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104-527: PHI’s mission is to enhance the lives, health, and independence of polio survivors, as well as those in the cross-disability category of home ventilator users, who are addressed through a subsidiary organization called the International Ventilator Users Network (IVUN). PHI’s headquarters are in St. Louis, Missouri , where it has a small paid staff. Otherwise, it is run by volunteers, including

208-671: A 3D-printed open-source prototype device called VentilAid. The makers describe it as a last resort device when professional equipment is missing. The design is publicly available. The first Ventilaid prototype requires compressed air to run. On March 21, 2020, the New England Complex Systems Institute (NECSI) began maintaining a strategic list of open source designs being worked on. The NECSI project considers manufacturing capability, medical safety and need for treating patients in various conditions, speed dealing with legal and political issues, logistics and supply. NECSI

312-538: A board of directors and various advisory committees. Financial support comes from donors, sponsors, member/subscribers, and also from a group of “association members” consisting of local and regional polio support groups . PHI publishes two quarterly newsletters, Post-Polio Health and Ventilator-Assisted Living . It runs a telephone and e-mail answer-line during business hours, responding to requests from polio survivors, clinicians, researchers, and journalists. Its websites are updated almost every business day, and have

416-422: A combination of multiple factors. Disabilities can be present from birth or can be acquired during a person's lifetime. Historically, disabilities have only been recognized based on a narrow set of criteria—however, disabilities are not binary and can be present in unique characteristics depending on the individual. A disability may be readily visible, or invisible in nature. The United Nations Convention on

520-505: A digitized archive of information on polio, and living with polio, that is relevant to all neuromuscular disabilities. And it has been working with other organizations to include rehabilitation for polio survivors in the current program for the worldwide eradication of polio . PHI’s core constituency is in North America, but its networks of polio survivors, clinicians, scientists, and historians have always been widely international. This

624-429: A disability can impact people's identities. Which style of language used varies between different countries, groups and individuals. Identity-first language describes the person as "disabled". Some people prefer this and argue that this fits the social model of disability better than people-first language, as it emphasizes that the person is disabled not by their body, but by a world that does not accommodate them. This

728-543: A disability community—such as with art, social media, and sports. Contemporary understandings of disability derive from concepts that arose during the scientific Enlightenment in the west; prior to the Enlightenment, physical differences were viewed through a different lens. There is evidence of humans during prehistory that looked after people with disabilities. At the Windover Archeological Site , one of

832-606: A disability". This style is reflected in major legislation on disability rights, including the Americans with Disabilities Act and the UN Convention on the Rights of Persons with Disabilities . "Cerebral Palsy: A Guide for Care" at the University of Delaware describes people-first language: The American Psychological Association style guide states that, when identifying a person with

936-426: A disability, the person's name or pronoun should come first, and descriptions of the disability should be used so that the disability is identified, but is not modifying the person. Acceptable examples included "a woman with Down syndrome " or "a man who has schizophrenia ". It also states that a person's adaptive equipment should be described functionally as something that assists a person, not as something that limits

1040-630: A familiar piece of medical equipment. The unit was sold as the Bird Mark 7 Respirator and informally called the "Bird". It was a pneumatic device and therefore required no electrical power source to operate. In 1965, the Army Emergency Respirator was developed in collaboration with the Harry Diamond Laboratories (now part of the U.S. Army Research Laboratory ) and Walter Reed Army Institute of Research . Its design incorporated

1144-405: A feature that creates an impairment, restriction, or limitation from reaching the social definition of health, the individual is labeled as disabled. Under this idea, disability is not defined by the physical features of the body but by a deviance from the social convention of health. The social construction of disability would argue that the medical model of disability 's view that a disability

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1248-528: A great favourite with European anaesthetists for four decades, prior to the introduction of models controlled by electronics. It was independent of electrical power and caused no explosion hazard. The original Mark I unit was developed to become the Manley Mark II in collaboration with the Blease company, which manufactured many thousands of these units. Its principle of operation was very simple, an incoming gas flow

1352-594: A large quantity of ventilators to the National Emergency Strategic Stockpile. From west to east, the companies include Canadian Emergency Ventilators Inc, Bayliss Medical Inc, Thornhill Medical, Vexos Inc, and CAE Inc. Disabilities Disability is the experience of any condition that makes it more difficult for a person to do certain activities or have equitable access within a given society. Disabilities may be cognitive , developmental , intellectual , mental , physical , sensory , or

1456-418: A life-threatening emergency for people using ventilators in a home care setting. Battery power may be sufficient for a brief loss of electricity, but longer power outages may require going to a hospital. The history of mechanical ventilation begins with various versions of what was eventually called the iron lung , a form of noninvasive negative-pressure ventilator widely used during the polio epidemics of

