Creating access to low-cost respiratory support equipment for disaster relief

L-R: Mr Justin Chan, Ms Louise Chen, and Ms Kate Koh. The snorkel mask can be used as an alternate form of PPE for health care providers and for non-invasive positive pressure ventilation for patients. Photo courtesy of Lydia Nagai Photography.

When the World Health Organization declared COVID-19 a global pandemic on 11 March 2020, I found myself with unexpected time on my hands as surgeries were cancelled to augment capacity at Vancouver General Hospital in the event of a COVID surge. I leveraged my longstanding research collaboration with UBC engineering sciences and issued a call-to-action with former students, Dr Philip Edgcumbe, a UBC radiology resident and biomedical engineer, and Mr Alex Waslen, a UBC engineering student, to come up with an idea for a low-cost ventilator to address the anticipated worldwide shortage. In less than 6 weeks COSMIC (www.cosmicmedical.ca) designed a ventilator prototype.

The gravity ventilator, or gVent, was awarded the $100 000 Roche Canada COVID-19 Innovation Challenge based on its unique inverted piston and water seal design; an affordable, mechanically simple, resilient design optimized for disaster relief. 

Our mission is to create access to respiratory support equipment and PPE for health care professionals and COVID patients in need, and we believe one of the best ways to do this is to share our work as widely as possible. All COSMIC designs, once finalized, will be available as open source content online, free for groups to iterate on and make their own. Locally, in partnership with the Arts Club Theatre Company, we held tours of our demonstration research field hospital to showcase the breadth and capabilities of COSMIC’s various devices to donors, youth groups, medical professionals, and community leaders. Our outreach team continues to field ongoing requests for our devices from low- and middle-income countries including India, Pakistan, Brazil, and Mexico among others, and we are actively engaged with local development and manufacturing partners in those countries to provide solutions and deliver our products to areas of greatest need.

COSMIC currently has more than 150 registered volunteers, including doctors, engineers, and designers ranging from students to professionals. In addition to gVent, COSMIC has designed other novel devices such as the clinical respiratory support system, designed to both supply safe air to patient-side devices as well as scavenge expiratory aerosols and render them virus free before releasing them back to the environment. A modified snorkel mask that provides full-face PPE for health care providers as well as an alternative non-invasive positive pressure ventilatory (NIV PPV) support version for patients are also finalized designs. The bubble helmet provides NIV PPV support and mitigates aerosols on a per-patient basis and is currently working its way through Health Canada approvals ahead of initiating a Canadian multicenter clinical trial. 

COSMIC’s device development approach has a heavy emphasis on early and continuous clinical input through the research and development cycle. Designs have been rigorously vetted for safety and function throughout the development process to facilitate regulatory and clinical adoption. 

COSMIC will continue work on existing and new devices in the fight against COVID-19, certify and widely disseminate our open-source designs, and connect with teams in developing countries experiencing a surge of COVID-19 cases, particularly those in communities with limited resources. 
—Christopher Nguan, MD 
Co-Founder of COSMIC Medical

Mr Brian MacMillan makes adjustments on the clinical respiratory support unit. Photo courtesy of Lydia Nagai Photography.

Mr Brian MacMillan makes adjustments on the clinical respiratory support unit. 
Photo courtesy of Lydia Nagai Photography.

Ms Vionarica Gusti demonstrates the use of the COSMIC bubble helmet for Dr Cailey Lynch. Photo courtesy of Lydia Nagai Photography.

Ms Vionarica Gusti demonstrates the use of the COSMIC bubble helmet for Dr Cailey Lynch.
Photo courtesy of Lydia Nagai Photography.

Ms Louise Chen and Mr Justin Chan simulate the use of snorkel masks during an operation. Photo courtesy of Lydia Nagai Photography.

Ms Louise Chen and Mr Justin Chan simulate the use of snorkel masks during an operation. 
Photo courtesy of Lydia Nagai Photography.

The COSMIC bag-valve-mask device provides positive pressure ventilation to patients in emergency situations when ventilators are not available. Photo courtesy of Lydia Nagai Photography.

The COSMIC bag-valve-mask device provides positive pressure ventilation to patients in emergency situations when ventilators are not available. 
Photo courtesy of Lydia Nagai Photography.

 

Project showcase video.


This post has not been peer reviewed by the BCMJ Editorial Board.

Dr Christopher Nguan is a kidney transplant urologist at Vancouver General Hospital.


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