instructables

OpenVent-Bristol V2.0 COVID-19 Rapid Manufacture Ventilator BVM

Ambubag

by Darren Lewis

We at OpenVent-Bristol are a team of volunteer engineers designing a simple 'low-tech' ventilator for COVID-19
treatment, on a not-for-pro t basis.The ventilator is made from readily available parts and manufacturing
processes and can be produced in high volumes in most countries in the world at low cost. The design is based on a
hand pumped ventilator called an ambu-bag (or BVM), these low cost devices are readily available in most country's
health care systems and crucially already have medical clearance.

Please take a moment to share our work and consider helping fund our design if you can: donate here

Video below shows what the V2.0 device does and how to use it:

//www.yout ube.com/embed/RIKmd1mEYg4

This prototype was tested on a test lung at the National Physical Laboratory with promising results. A avor of these
results is shown in the video below:

//www.yout ube.com/embed/Nv8YVDp8wuQ

Pro ble m s t a t e m e nt :
Ventilation is the only known available treatment for su erers of COVID-19. Existing ventilation machines in
hospitals are complex general purpose machines costing £10s of thousands. The availability of the existing
ventilators falls short of the need and many countries will struggle to a ord the expensive conventional ventilators.
Critically ill patients left without ventilation treatment are in danger of death. One e ect of the virus produces a
very sticky mucus in the lungs which causes the lungs to collapse and makes it very di cult for the patent to
breath of their own accord. Ventilation can be delivered either via intubation or a well sealed mask and delivers
positive air pressure into the lungs to keep them in ated at all times. Conscious less ill patients can be aided using a
CPAP (Continuous Positive Airway Pressure) ventilation device like a sleep apnoea device, this delivers a constant air
of the same ow rate and pressure. The more critically ill patients need a machine to breath for them or assist with
breathing which varies the pressure and ow according to inhale and exhale and relies on maintaining a good seal
and a PEEP valve to keep the lungs continually in ated. An analogy: Imagine in ating a balloon, letting it de ate
completely, then re-in ating it, that is like CPAP. If you in ated the balloon, de ated it half way, then re-in ated it,
that's more like the treatment needed for the worse su erers.

T he a im is :

OpenVent-Bristol V2.0 COVID-19 Rapid Manufacture Ventilator BVM Ambubag: Page 1

 For a very simple low cost design
made using readily available components
that can be manufactured quickly and easily in small quantities or on mass at low cost
to work reliably and with the lowest risk to the patient (partly to help speed up the medical product
approval process, if this project gets that far)

T he US P o f t his de s ig n is ho w e a s y a nd f a s t it ca n s ca le f o r m a s s pro duct io n f o r t he f o llo w ing

re a s o ns :

Aut o m a t e d pro duct io n: The production of each part is fully automated (laser cutting)
M inim a l o - t he - s he lf co m po ne nt s : Very few di erent components are needed and no exotic
parts are needed (not even a motor coupling)
Sim ple m e cha nis m : It uses a super simple mechanism with just an arm mounted to a motor - no
complicated mechanisms to go wrong, just one moving part
Adjus t a ble s e t t ing s : Has full adjustment of breath frequency, pressure & tidal volume alarms
(currently running PCV mode)
Lo w co s t : £100 - £200 total cost is likely possible with volumes of 100s - 1000s (one o cost is
around £360)

This device (running software version 5) was tested at the National Physical Laboratory on 04/05/2020 against the
MHRA testing plan with good results. Once received I will upload their test report.

An image is attached showing a comparison between a waveform measured from OpenVent-Bristol V2.0 compared
to an existing more sophisticated ventilator. They produce very similar output under the lung conditions used.

O pe ra t io na l f e a t ure s o f t his de v ice :

1. Pressure control ventilation (PCV). With a software change it is capable of VCV (Volume Control
Ventilation), PRVC (Pressure Regulated Volume Control) and likely adaptive mode (where each breath
is triggered by the patient)
2. A user interface consisting of LCD screen and buttons (details are described in the "performance
section")
3. A battery back up (approx. 45min run time)
4. Back up manual ventilation is possible in seconds - opening the lid of the device exposes the BVM
and prevents motorised arm from pressing on the bag
5. Alarm states including; upper and lower tidal volume alarm, main power disconnect (details are
described in the "performance section")

S e ns ing ca pa bilit y :

Airway pressure
Airway ow rate (and breath volume)
Motor current (used to sense mechanical end stops)
Main DC supply voltage sense to detect supply failure (this is not enabled in software V5)

M a xim um o ut put :

OpenVent-Bristol V2.0 COVID-19 Rapid Manufacture Ventilator BVM Ambubag: Page 2

For safety the device is limited to the the values listed below as these have been advised as the safe limits by our
clinical advisor, anything beyond this will risk barotrauma (lung damage). These numbers are lower than those
which would be necessary to meet the MHRA requirements V4, more on this described in the video below.