1560-400: A matter of the full integration of individuals into society . In this model, disability is not an attribute of an individual, but rather a complex collection of conditions, created by the social environment. The management of the problem requires social action and it is the collective responsibility of society to create a society in which limitations for disabled people are minimal. Disability

1664-506: A negative connotation that they are considered to be slurs. A current point of contention is whether it is appropriate to use person-first language (i.e. a person who is disabled) or identity-first language (i.e. a disabled person) when referring to disability and an individual. Due to the marginalization of disabled people, there have been several activist causes that push for equitable treatment and access in society. Disability activists have fought to receive equal and equitable rights under

1768-433: A person's capability to perform the activities of daily life. As Marta Russell and Ravi Malhotra argue, "The ' medicalization ' of disablement and the tools of classification clearly played an important role in establishing divisions between the 'disabled' and the 'able-bodied. ' " This positions disability as a problem to be solved via medical intervention, which hinders our understanding about what disability can mean. For

1872-413: A person's efforts to go to school, work, socialize, and more. Some examples of invisible disabilities include intellectual disabilities , autism spectrum disorder , attention deficit hyperactivity disorder , fibromyalgia , mental disorders , asthma , epilepsy , allergies , migraines , arthritis , and chronic fatigue syndrome . Employment discrimination is reported to play a significant part in

1976-611: A person, for example, "a woman who uses a wheelchair" rather than "a woman in/confined to a wheelchair". People-first terminology is used in the UK in the form "people with impairments" (such as "people with visual impairments"). However, in the UK, identity-first language is generally preferred over people-first language. The use of people-first terminology has given rise to the use of the acronym PWD to refer to person(s) (or people) with disabilities (or disability). However other individuals and groups prefer identity-first language to emphasize how

2080-492: A political construction is also widely used by international organizations of disabled people, such as Disabled Peoples' International . Using the identity-first language also parallels how people talk about other aspects of identity and diversity. For example: In the autism community, many self-advocates and their allies prefer terminology such as 'Autistic,' 'Autistic person,' or 'Autistic individual' because we understand autism as an inherent part of an individual's identity –

2184-451: A problem of the person, directly caused by disease, trauma, or other health conditions which therefore requires sustained medical care in the form of individual treatment by professionals. In the medical model, management of the disability is aimed at a "cure", or the individual's adjustment and behavioral change that would lead to an "almost-cure" or effective cure. The individual, in this case, must overcome their disability by medical care. In

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2288-615: A rapid supply of 30,000 ventilators capable of treating COVID-19 patients. A major worldwide design effort began during the 2019-2020 coronavirus pandemic after a Hackaday project was started, in order to respond to expected ventilator shortages causing higher mortality rate among severe patients. On March 20, 2020, the Irish Health Service began reviewing designs. A prototype is being designed and tested in Colombia . The Polish company Urbicum reports successful testing of

2392-648: A repeat of some of the early symptoms of poliomyelitis, or perhaps an accelerated aging process. In concert with clinicians, researchers, and polio survivors, PHI began to publish material on these “late effects of poliomyelitis,”. And in 1981 PHI convened the first of its international post-polio conferences to address this issue. There have now been nine international PHI conferences on post-polio syndrome and other topics having to do with living and aging with polio. These “St. Louis conferences” as they are often called in polio circles, are not always held in St. Louis. The first in

2496-454: A searchable archive of information on polio , post-polio syndrome , and independent living . It has recently begun to fund a modest amount of scientific research related to its mission – usually pilot studies , and occasionally to manage research projects for other organizations such as the Christopher and Dana Reeve Foundation . Increasingly, it is addressing the need to organize and fund

2600-410: A simple, hand-operated bag valve mask . Ventilators are chiefly used in intensive-care medicine , home care , and emergency medicine (as standalone units) and in anesthesiology (as a component of an anesthesia machine ). Ventilators are sometimes called "respirators", a term commonly used for them in the 1950s (particularly the "Bird respirator" ). However, contemporary medical terminology uses

2704-469: A small weighted arm visible to the lower right of the front panel. This was a robust unit and its availability encouraged the introduction of positive pressure ventilation techniques into mainstream European anesthetic practice. The 1955 release of Forrest Bird 's "Bird Universal Medical Respirator" in the United States changed the way mechanical ventilation was performed, with the small green box becoming

2808-552: A society) that help overcome or remove a disability. The first recorded example of the use of a prosthesis dates to at least 1800 BC. The wheelchair dates from the 17th century. The curb cut is a related structural innovation. Other examples are standing frames , text telephones , accessible keyboards , large print , braille , and speech recognition software . Disabled people often develop adaptations which can be personal (e.g. strategies to suppress tics in public) or community (e.g. sign language in d/Deaf communities). As

