Inspiration

When the New York state governor demonstrated using a bag-mask compressor in a press conference and mentioned that the state will be soon out of ventilators, it was the first realization to our team. In a country like India, once the pandemic blows over, the ventilators will not be enough and the patients, medical staff, their families will have to re-integrate in the environment in a safe and friendly manner. Over the next few days, we came together as a team with both the hackathon and COVID-19 in mind, we started gathering materials and components to build the device. We even started to talk to doctors and hospitals and got good demand and validation from them and finalized on an idea to build over the weekend. As we go deeper into the pandemic, hospitals will see a spike in demand for ventilators, non-breather masks, CPAP machines, and Ambu bag implementation, as confirmed by numerous medical teams we interviewed. With the current bag valve mask technology and ventilator, a medical health professional needs to be with the patient 24/7 to manually operate the bag valve mask, if not a ventilator. This would be gruesomely tiring for the medical teams and would also expose them to infected patients for extended periods of time. The understanding stands that the coronavirus damages the hosts' lungs by almost 30%. This means that a patient who is affected by coronavirus is susceptible to viruses/diseases affecting the lungs and has lesser power to battle the same. In a post COVID-19 world it is extremely necessary to be prepared for emergencies related to such patients and be in abundance of ventilators and respirators that can be used at will.

What it does

Our solution is an IoT portable ventilator device called reSPIRE that will provide respiration support to COVID-19 patients by compressing the bag valve mask at the correct breaths/minute, inhalation/expiration ratio, and tidal volume. It can be controlled by an operator using the on-system controls or using control on an app. The device can be switched between pressure and volume modes making it seamless just like an actual ICU ventilator. Our app, integrated with the device, will enable the health care professionals as well as the patient caregivers to remotely monitor and control pressure, volume, and flow rates in response to changing patient behavior such as FIO2 levels. Post the COVID-19 pandemic, it will assist doctors to care for remote patients, as they re-integrate themselves into the world.

In a simple explanation, the reSPIRE device helps rhythmically compress the bag valve mask to provide air to the patients as a non-invasive medical procedure. However, it is much more sophisticated as it allows medical professionals to change various parameters of how the air is delivered, just like a ventilator. The device allows changing the tidal volume delivered, breaths per minute( BPM) as well as the inspiration: expiration ratio( I: E ratio). The device is also equipped with modes such as the SIMV-P and SIMV-V mode which runs the device on a feedback loop and allows it to auto-adjust based on the current state of the patient thus aiding the breathing of the patient. The device can be controlled using the on-board switches and knobs. The device has been coupled with a WiFi module that transmits the data to a cloud database that has been configured in SQL for easy storage of data based on the structure. The data is further picked up by a mobile application to further view the data as well as modify the controls using an internet connection. The data stored in the SQL Server is shifted to an AWS cloud repository for storage at a fixed time and at a fixed frequency to keep the databases empty. The data stored on the cloud repository further can be used for analytical purposes as well as profiling the patients under the care and their breathing requirements during the ailment.

How we built it

We used the opportunity of the hackathon to ideate, make a proper design on paper, and also take feedback from medical professionals in our network. Then over the weekend, we paced up prototyping, testing and validating the product.

Since what we are offering is a complete end to the end product, we have numerous components that we are developing simultaneously, trying to make them more intuitive and context-relevant. We used this opportunity to align these different components to make it more a holistic product. We even made a glass-based wood casing using home-based materials for proper prototyping.

The Electronics of the device are simple yet sophisticated to match the scale of a medical device. For our prototype, we’ve used an OSEPP Max- Arduino Compatible board along with a DS3235 Servo motor. There are 3 pressure sensors used in devices that serve different purposes.

The differential pressure sensor in the device helps measure the flow of air from the bag-mask to the patient. The flow can be controlled and eventually used to measure the Tidal Volume of the respirator.

The gauge pressure sensors help measure the expiratory pressure and the plateau pressure generated by the respirator. These are critical measurements in terms of the device being medically feasible. The second gauge pressure sensor allows recording the activity of the patient. If a patient tries to put any effort into breathing himself/herself, the gauge pressure sensor records a drop and provides the feedback to the micro-controller device which in turn modifies the breathing cycles to aid the patient into breathing.

