Enhanced Automated Oxygen Level controller for COVID Patient By Using Internet of Things (IoT)

The Internet of Things (IoT) shall be merged firmly and interact with a higher number of altered embedded sensor networks. It provides open access for the subsets of information for humankind's future aspects and on-going pandemic situations. It has changed the way of living wirelessly, with high involvement and COVID-related issues that COVID patients are facing. There is much research going on in the recent domain, like the Internet of Things. Considering the financial-economic growth, there isn't much significance as IoT is growing with industry 5.0 as the latest version. The newly spreading COVID-19 (Coronavirus Disease, 2019) will emphasize the IoT based technologies in a greater impact. It is growing with an increase in productivity. In collaboration with Cloud computing, it shows wireless communication efficiently and makes the COVID-19 eradication in a greater way. The COVID-19 issues which are faced by the COVID patients. Many patients are suffering from inhalation because of lung problems. The second wave attacks mainly on the lungs, where there is a shortage of breathing problems because of less supply of oxygen (insufficient amount of oxygen). The challenges emphasized as proposed are like the shortage of monitoring the on-going process. Readily being active in this pandemic situation, the mentioned areas are from which need to be discussed. The frameworks and services are given the correct data and information for supply of oxygen to the COVID patients to an extent. The Internet of Things also analyzes the data from the user perspective, which will later be executed for making on-demand technology more reliable. The outcome for the COVID-19 has been taken completely to help the on-going COVID patients live, which can be monitored through Oxygen Concentration based on the IoT framework. Finally, this article discusses and mentions all the parameters for COVID patients with complete information based on IoT. © 2022 IEEE.

Raising the awareness for insufficient oxygen delivery from self-inflating resuscitation bags lacking expiratory valve during preoxygenation

We recently read an interesting study which demonstrated that self-inflating resuscitation bag (SIRB) lacking expiratory valve has unreliable performance in oxygen delivery during spontaneous breathing mimicked by mechanical lung simulator. It was postulated that the absence of an expiratory valve and the resulting air entrainment via the exhaust port accounts for the poor oxygen delivery performance. The current disposable SIRB in-use in our institutions (Med-Rescuer Disposable BVM Resuscitator 4000, BLS Systems Limited, ON, Canada) has a duckbill valve but no expiratory valve. Safety concerns regarding its oxygen delivery performance during spontaneous breathing were raised, as this SIRB was commonly used to preoxygenate critically ill patient with potentially transmissible respiratory infection (e.g. COVID-19) before tracheal intubation. We therefore performed an experiment on this SIRB using one of us as a healthy volunteer. Our small experiment demonstrated that air entrainment could occur via the exhaust port and affect oxygen delivery performance. Our experiment also demonstrated that attaching a positive end-expiratory pressure (PEEP) valve to the exhaust port improves the oxygen delivery performance. The findings of this experiment were sent to the relevant department of our institutions for safety consideration. © The Author(s) 2022.

Positive pressure application of oxygen using venturi nozzle corovalve made on a 3d printer. A simple and inexpensive method applicable in emergency conditions on a mass scale

Acute hypoxemic respiratory failure (which occures also with severe course of COVID-19) requires oxygen therapy. The in vasiveness and intensity of chosen therapy corresponds with patient's condition and technical means available. If a large number of patients with hypoxic failure suddenly occur, the available equipment and/or human capacity to provide effective oxygen therapy may be greatly strained. The goal of our experiment was to test functionality of a simple device equipped with a Venturi nozzle Corovalve which we designed and printed on a 3D printer. We incorporated the nozzle into a system assembled from parts commonly available in the Czech Republic. We put this device through a static test and a dynamic test performed on ourselves and measured its basic parameters. In our experiment during spontaneous ventilation the device was able to generate positive mean airway pressure. At higher flow rates, the system was able to maintain a slightly positive pressure even during the inspiration, so we can talk about a system that allows, under certain circumstances, spontaneous ventilation at continuous positive airway pressure. The most effective from setting tested was oxygen input of 15 L/min combined with PEEP valve set to 10-15 cm H 2 O. Mean airway pressure ranged at 9-12 cm H 2 O and oxygen concentration in the inspiration mixture was 40-42%. We therefore conclude that our nozzle Corovalve printed on a 3D printer can be used in a simple device allowing positive pressure oxygen application during spontaneous ventilation EPAP/CPAP. It is economical and easy to provide method and therefore of a rather interesting potential. With a sufficient number of 3D printed nozzles it could be deployed quickly and on a mass scale. Copyright © 2021, Czech Medical Association J.E. Purkyne. All rights reserved.

