By Kaitlyn Clark
The Haldimand Press
CAYUGA—When presented with a challenge, Battlefield International always has the will – and innovation – to find a way. Sandy Vermeulen knew Battlefield was the place to help back in March for the upcoming fight against COVID-19. As the mother of one of their designers and a friend of owner Steve Fenton, she asked them to consider designing and producing ventilators. Fenton said he was then officially asked by Haldimand Norfolk’s Medical Officer of Health, Dr. Shanker Nesathurai.
Fenton visited Nesathurai in late March to get a better understanding of the requirements. It was decided they would create an automatic squeeze that would replace the human hand normally used for a manual hand pump ventilator.
“Realizing the medical approval hurtles likely required to get new medical equipment approved by Health Canada, it made sense to us to start with an approved system,” said Fenton. “The two main issues with hand ventilators is the lack of control in how much exact air per squeeze, and pressures and timing being different from squeeze to squeeze…. The other issue … is that after just a short amount of hand pump breathing, the person gets hand cramping, so that is a real problem.”
Fenton knew all of these issues could be solved with an automated system, but they had to figure out how to put it together. Normally, Battlefield produces parts for the aerospace and defense industries. Despite never having built any medical machinery, Fenton wasn’t fazed by the daunting task ahead of his team.
The sign outside Battlefield’s “design house”.
“Our military aerospace and land systems producers know that if they need something that doesn’t exist, that we tackle it and have a high ‘win rate’ in uncovering solutions. Innovation is woven into all departments here,” said Fenton.
Still, the task didn’t come without challenges. First, already overwhelmingly busy with their current workload, the Battlefield team had to work nights and weekends for this project. Second, the ventilator bag first provided to them was “quite flimsy”. In response, their first design held the bag in a pressure chamber and avoided touching the bag directly, reducing the wear, by applying positive air pressure to squeeze it and re-inflating by creating a vacuum.
“We designed and produced that first prototype in 36 hours. That was a plant-wide effort that went around the clock over a weekend,” said Fenton. Hamilton Health Sciences visited them that Sunday. They also brought a higher-quality manual ventilator bag: “After the respiratory medical experts patiently taught us everything we needed to know about ‘what matters’ with a ventilator and the controllability they needed, they left and also sent us lung simulators, an actual pneumatically-powered hospital ventilator, oxygen, and several of the higher quality manual ventilators.”
With this new information and materials, Battlefield created a second design that cradles the bag and uses an electronic controller to send signals to the aluminum and polymer “fingers”.
“The motor is told to run one direction at a certain speed and power, causing the bag to be squeezed, sending air to the patient, and then the motor is told to reverse to let the patient breath out and the bag naturally returns to its ‘ready to pump’ state,” explained Fenton. They then uncovered any weak points where the machine could wear out by running the prototype “three weeks, day and night, without stopping”. The team discovered three weak points that were fully addressed.
Then there was the “massive and complicated coding” required for the level of control needed. This was exacerbated by the need to create a “patient-instigated breathing assist mode” so the patient can be weaned off the ventilator when they decide to breath on their own – a technology that didn’t previously exist for manual ventilators, which normally rely on patients being in a coma or paralyzed.
“We have a sensor near the patient that senses when the patient starts to try to breath; we align our timing with that and help by pushing air in at the patient’s timing,” explained Fenton. “There are hundreds to thousands of pressure and flow measurements being taken and sent to our processor every second…. Our programmed alarms are vast as we wanted to land with a system that was very competent and could be relied on in such a critical application.”
It was one step to figure out how to code, or explain, this information for the technology, and it was another step to figure out how to fit all the needed electronics in the “small footprint design that Hamilton Health Sciences wanted”. However, this hurdle was overcome thanks to their good friend Bill Dolphin, who was one of many to offer their unique skills to the project by helping them integrate circuitry into the framing. Cayuga Cabinets donated the required acrylic covers, Aluminum Surface Technologies provided the black anodize treatment for Barlow Manufacturing to laser cut and donate the needed aluminum plates, IPEC Automation donated the aluminum framing, Mike Montgomery provided his skills to populate the circuit board, and Adam Harrison was hired for the “truly genius” and advanced electronics design and coding.
Thanks to the assistance of these various partners, and the dedicated work of the Battlefield team, 50 units will be delivered to Haldimand Norfolk and 50 units to Hamilton Health Sciences once final testing and assembly is completed. Fenton estimates the device likely costs them about $2,000 each to produce, not including the design time and prototype phases that went into the project first: “If we do get funding, we will not add any profit to it. And we are going for funding, but should we not get it, this will be completed and would be considered a donation.”
“The best part of this effort was what it did to the mood of everyone who helped. Instead of just watching the ever-increasing miserableness of the news from hour to hour, there was the healing power of ‘making a difference’,” concluded Fenton, adding that he enjoyed meeting Nesathurai and those at Hamilton Health Sciences. “(I saw) their honest concern for their patients and willingness to do anything they can to help us with our effort. They are a remarkable group and we look forward to taking them to Twisted Lemon when this is over just to get to share a really good meal together.”