Pressure limited to 45 cmH2O

Tidal volume limited to 800 ml (with tolerance +100 ml)

//www.yout ube.com/embed/Rt xiVJMbwBY

This is our website for more project information: https://openventbristol.co.uk/

We are working with Helpful Engineering (a US based volunteer engineering) who are working to develop this
design for the US market and FDA clearance.

I'm not selling this product, just releasing the design as open source to help others. This design doesn't currently
meet all MHRA requirements and does not have medical product approval which will be needed for treatment. A
list of improvements for the next version V3.0 include:

PRVC ventilation mode

Adaptive ventilation mode (sensing patients breath)
Enclosure chassis to be made from 1.2mm stainless steel grade 304 using laser cutting and CNC
bending processes
Enclosure lid to be made from a medical approved transparent plastic that can be laser cut
Membrane switches for hygiene control bene t
Wipeable cover for LCD screen for hygiene control
Flow sensor to be made from medical safe plastic and integrated into chassis

Version 5 GitHub code link: https://github.com/RealFreshRate/OpenVent/tree/mas...

MHRA Rapidly manufactured ventilator system speci cation:

https://www.gov.uk/government/publications/speci ...

D is cla im e r:

All users of this design and device shall be deemed noti ed of the warnings stated herein. This device is a simply
designed, fast produced ventilator. This device should not be used in place of an existing hospital ventilator. These
should only be used as a last resort where a patient has no other alternative due to the lack of availability of
existing ventilators. This is not a fully medically certi ed device and should not be relied upon as such. The device is
designed for use by trained medical professionals and should only be used by trained medical professionals; it is
not intended for home use. The designers and manufacturers of this device shall not be held liable for any death or
injury that may result from this device. The designers and manufacturers of this device give no guarantees or
warranties as to the e cacy and/or safety of this device. This design isn't connected with dyson or any other
ventilator projects including Dyson CoVent design.

Cre dit s :

Credit to the people below for helping to make this all possible:

OpenVent-Bristol V2.0 COVID-19 Rapid Manufacture Ventilator BVM Ambubag: Page 3

 Sam Reilly - Software Certi cation Engineer
Sadie - ITU nurse
Tom Breddal
Dr Emilio Garcia - Consultant Anesthetist in UK ITU
Ross Goodwin - mechanical engineer
P3 Medical
all people who have kindly donated to help fund this project

Step 1: Performance

OpenVent-Bristol V2.0 COVID-19 Rapid Manufacture Ventilator BVM Ambubag: Page 4

This section provides a more detailed explanation of the performance of the system. Please see attached images
and video.

//www.yout ube.com/embed/M4 Qg_H6V9DY

Step 2: Buy Parts

The bill of materials is attached to this step as a .csv le which can be opened in excel.

The total comes to around £360 for a one o unit, this cost can be brought much lower with scale, perhaps to

OpenVent-Bristol V2.0 COVID-19 Rapid Manufacture Ventilator BVM Ambubag: Page 5

around £150- £200 with volumes of 100s-1000s. The next design V3.0 will be made with more DFM (Design For
Manufacture) methods

Download
https://www.instructables.com/ORIG/FE8/C1AT/K9XCVCWC/FE8C1ATK9XCVCWC.csv
…

Step 3: Lasercut Parts and Assemble Chassis

Everything of the chassis is laser cut from 8mm acrylic, but laser ply or MDF can be used instead.

Construction method is similar to the previous design (captive nuts and bolts).

Once yours is assembled it should look something like the attached images.

DXF les and STEP le of the assembly are stored on GrabCAD in this link: https://grabcad.com/library/openvent-
bristol-v2-0-...

Quantities and materials are:

Q1 "Motor plate V2.0 rig 2" - 8mm acrylic

Q10 "arm contact ring" - 8mm acrylic
Q1 "Left side big hole 2" - 8 acrylic
Q1 "Left side big hole hinged part V2.0 rig 2" - 8mm acrylic
Q1 "Right side small hole V2.0 rig 2" - 8mm acrylic
Q1 "Right side small hole hinged V2.0 rig 2" - 8mm acrylic
Q1 "Motor plate V2.0 rig 2_bk" - 8mm acrylic
Q1 "Base plate V2.0 2" - 8mm acrylic
Q1 "V2.0 front plate 2" - 8mm acrylic
Q1 "Buttons for buttons rig V2.0" - 8mm acrylic
Q1 "back lower part V2.0" - 8mm acrylic
Q3 "Base ns" - 8mm acrylic
Q1 "Top panel rig V2.0" - 8mm acrylic
Q1 "Lid latch rig V2.0" - 8mm acrylic
Q1 "Back panel rig V2.0" - 8mm acrylic

OpenVent-Bristol V2.0 COVID-19 Rapid Manufacture Ventilator BVM Ambubag: Page 6

OpenVent-Bristol V2.0 COVID-19 Rapid Manufacture Ventilator BVM Ambubag: Page 7
Step 4: Motor Mount