2912-422: A substantial archive of materials on living with polio. PHI is not itself a support group , but rather a network and resource for such groups. It is not a treatment facility, but rather a directory to such facilities and a reference desk for information about specific polio or ventilator related problems. Its many publications such as its Handbook , its two quarterly newsletters, its informational brochures on

3016-414: A variety of publications aimed at providing authoritative information on health issues for polio survivors, and on mainstream opportunities for them – as well as for other people with significant physical disabilities – in education, employment, family life, travel, and leisure activities. The organization’s magazine (until 1985), The Rehabilitation Gazette , had those matters as its dominant themes. By

3120-530: A ventilator only while sleeping and resting, mainly employ a nasal mask. Invasive methods require intubation , which for long-term ventilator dependence will normally be a tracheotomy cannula, as this is much more comfortable and practical for long-term care than is larynx or nasal intubation. As failure may result in death, mechanical ventilation systems are classified as safety-critical systems , and precautions must be taken to ensure that they are highly reliable, including their power supply . Ventilatory failure

3224-401: A wheelchair, multiple sclerosis , muscular dystrophy , obsessive–compulsive disorder (OCD), post-traumatic stress disorder (PTSD), spina bifida , and schizophrenia . This is not an exhaustive list and many injuries and medical problems cause disability. Some causes of disability, such as injuries, may resolve over time and are considered temporary disabilities . An acquired disability

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3328-405: Is a disaster-situation ventilator made using a freely-licensed design, and ideally, freely-available components and parts. Designs, components, and parts may be anywhere from completely reverse-engineered to completely new creations, components may be adaptations of various inexpensive existing products, and special hard-to-find and/or expensive parts may be 3D printed instead of sourced. During

3432-432: Is an impairment, restriction, or limitation is wrong. Instead what is seen as a disability is just a difference in the individual from what is considered "normal" in society. People-first language is one way to talk about disability which some people prefer. Using people-first language is said to put the person before the disability. Those individuals who prefer people-first language would prefer to be called, "a person with

3536-407: Is both cultural and ideological in creation. According to the social model, equal access for someone with an impairment/disability is a human rights concern. The social model of disability has come under criticism. While recognizing the importance played by the social model in stressing the responsibility of society, scholars, including Tom Shakespeare , point out the limits of the model and urge

3640-455: Is defined as the execution of a task or action. The ICF lists nine broad domains of functioning which can be affected: In concert with disability scholars, the introduction to the ICF states that a variety of conceptual models have been proposed to understand and explain disability and functioning, which it seeks to integrate. These models include the following: The medical model views disability as

3744-439: Is especially true in the UK, where it is argued under the social model that while someone's impairment (for example, having a spinal cord injury ) is an individual property, "disability" is something created by external societal factors such as a lack of accessibility. This distinction between the individual property of impairment and the social property of disability is central to the social model . The term "disabled people" as

3848-417: Is experienced differently based on the other multi-faceted identities of the individual is one often pointed out by disabled self-advocates. The ostracization of disability from mainstream society has created the opportunity for a disability culture to emerge. While disabled activists still promote the integration of disabled people into mainstream society, several disabled-only spaces have been created to foster

3952-555: Is normally the case. A first series is manufactured by Boston Scientific . The plans are to be freely available online to the general public without royalties. The COVID-19 pandemic has led to shortages of essential goods and services - from hand sanitizers to masks to beds to ventilators. Countries around the world have experienced shortages of ventilators. Furthermore, fifty-four governments, including many in Europe and Asia, imposed restrictions on medical supply exports in response to

4056-487: Is not itself a support group, but rather remains a network in support of such groups, and in support of individual polio survivors, clinicians, and researchers. Until 1984, though always incorporated as a nonprofit organization, PHI had operated entirely with a large network of volunteers, organized and led by Gini Laurie. Financial support came from donors and subscribers to the Rehabilitation Gazette . But after

4160-503: Is nowadays often replaced by a computer-controlled turbopump . Modern ventilators are electronically controlled by a small embedded system to allow exact adaptation of pressure and flow characteristics to an individual patient's needs. Fine-tuned ventilator settings also serve to make ventilation more tolerable and comfortable for the patient. In Canada and the United States, respiratory therapists are responsible for tuning these settings, while biomedical technologists are responsible for

4264-429: Is staffed with scientists from Harvard and MIT and others who have an understanding of pandemics, medicine, systems, risk, and data collection. The University of Minnesota Bakken Medical Device Center initiated a collaboration with various companies to bring a ventilator alternative to the market that works as a one-armed robot and replaces the need for manual ventilation in emergency situations. The Coventor device