The proprietary code that has been developed for the device allows efficient control of the system as well as a selection of modes that puts the ventilator into an autonomous setting for achieving the intended goals. The SIMV mode can control the bag-mask compressor to achieve required Tidal volume, Inspiration: Expiration ratio as well as the Breaths per minute. The modes can either be selected using the controls present on the device as well as the mobile app. The mobile app allows remote control of the device as well as access to patient information in a highly organized format.

The device is equipped with a WiFi module that enables this functionality. The data is uploaded to a SQL database online which is hosted on a cloud server. The data is shifted to an AWS cloud repository every 10 minutes to allow seamless performance benefits for the application connected to the SQL database. The AWS cloud repository hosts the data for analytical purposes and further learning such as profiling of patterns based on patient information.

On the tech side, we improved on our codes and integrated a cloud component with the device, on the design side we conducted various interviews of experts in practice and incorporated the feedback that we received into the product-service. On the research end, we used this opportunity to read in various fields by talking to medical professionals. One comment we got from most interviews that we conducted was to have these materials ready since there is a lot of interest in such product- service offerings especially with the cloud-service, application for monitoring and control, and the cost which is not matched by any other existing product. And hence, finally, on the dissemination end, we started preparing materials such as videos, app, write-ups that we can start using to reach out to the necessary network post the hackathon.

The data is recorded using the sensors and control potentiometers on the device. The microcontroller unit further records the movements of the servo motor to record the number of breaths supplied per minute( BPM), Inspiration to Expiration Ratio ( I: E ratio) and the Tidal Volume achieved to verify if the required controls are having the intended effect.

Challenges we ran into

Since the device belongs to the Medical Field, it required us to be in constant contact with medical teams and practitioners among our network. Medical devices require superior quality as it affects the lives of people being treated. Keeping this in mind, any changes on the device had to be reviewed before being uploaded on the server for testing. The remote location of the team proved challenging and required significant effort for collaboration. The team spread across 5 time zones which allowed limited scope for meeting times. The prototype had to be developed locally which required the availability of parts, electronics as well as the code to be tested and developed online. Due to the ongoing Pandemic, gathering the parts and electronics was not easy which played a significant role in up the ante for us.

Accomplishments that we're proud of

Despite being in 5 time-zones across the world, in just 48 hours, we managed to build a completely sleek first stage prototype, test it, get it validated by medical professionals, and also make an IOT based app to control it for seamless user experience. Our complete prototype cost was under $100 to make it completely low-cost and scalable for developing countries.

We managed to hack our skills and make a complete scalable product with lean design and parts available at home. The device can easily be mass-manufactured and distributed to doctors, recovered patients as well as healthcare caregivers so that re-integration in the post COVID-19 world is safe, friendly, and with complete ease and low-cost.

What we learned

During the last 48-72 hours, we’ve taken the project from the Ideation phase to development and reached here with an almost complete prototype. The times have proved to be extremely exciting as we learned multiple things about the medical field, collaboration as well as constantly kept in mind the millions affected by the deadly COVID-19 disease which motivated us to complete what we began and give back to the community. Some highlights of what we’ve learned during this Hackathon has been listed below:

Medical devices require extreme precision and you can’t put what works the best on a patient unless it's validated by someone who’s an expert in the field.

IoT, Cloud and Mobile technologies become extremely important when a pandemic such as COVID-19 occurs and requires us to socially distance. Using these has allowed us to efficiently focus on the problem statement and design a solution for a world after COVID-19.

What's next for reSPIRE

We hope to use the EUvsVirus Hackathon to validate our idea, gain some valuable feedback, and actually impact the world with our device.

We have a letter of intent from a Gujarat based hospital for devices like these. With the right resources, we can easily start manufacturing by exploiting 3D printing within the next 4 weeks and will be able to achieve 6000 devices/month. We can give to hospitals, patients to do proper testing.

We can achieve a ‘ready to use the product’ within 4 weeks and aim to supply more than 100,000 devices in 2020. Our solution can assist the exhausted medical teams, provide exceptional control and monitoring during high patient volumes, keep the medical staff and the patients safe from catching new infections by enabling social distancing with technology.

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