Vail Mountain School family helping confront COVID-19
Doctors’, makers’ create snorkeling mask that might help patients avoid a tube down their trachea
VAIL — Vail Mountain School parents Dr. Dave and Dr. Lisa Hile, both emergency medicine physicians at Valley View Hospital in Glenwood Springs, fight on the frontlines against COVID-19.
Every day they see what the virus does to their patients, their families and the community. They also see what they consider the limited effectiveness of ventilators. Generally, patients get a tube down their trachea — a process called intubation — that enables ventilators to push air into a patient’s lungs.
Finding a better way
There should be a better and gentler solution, and the Hiles set about trying to create one.
They brainstormed a wide variety of designs, settling on a contraption that combines a snorkel mask with a CPAP machine — Continuous Positive Airway Pressure — commonly used to treat obstructive sleep apnea. A CPAP machine uses a hose and mask or nosepiece to deliver constant and steady air pressure.
The Hiles found an Italian research institute doing something similar. The Institute of Studies for the Integration of Systems (Isinnova) had developed a way to adapt full-face snorkel masks to work with CPAP machines, creating a ventilator without the tube down the trachea.
Even better, Isinnova released engineering models that included a valve that connects a diving mask to a CPAP machine.
Teacher, a little help please
That created an opportunity — a teachable moment. The Hiles needed someone to help them manufacture the hardware that connects the snorkel mask to the CPAP machine. Like all schools, the Vail Mountain School building is closed and the maker/computer lab is devoid of students. So the Hiles asked VMS teachers Grant Gary, Dean Chambers and Tim Sinnott for help to fabricate the parts using 3D printers in the school’s maker lab.
Gary, a former biomedical engineer, directs the VMS maker lab. He, Chambers and Sinnott jumped on board immediately. VMS student Henry Prince and future VMS student Mylo Ornowski helped with the development, testing different materials and printing techniques, and assisted with production.
“This has been one of the most meaningful projects I have worked on in my life,” Gary said.
Gary and Dave Hile met with a team of pulmonologists, respiratory therapists and critical care doctors at Valley View Hospital in Glenwood Springs. At the same time, Chambers and Sinnott printed and tested models to adapt to different types of full-face masks and to make sure the masks don’t leak. That airtight seal helps patients breathe easier, and also helps protect health care workers when patients exhale virus particles from their lungs.
“I spent about 18 hours working on my first design modification and print. It was amazing to suddenly be working on a project that could save someone’s life the next day and in our community. I am grateful for the chance to help save lives,” Sinnott said.
The Hiles tried it on a live patient the first time on Wednesday, April 8. Three days later they jumped from the frying pan into the COVID-19 fire and placed their mask on a critically ill patient.
“Given the patient’s clinical condition, less than one week before I would have had to intubate him and place him on the ventilator,” Dave Hile said.
That procedure carried with it a 60%-80% mortality rate, Dave Hile said.
After 36 hours with air flowing to the patient through the snorkel mask instead of a trachea tube, the patient was doing well, Dave Hile said.
If he can avoid intubation, his mortality chances drop to less than 10%, Dave Hile said.
Scaling it up
The next steps are to create additional adapters and acquire more masks. The Hiles say the near-term goal is to support 18 patients in respiratory distress at Valley View Hospital. If they’re successful, it will nearly triple the hospital’s capacity to treat COVID-19 patients.
The ultimate goal is to help spread the technology throughout the United States and the world to save as many lives as possible, they said.
Dave Hile launched a study looking at the effects of their form of intervention on 20 patients at Valley View Hospital and has begun to share with the entire medical community and nation.
“The VMS team has made a life-saving difference in this patient, his family and community, and this is just the tip of the iceberg of where the work will lead. We are blessed to be part of such a great community!”
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Are we seeing more bears because there are more bears on the valley floor, or because we’re all spending more time at home? It could be a bit of both.