CPAP use for Coronavirus mitigation & severe pneumonia

[dahornor]

Following thread.

[becker44a]

This may not be the proper place to post this, so feel free to move it if needed.  My sister sent me this link, and it shows a rather different perspective on what is going on.

In Google search for (including quotes):  bergman youtube  "How to wipe out the coronavirus"

or use the Youtube link:  https://youtu.be/iRH2ei8U5xw

Some food for thought here . . .

[SuperSleeper]

Might be some good info, but he's try to sell monthly memberships with links in the description to his "Extreme Health Academy" and he's not an MD, but a Chiropractor.  Okay to post it here according to temporary new policy, but viewers should watch with a skeptical eye, since he's obvious trying to sell something.

[slowriter]

There's a couple of other open source ventilator projects listed here:

https://opensource.com/article/20/3/open...re-covid19

[dahornor]

The Israeli Defense Forces are working on this concept as well:


https://twitter.com/IDF/status/1240688115083169792

Courtesy of my 6 & 7th grade buddy, Harry, with whom I tried to make Nitro Glycerin (unsuccessfully)--back in the early 70's.

More from Harry:

"I'm asking an anesthesiologist and an MPH MD infectious disease doc about it. If they both agree I might actually go make a cpap/bipap hospital o2 intake adapter and find a way to do it in quantity and sell it."

Go, Harry, go!

[Cpapian]

Here is another working on a respirator 3d printed

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

[SuperSleeper]

Looks like a lot of engineer types are starting to step up and come up with alternative solutions to the ventilator shortage.  That's a very good thing.

That said, most of that type of effort is completely out-of-reach or of little near-term use by most of our members due to our lack of engineering skills and lack of personal access to 3-D printers and other equipment with which to experiment.

What I'd like us to get back to is focusing on what the majority of our forum members currently have on hand (CPAP, Bi-Level & ASV Machines).   How can we utilize those machines to help with COVID-19 & associated pneumonia when hospitals become overwhelmed?

Although important information has been posted here, I'd prefer the bulk of this thread focus more on using the machines we have now.  All these efforts to design new machines is great, but that type of task is literally impractical for the vast majority of our forum members.

So, I'm going to re-post my points in an earlier post, and ask folks who are more knowledgeable to comment, critique and express their thoughts or possible tweaks to this type of an approach.

Let's try to get this thread focused upon practical solutions that can easily be implemented by our members in a worse-case scenario, using the supplies & equipment they currently have on-hand.

Perhaps we can get something like a standard protocol that might help some people in the near-term as the healthcare systems become overwhelmed.

My post again:

I'm not as knowledgeable as others here on this forum, but I was thinking that if the situation arose where I or a family member got viral pneumonia as a result of COVID-19 and needed ventilation (at a time when hospital care is out of the question due to lack of ventilators), I would do something along these lines:


1.  Turn up the CPAP pressure to the maximum (20, 25, or whatever the particular max pressure for that machine).

2.  If CPAP, turn on the maximum of C-Flex, A-Flex or EPR for comfort when exhaling.  Or adjust EPAP & Pressure Support accordingly for a Bi-level etc.

3.  Monitor blood Oxygen levels with a pulse oximeter on a regular basis.

4. Re-adjust max pressure, perhaps lowering it as long as SpO2 remains at least 92 or higher.  Leave it on max pressure if it's lower than that.

4. Use a full face mask if the pressure is too much with a standard nasal mask or nasal prong/pillows system so that the extra pressure doesn't simply escape out of the mouth while sleeping.  Or use a pretty strong chin strap to keep the patient's mouth closed.

5. When serious pneumonia comes, stay on the machine 24/7, or as much as possible.

6.  Utilize the "prone position" method when in bed to help with fluid drainage as much as possible. 

7.  If patient is able, use a "Lung Flute" or flutter type PEP device to help break up fluid and assist with productive coughing.  Or use other methods to help with productive coughing.


As always, I'm hoping folks will critique the above approach and add their own comments or suggestions and correct any misconceptions that I may have.

I'd really like us to come up with a standard protocol that people can use in a dire emergency situation when conventional medical help is no longer available.  Again, this is not the best-case scenario-- it's for a situation where we're forced to do the best we can with what we have on hand.

Of course, if Johnny Lee comes up with a way to modify the mechanics of a CPAP machine to force breathing with timed pressure increases, that might be better, but in the mean time, most people aren't going to have the mechnical skills to do what he is doing and will need simple advice on how to use their CPAP machine as-is to help with pneumonia as best they can.

[Gideon]

In addition to what SuperSleeper mentions above, 
What can OSCAR do to help during this Pandemic?

1. Maximize the info you can get from your device. (I think OSCAR does this OK)
2. Distribute OSCAR for free (Always)  AB is conducting a donation drive which helps with this, any donations are appreciated.

what can OSCAR do that we are not currently doing?  What are your ideas?

[Gideon]

FYI, I would change #1 above from max pressure to optimize the device for the users current situation. Max pressure may or may not be the optimium.

[zzzZorro]

Kudos SS.  Got my curiosity as I am one who would be at the 'back of the line' no matter when I arrived.  Worthwhile brainstorming project.
I DID get assistance right off the bat with your "Lung Flute" or flutter type PEP device.  Had absolutely no idea what you were talking about so looked it up.
Hit me like a ton of bricks- didn't know anything like that existed.  I have fought for years with thick mucus collecting especially at night during sleep and the Bi-PAP seems to make it worse.  Usually have to get up to hack it out.  THIS DEVICE LOOKS LIKE THE BEES KNEES!  My daughter (50 years ago) had severe asthma and we had to continually whack on her back to dislodge mucus from her lungs.  What a Godsend this would have been to her then!
THANKS