Doing the splits: A novel way to increase ventilator capacity

Ian Bolland spoke to Eugene Canavan, medical design director at Design Partners, about its role in COVID-19 projects including a split ventilator in a bid to increase capacity.

The idea of a split ventilator, called VentShare, originally came from medical practitioners in NUI Galway and University Hospital Galway. Canavan explained that the project had potential at a time of need because of supply chain and logistical difficulties. 

“I knew the potential of this was real because of the idea was splitting already qualified EU market ventilators and using components that are readily available to achieve the splitting of the ventilator.”  

The role of Design Partners was to consider the project’s human factors, as well as providing technical support, including to help iron out any technical glitches that may arise. This involved combining human factors with a risk management process to spot where things could go wrong, and to help ensure the design could mitigate any issues. 

“We created a user’s manual and after we had created those, we worked with staff in Galway University Hospital to get the clinical aspect of it. We created those assets and then also lent technical support with engineering and prototyping. Various components that made up the system needed some work to make sure they worked in the system. 

“Normal control of a ventilator is through one screen. Our split ventilator has this screen plus two smaller ones. We made sure that although it was three screens that the usability was logical and well laid out with a hierarchy that was intuitive.

“This was supported with user manuals and instructions for use and a troubleshooting document. Also, a normal ventilator has one airflow and an exhaust tube. The split ventilator has this one airflow/ exhaust tube leading to a Y-connector and two additional airway tubes, these two additional airway tubes each have an airflow regulator to tailor how much air each patient gets. Our design and usability had to account for the correct use of all of these extra components and healthcare professional input points. 

The company went through the system and usability of the split ventilator and identified issues and risks, but also offered solutions to address the problems. These ranged from removing actions or changing their order to de-risk workflow, creating product graphics to help usability or adding custom design parts that improved usability, or reduced risk, but did not alter the existing component from a medical certification or a worthiness perspective.

Canavan acknowledged VentShare is a last resort option in order to prevent health services from being overrun by Coronavirus. 

Explaining the challenges of developing a system, Canavan also touched on the clinical aspect of the device being used on patients who would have similar ventilation needs. 

“What is set out in the user manual are the types of patients that should be used on the ventilator and that comes down to patients who are at a similar point in the condition. You know their ventilator requirements are close to each other as possible rather than being poles apart. A ventilator is a clever system because it assists breathing but if the patient is capable of breathing or doing some breathing themselves, the ventilator detects that and doesn’t override that.

“The components we used made it possible but what we still tried to achieve was complex. There was a lot of collaboration on sensor integration and valve integration so the airflow could be monitored, and software and firmware so we could understand that and communicate it along with a graphical user interface to communicate that and provide a means of control for the airflow.”

Design Partners also worked on projects including a face visor with an adjustable headband, as well as one made from office materials, eyewear goggles, and a COVID-19 test kit; as well as a materials research project to source N95 certified materials from other industries to make medical-grade face masks due to the raw materials becoming scarce.

The VentShare project was led by Tim Jones, Jack Connolly, Dr David Hannon and Professor John Laffey, with support from Design Partners, Smart Sensors Lab, App Design Intersurgical, Brandt Studios, Sharkey Consulting, Steris, Nicolay, Bioinnovate and Sensirion.