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  • 标题:Development of a rapidly deployable mobile medical unit for emergency disaster settings
  • 本地全文:下载
  • 作者:Esther J Kim ; Sergio M Navarro ; Sarah Michel
  • 期刊名称:The Lancet Global Health
  • 电子版ISSN:2214-109X
  • 出版年度:2018
  • 卷号:6
  • 页码:S50
  • DOI:10.1016/s2214-109x(18)30179-7
  • 出版社:Elsevier B.V.
  • 摘要:Background

    Mobile medical units are essential for rapid delivery of medical care in remote areas during crises. Baylor Global Innovation Center aimed to conceptualise, build, and deploy an Emergency Smart Pod (ESP)—a mobile medical unit customised for global emergencies—with a four-phase approach: human-centred design, development, user testing, and implementation.

    Methods

    An initial design was created based on the Ebola Grand Challenge Funding requirements granted by USAID in 2015. The design was then vetted using a 37-question survey via in-depth interviews with experts with field experience: logisticians, health-care workers, and Ebola Treatment Unit directors in the USA, Sierra Leone, Liberia, and Guinea. This design focused on addressing direct needs of end users by providing a rapidly deployable clinical solution with tablet-based wireless technologies, disinfectable materials, and appropriate storage for biohazard waste and medical supplies. The aluminium design of the unit optimised the lightweight capability, durability, and expandability. Manufacturers meeting these requirements were investigated for affordability, and technologies were developed for customised needs of infection control and emergency response. Feedback from field workers, NASA engineers, and physicians was continually evaluated throughout the building process.

    Findings

    A prototype equipped with smart applications optimised to protect health-care workers, improve patient care, and prevent disease transmission was built and tested. An ultraviolet C- heating, ventilation, and air conditioning system was implemented to kill 99·7% of pathogens. Medical record and wireless patient monitoring systems were developed for the high patient throughput in disaster situations. Remote video and push-to-talk systems were implemented to facilitate communication between the hot and cold zones. The ESP was built as an expandable aluminium-based box deployable via ships and trucks. A full simulation was initiated in Houston, TX, USA with simulated patients and health-care workers in full personal protective equipment. Improvements were made prior to shipping the unit to Monrovia, Liberia, for infectious disease care. The ESP was then successfully deployed in September, 2017, at the Eternal Love Winning Africa (ELWA) Hospital as a patient isolation unit.

    Interpretation

    Corresponding pharmacy and laboratory units are being developed as additions to the ESP. Similar validation will be used for these units for future deployment.

    Funding

    Vulcan Inc's Paul G Allen Ebola Program USAID Bureau for Global Health—Center for Accelerating Innovation and Impact.

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