The AmboVent initiative is led, by the Israeli Air Force (IAF) 108 electronic depot in partnership with Magen David Adom (MDA) (Israel's red cross). The R&D phase was backed by a large community of innovators, to include: makers from First Robotics Israel (mentors and students), physicians from leading Israeli hospitals such as Tel Aviv Sourasky and Hadassah JLM as well as other medical centers, Engineers from Haifa Technological Center and The garage program by Microsoft Israel, IAF Unit 108, and more. All have joined the endeavor on a voluntary basis. This Ad hoc team work together as an open organization aiming at providing in an ultra-short time a viable, usable, simple and intuitive to use mechanical ventilator.
Leading Open Source Code Mentality Initiative Global Partnership for the Greater good
“AmboVent” is a device inspired by the bag-valve mask ventilators that paramedics use when they’re manually ventilating patients in an ambulance, which also offers controls for respiration rate, volume and maximum peak pressure. The device is being developed as a global partnership for the greater good, in open-source code mentality, on a non-profit basis to enable free and simple mass production by anyone, anywhere in the world. It is designed as an alternative automatic, controlled, ventilation system for adults, to be used only in emergency situations when no other approved ventilation machines are available.
Validation and Evaluation
The team has managed to put in ultra-short time a working prototype, untested properly unauthorized for clinical use solution, knowing that it may go into clinical use shortly. With hope that there will be no need for such rapidly developed. Despite of the ultrashort time (10 days of extensive R&D work), with the help and work around the clock of the talented and committed teams and individuals who joined the effort, the device became real and went through various tests, to examine its performances and safety characteristics.
Regulating the device as a medical product was considered as a non-relevant procedure, due to the time of essence. So far, the testing shows the device can serve, in case there is no other regulatory-approved ventilator available, as an effective alternative ventilator for patients who require mechanical ventilation. A trial of the machine on pigs was conducted by the Hadassah Medical Center in Jerusalem. The machine performed remarkably well even in extreme simulated conditions.
All over the world, engineers are trying to address a current and expected shortfall of critical care ventilators. In a nutshell, if you don’t have enough ventilators, the mortality of COVID-19, which is very high to
start with, doubles. Without ventilators, twice as many people will die.
About an hour ago, a team from Isreal led by Maj. Dr. David Alkaher and supported by many Israeli institutions, including the military, released the complete designs, plans, code, and instructions for AmboVent. Dr. Alkaher gave me a run-through of the machine,
the documentation of the design, and the way they tested it. For the first time, the world now has a freely usable design with enough detail to be buildable that meets published standards for treating COVID-19 patients. The machine has parts and complexity which allow it to be constructed with the tools available in the average makerspace
or by any small manufacturing firm. They have made a video.
The whole world should thank Israel and this team for this. On the same day, Medtronic has released (almost fully now) plans for the Puritan Bennett™ 560 (PB 560), a full-featured ventilator. This device is more complicated to build, but probably offers more
features, and has already been approved by numerous governments. It is perhaps more expensive to make. Time will tell how easy it is for other firms to build. The Medtronic license lasts for a limited time and is
limited to this pandemic; many may see this as problematic. It cannot be the basis, even in part, of a solution that lasts past the pandemic, nor cannot it be the basis of modules to be reused.
Nonetheless, Medtronic has given the world a potentially life-saving gift, however reservedly, and deserves our gratitude. Taken together, these two donations change the landscape. They give a two-pronged approach to
solving the problem. Large firms, governments, and NGOs can set up production lines for the PB 560. I don’t know what the parts will cost. Thousands of small firms and makerspaces can begin making the AmboVent today.
The parts for an AmboVent probably cost about $500. I must now make some disclaimers. This is a fast evolving situation, and I may have gotten some things wrong. Nevertheless, the game has fundamentally changed.
— Robert L. Read, Keeshan Patel, and Nariman Poushin
(The web-published spreadsheet is easier to read
than the screenshot above.)
During this pandemic, everyone is trying to help. Whether temporarily giving up something you love, like going out with friends, or by sewing masks, or by trying to design a ventilator, most everyone is helping. In the USA right now there
is a high demand for mechanical ventilators. The COVID-19 disease causes some fraction of people, perhaps around 2%, to get Acute Respiratory Distress Syndrome (ARDS). This has been accurately called a “very bad lung thing.”
The overall prognosis of ARDS is poor, with mortality rates of approximately 40%.
Make magazine recently called open source efforts to make ventilators “Plan C”. “Plan A” is the government taking over factories.
Apparently that is not going to happen. “Plan B” is industry increasing production; we hope that happens. But the stakes are high. “Plan C” may be required.
In a public GitHub repo, volunteers at Public Invention and
EndCoronaVirus.org have compiled a list of resources and all known open source mechanical ventilator projects. This list is changing every day. Anyone
can suggest an improvement or update by entering an issue.
In order to allow volunteers to understand the state of these projects, we have analyzed each of these projects along seven attributes to provide information, transparency, and guidance. These values are purely our own opinions, and are
not meant to disparage any project. We have focused not on technical cleverness but on the chance that medical professionals would actually have enough confidence in a particular ventilator to deploy these life-critical devices to
patients who need them as a last resort. We have articulated a draft process that we hope is holistic and practical for actually testing and fielding these devices. Each attribute has five defined levels of readiness. The attributes are Openness, Buildability, Functional Testing, Reliability Testing, COVID-19 Suitability, and Clinician Friendliness. The web-published
spreadsheet is easier to read than the screenshot above.
In less than a day, since the material has been made available online, over 40,000 people have accessed the website and over 100 groups of experts from all over the world – including Iran, Egypt, South Africa, Guatemala, Italy and the United States – were starting working to build up their first prototypes.
All source codes, parts list, electronic specs and engineering designs can be found in GitHub here 👇👇👇
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