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.
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.
Work(s) (the “Work”) by:
COVID-19 Acute Ventilation Rapid Response Taskforce (AVERT) Medically Advanced Devices Laboratory
Department of Mechanical and Aerospace Engineering
Jacobs School of Engineering and the School of Medicine University of California, San Diego
9500 Gilman Drive MC411
La Jolla, CA 92093-0411
This Work is Copyright © 2020 The Regents of the University of California. All Rights Reserved. Permission to copy, modify, and distribute this Work and its documentation for educational, research and non-profit non-clinical purposes, without fee, and without a written agreement is hereby granted, provided that the above copyright notice, this paragraph and the following three paragraphs appear in all copies. Permission to make commercial and/or clinical use of this Work may be obtained by contacting:
Office of Innovation and Commercialization
9500 Gilman Drive, Mail Code 0910
University of California
La Jolla, CA 92093-0910
This Work and documentation are copyrighted by The Regents of the University of California. The Work and documentation are supplied “as is”, without any accompanying services from The Regents. The Regents does not warrant that the operation of the Work will be uninterrupted or error-free. The end-user understands that the Work was developed for research purposes and is advised not to rely exclusively on the Work for any reason.
IN NO EVENT SHALL THE UNIVERSITY OF CALIFORNIA BE LIABLE TO ANY PARTY FOR DIRECT, INDIRECT, SPECIAL, INCIDENTAL, OR CONSEQUENTIAL DAMAGES, INCLUDING LOST PROFITS, ARISING OUT OF THE USE OF THIS WORK AND ITS DOCUMENTATION, EVEN IF THE UNIVERSITY OF CALIFORNIA HAS BEEN ADVISED OF THE POSSIBILITY OF SUCH DAMAGE. THE UNIVERSITY OF CALIFORNIA SPECIFICALLY DISCLAIMS ANY WARRANTIES, INCLUDING, BUT NOT LIMITED TO, THE IMPLIED WARRANTIES OF MERCHANTABILITY AND FITNESS FOR A PARTICULAR PURPOSE. THE WORK PROVIDED HEREUNDER IS ON AN “AS IS” BASIS, AND THE UNIVERSITY OF CALIFORNIA HAS NO OBLIGATIONS TO PROVIDE MAINTENANCE, SUPPORT, UPDATES, ENHANCEMENTS, OR MODIFICATIONS.