Design and Implementation of IoT-Based Automatic Oxygen Flow Control in Response to the Covid-19 Crisis

Internet of Things (IoT) technology has brought a revolution in several ways to a common person's life by making everything smart and intelligent. During the Covid-19 crisis, health workers around the world needed to monitor patients' health and needed to provide sufficient oxygen, when necessary, as Covid-19 was responsible for many respiratory cases. Health workers were at high risk of being contaminated while treating Covid-19 patients. The study of this paper is to propose an IoT-based automatic oxygen flow control in response to the Covid-19 crisis. The proposed approach helped to real-time monitoring of SpO2, heartbeat, oxygen quantity of oxygen cylinder, and control of the flow of oxygen based on SpO2 value. A health worker can monitor a patient's health-related parameters and control the flow of oxygen without any physical contact with it. Also, provides an alarm to the health worker when SpO2 is below the threshold and re-measuring oxygen quantity of oxygen cylinder with the help of our developed android app. Implementation of IoT-based low-cost pulse oximeter and IoT-based pressure gauge helps to monitor and control different health parameters. The IoT-based system may potentially be valuable during the Covid-19 pandemic for accurate oxygen flow distribution and for saving people's lives. © 2022 IEEE.

Smart Vital Signs Monitoring System for Covid-19 Patients in Quarantine

A healthcare monitoring system based on the Internet of Things has been designed to monitor the vital signs of patients with COVID-19 while they are isolated at home. The complete system is designed using an embedded controller, medical sensors, a mobile application, and a cloud server. This Internet of Medical Things (IoMT) device is used to evaluate COVID-19 patients' critical levels during home isolation by monitoring their heart rate, body temperature, oxygen saturation (SpO2), cough intensity counts and geographic position. This approach enables physicians to assess COVID-19 patients without the need for direct contact, thereby minimizing the risk of infection. An embedded hardware device with internet connectivity collects and displays vital signs of COVID-19 patients and transmits the data to an IoT platform. The cloud layer and smartphone application store COVID-19 patient records via the API interface. Additionally, the Hospital Management System (HMS) is utilized to manage physician appointments and the prescriptions given to patients. Mobile applications and email notifications are sent to physicians and patients' families in case of an emergency, allowing them to respond quickly. The users can also view their vital signs and an alert message on the OLED screen. © 2022 IEEE.

High-flow nasal cannula: Evaluation of the perceptions of various performance aspects among Chinese clinical staff and establishment of a multidimensional clinical evaluation system.

Objective: In order to facilitate education for clinical users, performance aspects of the high-flow nasal cannula (HFNC) devices were evaluated in the present study. A multidimensional HFNC clinical evaluation system was established accordingly. Materials and Methods: Clinical staff from Chinese hospitals were invited to participate in an online questionnaire survey. The questionnaire was mainly about the accuracy of temperature, flow rate, and oxygen concentration of HFNC, as well as its humidification capacity. We also investigated how the clinical staff of different professions made decisions on HFNC evaluation indicators. Based on the results of the questionnaire survey of clinicians with rich experience in using HFNC, the relative weights of temperature accuracy, flow velocity accuracy, oxygen concentration accuracy, and humidification ability of HFNC equipment were calculated by the AHP to establish a clinical evaluation system. Four kinds of common HFNC devices were tested and evaluated, and the clinical performance of the four kinds of HFNC devices was evaluated by the new scoring system. Results: A total of 356 clinicians participated in and completed the questionnaire survey. To ensure the reliability of the HFNC evaluation system, we only adopted the questionnaire results of clinicians with rich experience in using HFNCs. Data from 247 questionnaires (80 doctors, 105 nurses, and 62 respiratory therapists [RTs]) were analyzed. A total of 174 participants used HFNC more than once a week; 88.71% of RTs used HFNC ≥ 1 score daily, 62.86% of nurses used HFNC ≥ 1 score daily, and 66.25% of doctors used HFNC ≥ 1 daily. There was no significant difference in the frequency of use between doctors and nurses. Finally, the relative weights of temperature accuracy (0.088), humidification capacity (0.206), flow velocity accuracy (0.311), and oxygen concentration accuracy (0.395) in the HFNC clinical evaluation system were obtained. The relative weights of clinicians with different occupations and the frequency of HFNC use were obtained. After testing four kinds of HFNC devices through the evaluation system, it was found that the four kinds of HFNC devices have different advantages in different clinical performances, and AiRVO2 has excellent performance with regard to temperature accuracy and humidification ability. HF-75A and NeoHiF-i7 are good at ensuring the stability of oxygen concentration and the accuracy of the flow velocity of the transported gas, while OH-80S is relatively stable in all aspects. Conclusion: The clinical evaluation system of HFNC is based on the weight of the experience of clinical personnel with different medical backgrounds. Although the existing practitioners have different educational backgrounds (academic qualifications, majors), our evaluation system can enhance clinical staff's awareness of HFNC and further optimize the clinical use of HFNC.