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4368-492: Is the idea that disability is constructed by social expectations and institutions rather than biological differences. Highlighting the ways society and institutions construct disability is one of the main focuses of this idea. In the same way that race and gender are not biologically fixed, neither is disability. Around the early 1970s, sociologists, notably Eliot Friedson, began to argue that labeling theory and social deviance could be applied to disability studies. This led to

4472-520: Is the inability to sustain a sufficient rate of CO 2 elimination to maintain a stable pH without mechanical assistance, muscle fatigue, or intolerable dyspnea. Mechanical ventilators are therefore carefully designed so that no single point of failure can endanger the patient. They may have manual backup mechanisms to enable hand-driven respiration in the absence of power (such as the mechanical ventilator integrated into an anaesthetic machine ). They may also have safety valves, which open to atmosphere in

4576-403: Is the result of impairments that occur suddenly or chronically during the lifespan, as opposed to being born with the impairment. Invisible disabilities may not be obviously noticeable. The medical model focuses heavily on finding treatments, cures, or rehabilitative practices for disabled people. Assistive technology is a generic term for devices and modifications (for a person or within

4680-447: Is true also of its medical and consumer advisory committees (the latter now being explicitly an international committee), attendance at its international conferences, the extent to which it communicates with polio and disability organizations in Europe , South America , Asia , Australasia , and Africa , and the extent to which its work is known by international organizations. PHI also holds

4784-500: The Middle Ages , disabled people were still able to play significant roles in the rural production based economy, allowing them to make genuine contributions to daily economic life. The Industrial Revolution and the advent of capitalism made it so that people were no longer tied to the land and were then forced to find work that would pay a wage in order to survive. The wage system, in combination with industrialized production, transformed

4888-738: The United States Department of Health and Human Services . In preparation for a possible epidemic of respiratory disease, the newly created office awarded a $ 6 million contract to Newport Medical Instruments , a small company in California, to make 40,000 ventilators for under $ 3,000 apiece. In 2011, Newport sent three prototypes to the Centers for Disease Control . In 2012, Covidien , a $ 12 billion/year medical device manufacturer, which manufactured more expensive competing ventilators, bought Newport for $ 100 million. Covidien delayed and in 2014 cancelled

4992-639: The United States Food and Drug Administration for the new ventilator. On May 29, NASA reported that eight manufacturers were selected to manufacture the new ventilator. On April 7, 2020, Prime Minister Justin Trudeau announced that the Canadian Federal Government would be sourcing thousands of 'Made in Canada' ventilators. A number of organisations responded from across the country. They delivered

5096-482: The World Health Organization , distinguishes between body functions (physiological or psychological, such as vision) and body structures (anatomical parts, such as the eye and related structures). Impairment in bodily structure or function is defined as involving an anomaly, defect, loss or other significant deviation from certain generally accepted population standards, which may fluctuate over time. Activity

5200-445: The medical model and the social model . The medical model serves as a theoretical framework that considers disability as an undesirable medical condition that requires specialized treatment. Those who ascribe to the medical model tend to focus on finding the root causes of disabilities, as well as any cures—such as assistive technology. The social model centers disability as a societally-created limitation on individuals who do not have

5304-612: The personal computer has become more ubiquitous, various organizations have formed to develop software and hardware to make computers more accessible for disabled people. Some software and hardware, such as Voice Finger , Freedom Scientific 's JAWS , the Free and Open Source alternative Orca etc. have been specifically designed for disabled people while other software and hardware, such as Nuance 's Dragon NaturallySpeaking , were not developed specifically for disabled people, but can be used to increase accessibility. The LOMAK keyboard

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5408-421: The 1830s of l'homme moyen – the average man. Quetelet postulated that one could take the sum of all people's attributes in a given population (such as their height or weight) and find their average and that this figure should serve as a statistical norm toward which all should aspire. This idea of the statistical norm threads through the rapid take-up of statistics gathering by Britain, the United States, and

5512-407: The 1983 St. Louis conference, it was evident that a more formal organizational structure was required. Judith Raymond was hired as executive director in 1984, and took over PHI’s day-to-day operations as well as editorial work on its publications and organizational work on its conferences. She was succeeded in 1987 by Joan L. Headley, who served as executive director for 30 years, retiring in 2017. She

5616-543: The 2019–2020 COVID-19 pandemic , various kinds of ventilators have been considered. Deaths caused by COVID-19 have occurred when the most severely infected experience acute respiratory distress syndrome , a widespread inflammation in the lungs that impairs the lungs' ability to absorb oxygen and expel carbon dioxide. These patients require a capable ventilator to continue breathing. Among ventilators that might be brought into use for treating people with COVID-19, there have been many concerns. These include current availability,

