is a ventilator and what does the machine do?
A ventilator takes over the respiratory process of the body if illness causes one’s lungs to not function as normal. This gives the patient time to fight the infection and to recover while the machine takes over the work of the lungs. There is a variety of ventilators available and which of the different options to use are determined by the condition of the patient.
How many ventilators does South Africa have available?
There is an enormous shortage of ventilators, even in First World Countries. However, it is very difficult to determine a true number of the shortage since there are so many different opinions about the matter. The short, honest answer is that there is not nearly enough.
According to Professor Alex van den Heever, a health economist at the Wits School of Governance, government hospitals have 1 178 bed in intensive care units across the country. Private hospitals have an extra 2 140. ICU beds are equipped with ventilators.
IOL reports that according to a source close to the President, the number of available ventilators is approximately 4 000. The number is still far from sufficient for the likely crisis in which South Africa may find itself.
What is being done about the crisis?
Although all governments worldwide are currently planning to acquire more ventilators, entrepreneurs and private companies across the world has taken their own initiative to manufacture new ventilators. Innovative companies that normally manufacture other products, jumped in overnight and within the span of a few days and weeks, produced new ventilators.
Even South African motor manufacturers who normally manufacture automotive components had to learn new skills. These manufacturers not only keep cars safely on the road now, but also take of people’s health.
The French sports dealer Decathlon, which also has branches in South Africa, developed the Easybreath mask for snorkelling purposes. However, an Italian doctor saw the potential to adapt this snorkel for use in intensive care units struggling to cope with a large number of patients.
Dr Renato Favero contacted the Itailan 3D printing company, Isinnova, and with the help of designers, they were able to design a 3D printed valve that could connect the mask to a traditional hospital breathing system. According to reports there are already 500 patients that are now treated with this custom mask. Follow this link to look at the video which shows how the recreational equipment has been transformed into a medical device that saves people’s lives: https://youtu.be/w4Csqdxkrfw
There are many people globally, many of whom may not yet even have drawn the attention of the local or international media, who are working on new designs to produce cost-effective ventilators that can be used around the world.
Ventilators can cost thousands of Rands and therefore, designers and engineers are trying to keep the cost as low as possible so that countries can benefit from this.
A team from the Massachusetts Institute of Technology (MIT) consisting of engineers, doctors, computer scientists and other people is working on a low-cost design that will be available online for free so people can copy and manufacture it.
These students worked together with local doctors to design a simple ventilator apparatus that can be built with parts of less than $100. The students published an article detailing their design and testing, where after they ended the work at that stage. With the large-scale need for ventilators, a new team, also linked to the same course, resumed the project at an extremely fast speed.
This simple ventilator is a hand-help plastic bag called a bag valve resuscitator and is also known as an Ambu bag. Hospitals already have large quantities of this bag available.
The Ambu bag is usually pressed by hand to give oxygen to a patient until a ventilator is available. A tube is inserted into the patent’s airway, as with a ventilator. It is a task for qualified personnel that are trained to evaluate patients and who can determine the timing and pressure of the pump according to the patient’s needs.
The idea the team had in mind was to design a mechanical system to make the Ambu bag work mechanically without the help of a person, since one person will not be able to manually handle the Ambu bag for an indefinite period of time.
It is also crucial that the design is manufactured in such a way that it does not damage the Ambu bag and that it can be controlled in order to adjust the amount of oxygen and pressure delivered to each specific patient’s needs. The device must also be very reliable as an unexpected failure of the device can be fatal, but as designed by the MIT team the bag can be used immediately by hand.
Well-meaning DIY, yet inexperienced people will probably not be able to build this device as there are many technical elements bound to it and it would have to be ensured that the device works a hundred percent over a long period of time. About 1 million cycles are necessary to ventilate and support one person for two weeks.
The ventilator the MIT team is currently working on.
If your or someone you know is working on a different design or has one that already exists, please share it with the world. You can make a difference in millions of people’s lives! There are many clever and innovative people in South Africa. If we could design the Kreepy Kraul, we can certainly go bigger!
* All information was correct at the time of publication.