Oxygen saturation measurements using novel diffused reflectance with hyperspectral imaging: Towards facile COVID-19 diagnosis.

Oxygen saturation level plays a vital role in screening, diagnosis, and therapeutic assessment of disease's assortment. There is an urgent need to design and implement early detection devices and applications for the COVID-19 pandemic; this study reports on the development of customized, highly sensitive, non-invasive, non-contact diffused reflectance system coupled with hyperspectral imaging for mapping subcutaneous blood circulation depending on its oxygen saturation level. The forearm of 15 healthy adult male volunteers with age range of (20-38 years) were illuminated via a polychromatic light source of a spectrum range 400-980 nm. Each patient had been scanned five times to calculate the mean spectroscopic reflectance images using hyperspectral camera. The customized signal processing algorithm includes normalization and moving average filter for noise removal. Afterward, employing K-means clustering for image segmentation to assess the accuracy of blood oxygen saturation (SpO2) levels. The reliability of the developed diffused reflectance system was verified with the ground truth technique, a standard pulse oximeter. Non-invasive, non-contact diffused reflectance spectrum demonstrated maximum signal variation at 610 nm according to SpO2 level. Statistical analysis (mean, standard deviation) of diffused reflectance hyperspectral images at 610 nm offered precise calibrated measurements to the standard pulse oximeter. Diffused reflectance associated with hyperspectral imaging is a prospective technique to assist with phlebotomy and vascular approach. Additionally, it could permit future surgical or pharmacological intercessions that titrate or limit ischemic injury continuously. Furthermore, this technique could offer a fast reliable indication of SpO2 levels for COVID-19 diagnosis.

Anemia in patients with Covid-19: pathogenesis and clinical significance.

COVID-19 patients typically present with lower airway disease, although involvement of other organ systems is usually the rule. Hematological manifestations such as thrombocytopenia and reduced lymphocyte and eosinophil numbers are highly prevalent in COVID-19 and have prognostic significance. Few data, however, are available about the prevalence and significance of anemia in COVID-19. In an observational study, we investigated the prevalence, pathogenesis and clinical significance of anemia among 206 patients with COVID-19 at the time of their hospitalization in an Internal Medicine unit. The prevalence of anemia was 61% in COVID-19, compared with 45% in a control group of 71 patients with clinical and laboratory findings suggestive of COVID-19, but nasopharyngeal swab tests negative for SARS-CoV-2 RNA (p = 0.022). Mortality was higher in SARS-CoV-2 positive patients. In COVID-19, females had lower hemoglobin concentration than males and a higher prevalence of moderate/severe anemia (25% versus 13%, p = 0.032). In most cases, anemia was mild and due to inflammation, sometimes associated with iron and/or vitamin deficiencies. Determinants of hemoglobin concentration included: erythrocyte sedimentation rate, serum cholinesterase, ferritin and protein concentrations and number of chronic diseases affecting each patient. Hemoglobin concentration was not related to overall survival that was, on the contrary, influenced by red blood cell distribution width, age, lactate dehydrogenase and the ratio of arterial partial oxygen pressure to inspired oxygen fraction. In conclusion, our results highlight anemia as a common manifestation in COVID-19. Although anemia does not directly influence mortality, it usually affects elderly, frail patients and can negatively influence their quality of life.

Potential Predictors of Poor Prognosis among Critical COVID-19 Pneumonia Patients Requiring Tracheal Intubation.

Coronavirus disease 2019 (COVID-19) is a global public health concern that can be classified as mild, moderate, severe, or critical, based on disease severity. Since the identification of critical patients is crucial for developing effective management strategies, we evaluated clinical characteristics, laboratory data, treatment provided, and oxygenation to identify potential predictors of mortality among critical COVID-19 pneumonia patients. We retrospectively utilized data from seven critical patients who were admitted to our hospital during April 2020 and required mechanical ventilation. The primary endpoint was to clarify potential predictor of mortality. All patients were older than 70 years, five were men, six had hypertension, and three ultimately died. Compared with survivors, non-survivors tended to be never smokers (0 pack-years vs. 30 pack-years, p = 0.08), to have higher body mass index (31.3 kg/m2 vs. 25.3 kg/m2, p = 0.06), to require earlier tracheal intubation after symptom onset (2.7 days vs. 5.5 days, p = 0.07), and had fewer lymphocytes on admission (339 /µL vs. 518 /µL, p = 0.05). During the first week after tracheal intubation, non-survivors displayed lower values for minimum ratio of the partial pressure of oxygen to fractional inspiratory oxygen concentration (P/F ratio) (44 mmHg vs. 122 mmHg, p < 0.01) and poor response to intensive therapy compared with survivors. In summary, we show that obesity and lymphopenia could predict the severity of COVID-19 pneumonia and that the trend of lower P/F ratio during the first week of mechanical ventilation could provide useful prognostic information.