5720-538: The Ancient Greeks may not have viewed persons with disability all that differently from more able-bodied individuals as terms describing them in their records appear to be very vague. As long as the disabled person in question could still contribute to society, the Greeks appeared to tolerate them. During the Middle Ages , madness and other conditions were thought to be caused by demons. They were also thought to be part of

5824-476: The Rights of Persons with Disabilities defines disability as including: long-term physical, mental, intellectual or sensory impairments which in interaction with various barriers may hinder [a person's] full and effective participation in society on an equal basis with others. Disabilities have been perceived differently throughout history, through a variety of different theoretical lenses. There are two main models that attempt to explain disability in our society:

5928-458: The Western European states during this time period, and it is tied to the rise of eugenics . Disability, as well as the concepts of abnormal, non-normal, and normalcy, came from this. The circulation of these concepts is evident in the popularity of the freak show , where showmen profited from exhibiting people who deviated from those norms. With the rise of eugenics in the latter part of

6032-411: The absence of power to act as an anti-suffocation valve for spontaneous breathing of the patient. Some systems are also equipped with compressed-gas tanks, air compressors or backup batteries to provide ventilation in case of power failure or defective gas supplies, and methods to operate or call for help if their mechanisms or software fail. Power failures , such as during a natural disaster, can create

6136-557: The challenge of making more and lower cost ventilators, effectiveness, functional design , safety, portability, suitability for infants, assignment to treat other illnesses, and operator training. Deploying the best possible mix of ventilators can save the most lives. Although not formally open-sourced, the Ventec V+ Pro ventilator was developed in April 2020 as a shared effort between Ventec Life Systems and General Motors , to provide

6240-589: The contract. BARDA started over again with a new company, Philips , and in July 2019, the FDA approved the Philips ventilator, and the government ordered 10,000 ventilators for delivery in mid-2020. On April 23, 2020, NASA reported building, in 37 days, a successful COVID-19 ventilator, named VITAL ("Ventilator Intervention Technology Accessible Locally"). On April 30, NASA reported receiving fast-track approval for emergency use by

6344-417: The cooperation of the anaesthesia department at Harvard University . Mechanical ventilators began to be used increasingly in anaesthesia and intensive care during the 1950s. Their development was stimulated both by the need to treat polio patients and the increasing use of muscle relaxants during anaesthesia. Relaxant drugs paralyse the patient and improve operating conditions for the surgeon but also paralyse

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6448-409: The coronavirus pandemic. The capacities to produce and distribute invasive and non-invasive ventilators vary by country. In the initial phase of the pandemic, China ramped up its production of ventilators, secured large amounts of donations from private firms, and dramatically increased imports of medical devices worldwide. As a result, the country accumulated a reservoir of ventilators throughout

6552-430: The creation of the social construction of disability theory. The social construction of disability is the idea that disability is constructed as the social response to a deviance from the norm. The medical industry is the creator of the ill and disabled social role. Medical professionals and institutions, who wield expertise over health, have the ability to define health and physical and mental norms. When an individual has

6656-412: The field include Marta Russell , Robert McRuer , Johanna Hedva , Laura Hershey , Irving Zola , and many more. Prominent disability scholar Lennard J. Davis notes that disability studies should not be considered a niche or specialized discipline, but instead is applicable to a wide range of fields and topics. The International Classification of Functioning, Disability and Health (ICF), produced by

6760-715: The gods. In Ancient Egypt , staffs were frequently used in society. A common usage for them was for older persons with disabilities to help them walk. Provisions that enabled individuals with impaired mobility to access temples and healing sanctuaries were made in ancient Greece. Specifically, by 370 B.C., at the most important healing sanctuary in the wider area, the Sanctuary of Asclepius at Epidaurus , there were at least 11 permanent stone ramps that provided access to mobility-impaired visitors to nine different structures; evidence that people with disabilities were acknowledged and cared for, at least partly, in ancient Greece. In fact,

6864-668: The groups targeted by the Nazi regime in Germany, resulting in approximately 250,000 disabled people being killed during the Holocaust . At the end of the Second World War , with the example of Nazi eugenics , eugenics faded from public discourse , and increasingly disability cohered into a set of attributes to which medicine could attend – whether through augmentation, rehabilitation, or treatment. In both contemporary and modern history, disability

6968-456: The late 1960s and early 1970s, PHI was also at the forefront of what has come to be called the independent living movement (or as Gini Laurie preferred to call it, the interdependent living movement) and was also involved in advocacy for the US 1973 Rehabilitation Act . Accessibility (of public places, education, governmental institutions, and of transportation and accommodations) was a major theme, as

