The MADBox Solution

Ventilation is a valuable method to keep patients respirating while sedated and when recovering from disease and injury. Unfortunately, with the COVID-19 pandemic, all too many people are finding themselves in the hospital due to an inability to sufficiently breathe. Healthcare providers currently have little choice but to invasively intubate these patients, as non-invasive methods spread virus-laden droplets through the hospital room and hospital to potentially infect others and especially healthcare workers.

But intubation implies ventilation, which brings its own risks to patient recovery. With COVID-19, the lungs are often compromised, with reduced volume that makes it more difficult to sustain life even with a ventilator. In ventilation, the patient is usually sedated, is dependent on careful attention to their survival by overwrought healthcare workers, and, after recovery, the patient must be weaned off of the ventilator. Each of these stages carries a risk of morbidity and mortality.

If non-intubated options were made available, including continuous positive airway pressure ventilation and O2 delivery, the risks of ventilation could be reduced for the patient unless absolutely necessary. Further, non-ventilated treatment saves a ventilator for a patient who needs it. Since ventilators and ventilator technicians are scarce worldwide in this public health emergency, any means to free up these resources benefits society.

Our team has devised solutions to the problem as described below.

COronavirus Safety during Intubation and Extubation (COSIE)

Devised by Dr. Alexander M. Girgis, M.D., with Gopesh Tilvawala, James Friend, and other engineering and medical staff from UC San Diego School of Medicine, the Jacobs School of Engineering and the Qualcomm Institute, the healthcare worker can treat patients without requriing intubation.


After construction of the boxes, showing the mounting handle, the bed fixation, and the ports for healthcare worker access to the patient during intubation.


Box design indicating port sizes, cuts, and shapes. The boxes may be fabricated from acrylic or polycarbonate, the latter providing greater durability. 

Our team engaged in mass manufacture of the COSIE boxes with volunteer effort.

Gratefully supported by

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with funding, facilities, and staff

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