Medical and Hospital
Introduction
Mobile Hospital Solutions with NATO standard. Uniteam, together
with the Norwegian Army Medical Service, found their initial goal
to develop a mobile hospital, able to cope with the difficult conditions
of disaster and war. This process was initiated in 2000 and has
been modified following experience from in-field testing in 2001,
NATO Strong Resolve exercise and NATO Field Surgeon Live Training
Exercise in Norway 2002.
Several newly developed technical systems have been adopted to refine
the concept after NATO standards. The guidelines for projecting
has been: easy relocation, short set up time, rugged basic technology,
easy maintenance and good working conditions for doctors and nurses
equal to civilian hospitals of European standards.
Hospital delivered to the Norwegian Armed Forces.
The main idea is that situations with a large number of several
wounded patients by itself offer a great challenge, and fighting
with complex or non-functioning equipment will only contribute further
to chaos and mental paralysis, the key elements of any disaster.
Subsequent to this, good functioning equipment, present and ready,
is necessary to manage a medical disaster.
The following has then, through the process of development
come to be the characteristics of the concept based on the Uniteam
“3in1” Operating Theatre.
Flexibility and wide applications
The Mobile Hospital Units is very well fitted for civilian disaster
as well as military war medical services. Easy handling/operation
and sturdy manufacture makes it possible to use this Mobile Hospital
Solutions at locations of urgent needs.
The comprehensive technical and logical systems will permit final
treatment of the majority of the patients if necessary.
By our decentralized technology, with small support machines placed
in each of the units, you will obtain max flexibility; “STAND
ALONE CAPABILITY”!
The units can then be operated separately or as a whole without
much planning and installation. Light weight technology with extensive
use of aluminium, makes the units easy to move and prepare for use
at site.
From the user’s point of view
The Mobile Hospital Solutions have the appearance of an international
hospital and with equivalent equipment. Well-trained staff, as doctors
and nurses, will immediately be able to operate the units without
previous retraining for field medical service.
Using a central containerized treatment zone in one level, patients
may be rolled in their bed to the site of examination or treatment,
pushed by one person.
Consequently less staff is needed to prepare and run this hospital
compared with tent hospitals or hospitals improvised in existing
buildings.
Possibilities for treatment
In the Operation Theatre there are 1-2 working stations equipped
for resuscitation and stabilization of trauma cases as done at a
regimental aid post or battalion aid station. One of these working
stations is equipped so further major surgical emergency operations
can take place as usually in a field hospital.
By moving one Operation Table to the walls, the Operating Theatre
is enlarged considerably, and in this way it will be possible to
include several assistants during complex operations, and to teach
as well.
There can also be placed 2 Intensive Care (ICU) working stations
in one end of the operating theatre, for effective use of the anaesthesiologist.
The most rational use of the anaesthesiologist in a single operating
theatre unit is obtained with the following rotation system:
• Induction of anaesthesia on one station,
• Surgery in the operating theatre,
• Recovery at the third station
In this way the anaesthesiologist will be able to manage 3 patients
in rotation.
Anaesthesia may be of inhalation type, intravenous, regional or
local. Explosive inhalants should be, and is, avoided.
Treatment is only limited by instruments available and by the skills
of the staff.
Hygiene
The criteria for a good level of hygiene in a mobile field hospital
in addition to strong hygiene discipline by doctors and nurses are:
• Easy cleaning of the units
• Sufficient sanitary installations
• Sufficient room to carry out correct procedures
• The possibility to maintain order
• Stabile temperatures in the treatment and recovery zone.
All of this has been taken care of in the UNITEAM Mobile Hospital
Solutions:
• The surface of walls, ceiling, floor and equipment is smooth and
will stand soap and disinfectants.
• In each unit there is running water with a sink and local UV water
purification.
• A convenient indoor climate reduces perspiration.
• Consistent use of cupboards with trays permits the use of one
tray for one procedure, and facilitates maintaining of good order.
• Equipment which is easily contaminated during procedures, can
be clicked off from the equipment rails to be cleaned and disinfected
in a sink or sterilized.
In this way hygiene becomes a natural routine, which will not be
compromised even during heavy stress situations.
Balanced technology
We have succeeded in selecting and developing technical equipment,
which is rugged and easy to maintain, and it is our experience from
field work that after one week of introduction, a UNITEAM Mobile
Hospital, can be maintained by one person without special pre-qualification.
Maintenance will require about one hour’s work daily.
After 3 month’s in service more extensive servicing is necessary,
especially concerning change of filter components. Special procedures
must be followed if the units are going to be stocked at temperatures
below 0°C.
The decentralized technology, which may be found in relevant units
includes:
• Oxygen system with oxygen generator, and oxygen cylinder back
up.