7072-599: The late effects of poliomyelitis (published in Chinese , Persian , French , German , Italian , Japanese , and Spanish ), and its occasional formal statements on controversial issues such as physical exercise and on anesthesia for people with neuromuscular disabilities are widely referenced. After the polio epidemics in the United States ended, the March of Dimes had changed its mission from polio to birth defects ; most of

7176-508: The law—though there are still political issues that enable or advance the oppression of disabled people. Although disability activism serves to dismantle ableist systems, social norms relating to the perception of disabilities are often reinforced by tropes used by the media. Since negative perceptions of disability are pervasive in modern society, disabled people have turned to self-advocacy in an attempt to push back against their marginalization. The recognition of disability as an identity that

7280-473: The lungs. Electric motors were, however, a problem in the operating theatres of that time, as their use caused an explosion hazard in the presence of flammable anaesthetics such as ether and cyclopropane . In 1952, Roger Manley of the Westminster Hospital , London, developed a ventilator which was entirely gas-driven and became the most popular model used in Europe. It was an elegant design, and became

7384-695: The machine could deliver the set volume in volume control ventilation. Microprocessor control led to the third generation of intensive care unit (ICU) ventilators, starting with the Dräger EV-A in 1982 in Germany which allowed monitoring the patient's breathing curve on an LCD monitor . One year later followed Puritan Bennett 7200 and Bear 1000, SERVO 300 and Hamilton Veolar over the next decade. Microprocessors enable customized gas delivery and monitoring, and mechanisms for gas delivery that are much more responsive to patient needs than previous generations of mechanical ventilators. An open-source ventilator

7488-645: The maintenance. In the United Kingdom and Europe the management of the patient's interaction with the ventilator is done by critical care nurses. The patient circuit usually consists of a set of three durable, yet lightweight plastic tubes, separated by function (e.g. inhaled air, patient pressure, exhaled air). Determined by the type of ventilation needed, the patient-end of the circuit may be either noninvasive or invasive. Noninvasive methods, such as continuous positive airway pressure (CPAP) and non-invasive ventilation , which are adequate for patients who require

7592-408: The medical approach to disability. Due to this work, physical barriers to access were identified. These conditions functionally disabled them, and what is now known as the social model of disability emerged. Coined by Mike Oliver in 1983, this phrase distinguishes between the medical model of disability – under which an impairment needs to be fixed – and the social model of disability – under which

7696-562: The medical model, medical care is viewed as the main issue, and at the political level, the principal response is that of modifying or reforming healthcare policy. The medical model focuses on finding causes and cures for disabilities. There are many causes of disability that often affect basic activities of daily living , such as eating, dressing, transferring, and maintaining personal hygiene ; or advanced activities of daily living such as shopping, food preparation, driving, or working. However, causes of disability are usually determined by

7800-550: The natural order, especially during and in the fallout of the Black Death , which wrought impairments throughout the general population. In the early modern period there was a shift to seeking biological causes for physical and mental differences, as well as heightened interest in demarcating categories: for example, Ambroise Pare, in the sixteenth century, wrote of "monsters", "prodigies", and "the maimed". The European Enlightenment 's emphases on knowledge derived from reason and on

7904-457: The need for a new model that will overcome the "medical vs. social" dichotomy. The limitations of this model mean that often the vital services and information persons with disabilities face are simply not available, often due to limited economic returns in supporting them. Some say medical humanities is a fruitful field where the gap between the medical and the social model of disability might be bridged. The social construction of disability

8008-493: The nineteenth century, such deviations were viewed as dangerous to the health of entire populations. With disability viewed as part of a person's biological make-up and thus their genetic inheritance, scientists turned their attention to notions of weeding such as "deviations" out of the gene pool. Various metrics for assessing a person's genetic fitness were determined and were then used to deport , sterilize, or institutionalize those deemed unfit. People with disabilities were one of

8112-553: The number of ventilators needed and used during the pandemic. When data is often not available for ventilators specifically, estimates are sometimes made based on the number of intensive care unit beds available, which often contain ventilators. In 2006, president George W. Bush signed the Pandemic and All-Hazards Preparedness Act , which created the Biomedical Advanced Research and Development Authority (BARDA) within

8216-614: The pandemic in Wuhan. Western Europe and the United States, which outrank China in their production capacities, suffered a shortage of supplies due to the sudden and scattered outbreaks throughout the North American and European continents. Finally, Central Asia , Africa , and Latin America , which depend almost entirely on importing ventilators, suffered severe shortages of supplies. Healthcare policy-makers have met serious challenges to estimate

