Facility Overview

'The Brook Cherith' is the name of our improvised disaster clinic simulation model / testing ground. This is not a practicing clinic, but is a training simulator for creative solutions to infrastructure needs often encountered by medical missions on the field.

This eclectic facility directly models, and tests, the improvised and ad-hoc nature following a disaster - or even in just austere environments. The site situation also helps recreate challenging obstacles and the un-planned nature that is often encountered in these scenarios.

This semi-working model allows us to test and try different improvised techniques, as well as collect valuable hands-on experience and ideas that can be passed on in the printed resources. This is a partial facility modeling only the main infrastucture needs. As time and funds permit, we will expand the model to review all the necessary components of a theoretical disaster clinic. New resources will be compiled for the different aspects of the entire system. You can find more in-depth information about some of the key systems, in our resource Volume II: Establishing a Disaster Medical Clinic

OR Theatre

This area models the infrastructure needed for the most important and delicate functions. Multiple areas and systems must work together to enable a productive surgical suite. All of these components must be considered and maintained for optimal performance. Without the infrastructure and auxillary areas, it is detrimental to attempt a surgical area.

Triage area: many details must be considered, even down to the traffic and workflow. Receiving areas identify patients, as well as provide additional room for patient prep, staging, and support prior to moving into the OR.

Patient Prep area gives more direct staging and preparation for those about to be moved into surgery. If need be, this area also can be used for more involved treatment, while the OR is occupied.

Auxillary areas include a Clean Utility room/area, for items needed close at hand. A Soiled Utility room/area, for processing all soiled items that come out of the OR. Other nearby areas may include addressing specific power and water requirements.

The OR is an environment working within - and by - its support systems. Many things must come together to make this work.

Central / sterile processing for proper cleaning and preparation of instruments and supplies. Special emphasis on instrument flow, passthrough windows for soiled and sterile transfer cases, air filtration, and other key points means this area has as much attention to detail as the operating room.

Hospice / Expectant

Triage, of those arriving, will often involve patients in the Expectant category. They are sent to this area, to focus priority on those with a greater chance of positive outcome.

Resources and considerations must be taken, though, to give the greatest amount of care and compassion, under the circumstances. Those in the Delayed category may also be staged here, unless a separate area is available.

Patient Wing

The Patient Wing is situated close to the OR, to allow observation and care of patients after surgery. This is only a short-term care setup. Long-term care would require more suitable facilities, where the short-term patients could be moved once they are able.

The nurses station oversees the nearby Hospice as well; and gives a central go-to station for the nurses.

Our Patient Wing models a 6-bed capacity (not including Hospice), and its most pressing considerations for that number of patients and caregivers. This includes a Workroom with the linen and care supplies most used in this environment.

Minimal

Those patients needing minimal care (walking wounded) are sent here, for first-aid and more involved treatment.

Even with a small space, three patients can be treated; including in a privacy area.

Support Areas

Even with just this small bed capacity (upwards of 12), the potential number of people that will be on-site (patients, caregivers, admin, medical experts, patient guests, security, maintenance, etc.) quickly climbs to around 60-80! Logistical concerns about feeding, santitation, housing, etc. are crucial to maintaining the medical focus, especially during trying times where outside infrastructure may be greatly compromised.

Having dedicated areas where the staff can eat, sleep, wash, and be refreshed is paramount.

Multiple maintenace considerations come together, and need their dedicated areas. This includes fire control measure, power generation, proper fuel storage, water storage and delivery, water purification, etc.

Administrative Areas. Organization is key - especially in chaotic circumstances. Special care must be given to keep everything - and everyone - working together in the best manner.

 

Thank you for taking the tour! While the facility may appear simplistic, once we examine the systems, we can see how attention to infrastructure detail - even with simple means - can help medical personnel provide a high level of care even during trying situations.

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