4/20/2020 Chicago
“How can you help us, and what can we do to make it happen?” This is how Aurika Savickaite began her interview with Dr. Yuri Gelland, from Sharp Grossmont Hospital based in San Diego, California. They were discussing helmet based ventilation equipment, and how it could be used against the COVID-19 pandemic.
Dr. Gelland has experience using helmet based ventilation for pediatric patients with pneumonia, stretching back to his practice in Russia during the 1980’s. Similar ad-hoc helmet devices were used in rural hospitals when pediatric ventilators were not available. These helmets provide continuous positive airway pressure (CPAP) with an up to a 100% oxygen environment.
Dr. Gelland is working to use that experience to help medical teams around the world create similar simple, inexpensive, and effective devices for non-invasive ventilation. In developing countries, there is not always access to traditional ventilators for COVID-19 patients in critical condition, so this simple method of creating a CPAP helmet for non-invasive ventilation is imperative.
It is intended for non-intubated patients who may or may not be conscious. It can be applied and used in a supine or prone position. For some patients, it will delay or avoid endotracheal intubation and mechanical ventilation. Applying CPAP early in a prone position helps the lungs of COVID-19 patients suffering pneumonia to recruit alveoli and improve ventilation-perfusion matching.
There are a few commercial models on the market, but for the most part, they are unavailable internationally. Currently, the Sea-long brand helmet is approved by the Food and Drug Administration (FDA) for use in the United States and is readily available at a low cost.
But what about other countries? Dr. Gelland believes that by designing a helmet that is effective, comfortable, and can be assembled locally with simple materials, many people abroad that otherwise wouldn’t receive effective treatment can be saved. He currently shares his ideas for improvement on Twitter.
Many of the current helmet-based ventilation systems that are appearing on the market today can be too heavy for the patient and limit their neck movement, and make eating and drinking difficult. Neck openings need to be sufficiently sealed while allowing the patient to move comfortably. Some European companies have solved this problem by making each helmet completely personalized for the user by cutting an almost wet-suit-like fabric to fit.
So, how can Dr. Gelland help? He will work to improve existing designs and create something simple that can be distributed as quickly to areas that may not have access to helmet based ventilation equipment.
The real challenge will be distribution. As Dr. Gelland said, we all need to work as quickly as possible to create a simple design and distribute it to manufacturing companies all over the world. We will be working to facilitate distribution channels. If you are a manufacturer or distributor, please get in touch.