• Laughing Gas system with pressure guard
• Vacuum system with pressure stat-controlled vacuum pump.
• Medical air compressor to support of medical air, and to run surgical
tools and ventilators.
• Air-Conditioning incl. cooling/heating of fresh and recycled air.
• Thermostatic electrical heating panels or integrated floor heating.
• Humidifier is supplied to prevent corrosion during storage – will
support inner climate as well when many people work together.
• Water is led to the unit through insulated frost-secured hose
and stored in a local water tank in technical compartment of each
unit.
• Local water purification is based on both filtering and UV-treatment.
(Water must be taken from a non-toxic source and preferably chlorinated.
• Water is heated online in a thermostatic immersion heater.
• Grey water pumps are placed at each waste-pipe outlet. Waste water
is pumped to external sewage tank, through an insulated frost-secured
hose.
Equipment
Equipment list could be adapted to customers needs.
• The instrument kits, supplied in sterilization boxes, are equal
to typical equipment at modern hospitals. Only equipment from recognized
suppliers is used.
• For Operating Theatre Unit to be used separately, without sterilization
unit available, an autoclave with small outer dimensions, but with
(320*320*620mm) chamber dimensions, is recommended. This small autoclave
has a double chamber, and re-circulation of vacuum pump water.
• The anaesthesia machine includes the following features: Oxygen,
N²O and pressurized air flow metres, universal evaporator,
a volume controlled ventilator with “bag-in-bottle” system. The
anaesthesia machine has 3 back-up systems (“draw over” possibility
e.g.) making anaesthesia safe even under critical conditions. It
is delivered with a circle system to save gases and with a disposable
coaxial system for simple use and for quick change of patients.
• The respirators for Post Operative ventilation are equal to the
one used in the anaesthesia machine.
• The main Operation Table is hydraulic and adjustable for all types
of surgery.
• The second Operation Table is mechanical and ready for X-Ray examination
and operations.
• The operating lamp equipped with twin heads is rail mounted or
swivel mounted in the ceiling.
During transportation all equipment is strapped or fixed to the
walls.
The field environment
It is assumed that the units will not have to resist bombshell fragments
or other impact from artillery and heavy missiles.
If intended for a tactical environment the units will be delivered
without windows or with plastic windows at your request.
The roof can be sandbagged with max load of 80 kg / square metre.
The Mobile Hospital Shelters is of course rainproof, and chemical
agents will not penetrate the unit. The unit is sealed when fully
employed, and application of a slight positive pressure will prevent
ingress of hazardous vapour.
The air-conditioning module of the unit can have integrated EU7
and NBC filters. Combined with an air-sluice and decontamination
tent, it can thus be used as a collective protection area, incl.
all necessary precautions.
The unit is built from materials able to resist decontamination
with aggressive matters such as DS2, and the smooth surfaces make
decontamination easy.
Uniteam Mobile Field Hospital Modules
Other modules than the Operating Theatre in the Mobile Hospital
System can with success be built into 3in1 units:
• Reception/Triage Unit with 2 treatment stations
• Emergency Unit with 4 treatment stations
• Intensive Care Unit with 4 ICU stations
• X-Ray unit with conventional or digital x-ray machine and C-Arm.
• Pre-OP/Laboratory Unit with range of modern laboratory machines,
toilet and sluice room.
• Post-OP/Recovery with 6 recovery beds
• Pharmacy/Administration Unit
• Dental Unit with 2 treatment stations.
• Sterilization Unit with instrument washing machine, instrument
dryer, Qty 2 large 2-door Sterilizers (Autoclave), sealing equipment.
The unit is divided into a clean ”controlled access section” and
a “general access section”.
The different units can be selected according to the needs of client,
and easily combined to different rational Level 1-3 Mobile Field
Hospitals configurations.
Outside wiew of a Pharmacy shelter
All medical units are united together by tent connectors and/or
containers, giving the total treatment area flat floor and easy
access to different treatment stations.
Accessories
Medical Gas Installations
Local Compressor for Medical Air
Laminar airflow
Local water storage
Integrated Power Generators, adapted to the expected power consumption.
Levelling jacks
NBC Filtration
Support and implementation
Uniteam technicians are used to travel under all conditions, and
can assist in installation, user training programmes and maintenance
programmes all over the world.
Configuration of a 50 beds Mobile Field Hospital.
References:
Our hospitals are currently in service with
•The Norwegian Army Medical Corps (currently deployed in Afghanistan)
•The Swedish Army United Nations Mission in Kosovo
•The Norwegian Air Force Immediate Reaction Fighter Squadron (NBC
Protected Medical Facility)
•The United Nations Mission in Sierra Leone (100 bed hospital)
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