8320-662: The patient. If a turbine is used, the turbine pushes air through the ventilator, with a flow valve adjusting pressure to meet patient-specific parameters. When over pressure is released, the patient will exhale passively due to the lungs ' elasticity, the exhaled air being released usually through a one-way valve within the patient circuit called the patient manifold. Ventilators may also be equipped with monitoring and alarm systems for patient-related parameters (e.g., pressure, volume, and flow) and ventilator function (e.g., air leakage, power failure, mechanical failure), backup batteries, oxygen tanks, and remote control. The pneumatic system

8424-408: The principle of fluid amplification in order to govern pneumatic functions. Fluid amplification allowed the respirator to be manufactured entirely without moving parts, yet capable of complex resuscitative functions. Elimination of moving parts increased performance reliability and minimized maintenance. The mask is composed of a poly(methyl methacrylate) (commercially known as Lucite ) block, about

8528-562: The purposes of the Americans with Disabilities Act of 1990 , the US Equal Employment Opportunity Commission regulations provide a list of conditions that should easily be concluded to be disabilities: amputation , attention deficit hyperactivity disorder (ADHD), autism , bipolar disorder , blindness , cancer , cerebral palsy , deafness , diabetes , epilepsy , HIV/AIDS , intellectual disability , major depressive disorder , mobility impairments requiring

8632-413: The respirator to synchronize with the breathing of the patient. Intensive care environments around the world revolutionized in 1971 by the introduction of the first SERVO 900 ventilator (Elema-Schönander), constructed by Björn Jonson . It was a small, silent and effective electronic ventilator, with the famous SERVO feedback system controlling what had been set and regulating delivery. For the first time,

8736-480: The respiratory muscles. In 1953 Bjørn Aage Ibsen set up what became the world's first Medical/Surgical ICU utilizing muscle relaxants and controlled ventilation. In the United Kingdom, the East Radcliffe and Beaver models were early examples. The former used a Sturmey-Archer bicycle hub gear to provide a range of speeds, and the latter an automotive windscreen wiper motor to drive the bellows used to inflate

8840-447: The same ability as the majority of the population. Although the medical model and social model are the most common frames for disability, there are a multitude of other models that theorize disability. There are many terms that explain aspects of disability. While some terms solely exist to describe phenomena pertaining to disability, others have been centered around stigmatizing and ostracizing those with disabilities. Some terms have such

8944-600: The same way one refers to 'Muslims,' 'African-Americans,' 'Lesbian/Gay/Bisexual/Transgender/Queer,' 'Chinese,' 'gifted,' 'athletic,' or 'Jewish.' Similarly, Deaf communities in the US reject people-first language in favor of identity-first language. In 2021, the US Association on Higher Education and Disability (AHEAD) announced their decision to use identity-first language in their materials, explaining: "Identity-first language challenges negative connotations by claiming disability directly. Identity-first language references

9048-591: The series was held in Chicago , and the tenth was held in Warm Springs, Georgia , in 2009. During the 1980s, as support groups for polio survivors began to form throughout the US and elsewhere, PHI offered help to such groups in various ways – especially through its conferences and publications (including directories of support groups and health care professionals), but also through arranging speakers, assisting with local or regional conferences, and sponsoring workshops. PHI

9152-496: The size of a pack of cards, with machined channels and a cemented or screwed-in cover plate. The reduction of moving parts cut manufacturing costs and increased durability. The bistable fluid amplifier design allowed the respirator to function as both a respiratory assistor and controller. It could functionally transition between assistor and controller automatically, based on the patient's needs. The dynamic pressure and turbulent jet flow of gas from inhalation to exhalation allowed

9256-486: The skeletons was a male about 15 years old who had spina bifida . The condition meant that the boy, probably paralyzed below the waist, was taken care of in a hunter-gatherer community. Disability was not viewed as a means of divine punishment and therefore disabled individuals were neither exterminated nor discriminated against for their impairments. Many were instead employed in different levels of Mesopotamian society including working in religious temples as servants of

9360-461: The society that limits a person needs to be fixed. Like many social categories, the concept of "disability" is under heavy discussion amongst academia, the medical and legal worlds, and the disability community. The academic discipline focused on theorizing disability is disability studies , which has been expanding since the late twentieth century. The field investigates the past, present, and future constructions of disability, along with advancing

9464-619: The special rehabilitation hospitals and clinics devoted to polio survivors were closing; clinical specialists in polio were scattering. Polio survivors (substantially more in 1960 than the CDC -estimated one million in the US who were still alive in 1995) were often isolated from the support needed to cope with maturing and aging with a significant physical disability. PHI at first devoted itself to making sure polio survivors could stay in touch with each other as needed, and with clinicians who had special expertise with polio . These efforts evolved into