As shown in the pictures;

attach 4 cable ties (the bee er the better, I used 8mm wide ties) through the 6 holes in the back
plate such that 4 of them sit parallel to each other in the horizontal axis
then pass 2 jubilee clips (I used 25-40mm clips) through the loops in the cable ties and around the
motor
Then tighten the clips until it grips the motor nicely, but don't tighten it too much!!! Because it can
crush the casing and damage the motor

OpenVent-Bristol V2.0 COVID-19 Rapid Manufacture Ventilator BVM Ambubag: Page 8

Step 5: Mount Motor Arm

Laser cut the motor arm from 6mm mild steel. DXF is end of the arm with the long M6 bolt (I used a
in the following link: 100mm) and nut to distribute the pressing force on
https://grabcad.com/library/openvent-bristol-v2-0-... the bag. I didn't cut enough ovals so I spaced them
out with nuts and washers (as you see in the pictures).
Attach the motor arm to the motor shaft using the M8 It is best to use a nylock M6 nut if you have one here.
nylock nut and bolt. Hold the nut in its 'captive' slot You may also want to add some bubble wrap or
and tighten the bolt up against the at of the motor something around the end of the arm for extra
shaft with a hex key. cushioning as it may wear into the bag over extended
use.
Attach some of the small laser cut oval pieces to the

Step 6: Build Flow Sensor

Instructions for ow sensor build are in a separate Instructables post here: https://www.instructables.com/id/How-
to-Make-an-A...

OpenVent-Bristol V2.0 COVID-19 Rapid Manufacture Ventilator BVM Ambubag: Page 9

Step 7: Pressure Sensor

Connect the pressure sensor

https://www.instructables.com/id/How-to-Read-MPX50...

Step 8: Build Electronics

Follow the electronic system diagram in the attached image. Steps are as follows:

OpenVent-Bristol V2.0 COVID-19 Rapid Manufacture Ventilator BVM Ambubag: Page 10

 1. Buttons on the LCD shield are connected to pin A0, problem is A0 is also used for current sensing on
the motor driver shield so we need to de-solder the A0 male header pin from the LCD shield and
attach a jumper wire connecting A0 to A3 on the LCD shield (shown in images)
2. Wire up your gauge pressure sensor and di erential pressure sensor (for ow meter). I wired these on
oating wires (shown in pics) but a better way would be to use an Arduino proto shield
3. Add your potential divider circuit to your proto shield
4. Wire up your 2.1mm DC power socket with parallel connection to 12V lead acid battery and power
connection to both motor shields
5. Make an Arduino shield sandwich of :
1. LCD shield (on top)
2. Motor driver shield 1st
3. Motor driver shield 2nd
4. Proto shield
5. Arduino Uno (bottom)

6. Wire up motor to the motor driver shield

Circuit t e s t ing :

You will need to install the following libraries for full functionality of the test codes:

Wire.h
and Sensirion_SFM3000_arduino
Liquid crystal

1. Do a test upload with the blink program

2. Test the gauge pressure sensor on pin A5 with code from here:
https://www.instructables.com/id/How-to-Read-MPX50...
3. test the di erential pressure sensor on pin A4 with code from here:
https://www.instructables.com/id/How-to-Make-an-Ai...
4. test the LCD screen using code from here: https://www.velleman.eu/downloads/29/vma203_a4v03....
Note; the default analogue ranges didn't work with my buttons, maybe my resistors were out of
tolerance or something, so you may have to change these too

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OpenVent-Bristol V2.0 COVID-19 Rapid Manufacture Ventilator BVM Ambubag: Page 12
Step 9: Software

Download the software from GitHub in the link below:

Version 5 code: https://github.com/RealFreshRate/OpenVent/tree/mas...

Make sure the main le (e.g. OpenVent_Bristol_rig_V2.0_PCV_V5.ino) is in a folder with the same name and the
"Analogue_ ltering.ino" le is in that same folder, that way when you open the main le the analog_ ltering le
should open in the second tap in the Arduino IDE.

You will need to make sure you have the following Arduino libraries installed:

Wire.h https://www.arduino.cc/en/reference/wire

Liquid crystal https://www.arduino.cc/en/Reference/LiquidCrystal

Motor driver library: https://github.com/gallingern/arduino-motor-shiel...

OpenVent-Bristol V2.0 COVID-19 Rapid Manufacture Ventilator BVM Ambubag: Page 13

Step 10: Test Whole System

Test your whole system using the Arduino plotter to create some dynamic graphs like in this video:

//www.yout ube.com/embed/M4 Qg_H6V9DY

MPX4250DP 0 250kPa Differential Pressure Sensor

Can i use this differential sensor for pressure and flow rate kindly suggests me
Unfortunately I would suggest not using MPX4250DP as it has much courser resolution than the
MPX5010DP. For each ADC 'tick' of the MPX5010DP the pressure would change by about 10Pa
but the MPX4250DP would need a change of about 244Pa. I don't think this would give fine
enough control for the motor PID loop. Sorry
Impressive and admirable work. Strong evidence that complex exorbitantly priced ventilators aren't
the only solution. Thank you for participating in the effort to help sustain lives.

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