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Comment by tcbawo | Hacker News Reader

Not a doctor. A major issue with using this type of CPAP machine on a Covid-19 positive person is the high amount of aerosolized virus particles it exhausts. Anyone using this should be extremely careful and know what they're doing. That being said, doctors in many countries are using positive air pressure machines with an air-tight helmet/bag with filtered exhaust.

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Mt. Sinai developed a procedure for using these safely in a clinical setting, by using an alternate patient circuit with viral filters to capture the aerosolized particles: https://health.mountsinai.org/wp-content/uploads/sites/14/20...

That's what it says right there on the page already: "Additional equipment like viral filters are also required."

If you're using this where non-COVID patients could be exposed (e.g. at home) this is a very important consideration.

In a hospital setting (aka an emergency), it's less of an issue. The situation that would warrant this would likely also warrant full PPE just to enter a unit or building.

> it's less of an issue. The situation that would warrant this would likely also warrant full PPE just to enter a unit or building.

Isn't it still important not to spray covid everywhere?

See for example this post: https://emcrit.org/emcrit/covid-airway-management/

> Critical Note: If you use the vent for preox, you MUST disconnect the vent circuit proximal to the viral filter before removing the mask. Otherwise, COVID will be sprayed all around the room!!!!! See Triple C below.

{EDIT: genuinely don't know why this got downvotes.}

What's scary is that CPAP machines are allowed on airplanes. If they really aerosolize virus particles, maybe they shouldn't be.

At least on Delta flights they’re not allowed to be used, I’m not sure if the same policy exists on other airlines.

Edit: I was wrong, see below

I'd be very surprised to see any airline restrict the use of a medical device onboard. The manual that came with mine states that airlines are required to let you use it, and the manufacturer sells an airline-friendly battery pack. Do you have a link to Delta's policy on this?

My mistake, I was wrong. They allow use, but it has to have its own power supply https://www.delta.com/us/en/accessible-travel-services/assis...

This would seem to be because they don't want to be held to providing medical grade reliability of electricity to the seat.

I've sat next to people using them on Delta and United. Of course, I'm not without empathy for people who depend on them. But if a person has a viral infection that can be spread through droplets, this can be a very dangerous situation. If I'm ever in this situation again, I'll ask to be reseated. If they can't do that, I'm not sure I'd want to fly.

You'd better not let someone sitting next to you breathe, or cough, or sneeze then.

When I'm using my CPAP, my mouth is closed and I'm asleep. I'm breathing through my nose, which has hairy filters in it, plus a mask that has a filter on its exhaust, plus the machine has a filter on its inlet.

Please stop the knee-jerk reactions. CPAP devices and aerosolized droplets are a problem if you know the patient is infected and you are up close to them putting the masks on.

These are not "knee-jerk" reactions.

There's a special, enhanced, risk with CPAP that authoritative medical sources warn about.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3338532/

Let's be civil here and assume good faith.

The parent commenter only mentioned that it exhausts aerosolized virus particles, not that it produces any. Do they emit/amplify aerosolized virus particles themselves? If so, by what mechanism?

If anything, more tubing would might condense humid lung air in the walls so whatever leaves the tubes is drier.

I don’t want to alarm you unnecessarily, but they let ordinary people with virus aerosolizing equipment (lungs + diaphragm) onto airplanes, currently.

There's a special, enhanced, risk with CPAP that authoritative medical sources warn about.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3338532/

I'm not sure I get your point. Did you have one?

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