9568-487: The twentieth century after the introduction of the "Drinker respirator" in 1928, improvements introduced by John Haven Emerson in 1931, and the Both respirator in 1937. Other forms of noninvasive ventilators, also used widely for polio patients, include Biphasic Cuirass Ventilation , the rocking bed, and rather primitive positive pressure machines. In 1949, John Haven Emerson developed a mechanical assister for anaesthesia with

9672-416: The value of natural science to human progress helped spawn the birth of institutions and associated knowledge systems that observed and categorized human beings; among these, the ones significant to the development of today's concepts of disability were asylums , clinics , and prisons . Contemporary concepts of disability are rooted in eighteenth- and nineteenth-century developments. Foremost among these

9776-511: The variety that exists in how our bodies and brains work with a myriad of conditions that exist, and the role of inaccessible or oppressive systems, structures, or environments in making someone disabled." Invisible disabilities, also known as Hidden Disabilities or Non-visible Disabilities (NVD), are disabilities that are not immediately apparent, or seeable. They are often chronic illnesses and conditions that significantly impair normal activities of daily living. Invisible disabilities can hinder

9880-439: The viewpoint that disability is a complex social identity from which we can all gain insight. As disabilities scholar Claire Mullaney puts it, "At its broadest, disability studies encourages scholars to value disability as a form of cultural difference". Scholars of the field focus on a range of disability-related topics, such as ethics, policy and legislation, history, art of the disability community, and more. Notable scholars from

9984-528: The way bodies were viewed as people were increasingly valued for their ability to produce like machines. Capitalism and the industrial revolution effectively solidified this class of "disabled" people who could not conform to the standard worker 's body or level of work power. As a result, disabled people came to be regarded as a problem, to be solved or erased. In the early 1970s, the disability rights movement became established, when disability activists began to challenge how society treated disabled people and

10088-464: The word " respirator " to refer to a face-mask that protects wearers against hazardous airborne substances. In its simplest form, a modern positive pressure ventilator , consists of a compressible air reservoir or turbine, air and oxygen supplies, a set of valves and tubes, and a disposable or reusable "patient circuit". The air reservoir is pneumatically compressed several times a minute to deliver room-air, or in most cases, an air/oxygen mixture to

10192-552: Was designed in New Zealand specifically for persons with disabilities. The World Wide Web consortium recognized a need for International Standards for Web Accessibility for persons with disabilities and created the Web Accessibility Initiative (WAI). As at Dec 2012 the standard is WCAG 2.0 (WCAG = Web Content Accessibility Guidelines). The social model of disability sees "disability" as a socially created problem and

10296-451: Was developed in a very short time and approved on April 15, 2020, by the FDA , only 30 days after conception. The mechanical ventilator is designed for use by trained medical professionals in intensive care units and easy to operate. It has a compact design and is relatively inexpensive to manufacture and distribute. The cost is only about 4% of a normal ventilator. In addition, this device does not require pressurized oxygen or air supply, as

10400-467: Was often viewed as a by-product of incest between first-degree relatives or second-degree relatives . Disability scholars have also pointed to the Industrial Revolution , along with the economic shift from feudalism to capitalism , as prominent historical moments in the understanding of disability. Although there was a certain amount of religious superstition surrounding disability during

10504-465: Was succeeded by Brian M. Tiburzi on September 1, 2017. Ventilator A ventilator is a type of breathing apparatus , a class of medical technology that provides mechanical ventilation by moving breathable air into and out of the lungs , to deliver breaths to a patient who is physically unable to breathe, or breathing insufficiently. Ventilators may be computerized microprocessor-controlled machines, but patients can also be ventilated with

10608-498: Was the development of an effective system of home health care and personal attendants to ensure that people with serious physical disabilities would be able to live in the community of adults rather than as perpetual dependents within families or institutions. Toward the end of the 1970s, PHI began to receive an increasing number of reports from polio survivors of new symptoms – a constellation of fatigue , decreased endurance , increased muscle weakness and pain – that sounded like

10712-533: Was the development of clinical medical discourse, which made the human body visible as a thing to be manipulated, studied, and transformed. These worked in tandem with scientific discourses that sought to classify and categorize and, in so doing, became methods of normalization . The concept of the "norm" developed in this time period, and is signaled in the work of the Belgian statistician , sociologist , mathematician , and astronomer Adolphe Quetelet , who wrote in

10816-408: Was used to lift a weighted bellows unit, which fell intermittently under gravity, forcing breathing gases into the patient's lungs. The inflation pressure could be varied by sliding the movable weight on top of the bellows. The volume of gas delivered was adjustable using a curved slider, which restricted bellows excursion. Residual pressure after the completion of expiration was also configurable, using

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