On my birthday last summer, I had a video call with my mother several hundred miles away and my brother who lives in France. As we laughed and joked in the sunshine, I had no idea that would be the last time the three of us would really talk.
I’d been involved with the exovent project since March 2020. Although I’m a children’s kidney specialist I have experience of developing a novel medical device – a haemodialysis machine for small babies – and understand the huge importance of both usability and acceptability of new technology in the clinical environment.
So far exovent has been tested out on volunteers who are part of the development team and what is striking to me, viewing the short video clips and photos, is how relaxed the subjects are whilst in the exovent device: sipping a drink through a straw, eating a ham sandwich, shuffling their position to get comfy, or simply dozing off. But most poignant is their ability to talk to the people around them. With a bit of explanation from the clinical team, the individual quickly settles into talking whilst breathing out – which, when you think about it, is what we naturally do.
Currently there’s exovent testing and simulations happening in two hospitals with clinical staff working out the best ways to practically use the exovent; how to most simply get the subject into it, how to lift it on and off the bed, how to disentangle the practicalities of intravenous drips and other monitoring lines and wires. If the nursing and other staff find it too difficult to use in the real clinical world then no matter how fantastic it is in theory, it is unlikely to be successful nor adopted as a useful additional method for supporting ventilation in patients with COVID or other breathing problems. This part of the development process may seem tedious or unexciting compared to the next stage, which will be clinical trials on patients, but it is absolutely crucial to getting the eventual product right.
Returning to my happy memories of that summer afternoon spent talking: my Mum had a severe stroke a couple of days later and I never had a proper conversation with her again. Being able to communicate with loved ones especially when they are unwell is just so important for both patient and family. That the exovent allows the patient to freely talk whilst receiving ventilatory support, is something that makes it so special to me.