final presentation script

The goal of this project was to analyze and combat the high road traffic accident mortality rate in Malawi with a special focus on mass casualty incidents.

To express the weight of this issue, malawi ranks 1st in Africa in road traffic accident mortality rate at 35 fatalities per 100,00 people. The United Nations recognized this as a global issue and set a sustainable development goal which has not been met.

1/3rd of all injury related deaths are caused due to road traffic accidents and 30% of all accidents result in at least 1 fatality. The cause for this has been identified to be the delay in emergency medical attention, lack of ambulance services, and a shortage of pre-hospital teams. This identifies the main issue to lie in the response system for road traffic accidents.

I first looked at the timeline for a typical road traffic accidents and identified the issues in the process in red.

I then looked at the timeline for a mass casualty road traffic accident. A mass casualty is defined as an accident which results in more patients than the local resources are able to handle. In red, I have identified issues that are faced in addition to the ones identified for a typical accident.

As stated before, the main issue lies in the response system for road traffic accidents. This includes the initial triage and urgent care, which is the area of intervention.

This brings me to my thesis question:

Could a deployable prefabricated mobile emergency response unit help reduce the on-site road traffic accident fatality rate?

By enabling the first responders to conduct efficient triage, the medical staff is able to quickly recognize victims in critical condition. These victims could then be transported to a healthcare facility where they will have access to definitive care, while other victims may be treated on site. This will reduce the amount of time that it takes for a critical patient to be recognized and taken to a hospital.

To assist healthcare providers on a chaotic crash site, the crisis response unit, or CRU, will be a deployable emergency unit which will provide a space for the responders to recognize and treat patients.

I studied the three main components of the system: the ambulance, trailer, and tent and established their uses and relationships on the site.

I also established a set of deployment, structural, and programmatic criteria to assess the success or failure of the proposed solution within the context of Malawi.

A goal for this project especially within the context of Malawi, was to be able to design the CRU to be a prefab and efficiently shippable design. A 2-unit set would aim to be fit into a 45 long shipping container.

The timeline of the crash was then reanalyzed as the response system was recreated. After a crash occurs, the police is contacted. As the police race to arrive at the crash-site and deploy the Crisis Response Unit, the ambulance makes it’s way to the crash site. This way, the medical staff is not wasting precious time deploying the tent when they could be triaging the victims. Once the critical victims are identified, they are stabilized and taken to the healthcare facility while the rest of the patients are addressed on site.

The unit is divided into two sections: the primary treatment zone and the secondary storage zone. The primary zone is home to the emergency supplies, and the connection to oxygen, electricity, and water. The secondary zone contains the larger units needed on site such as the foldable stretchers, go bags, portable batteries, portable oxygen, and extra supplies.

When dealing with a mobile unit, there had to be a flexibility in the features to be able to exist in different conditions. Things such as a PVC fabric for durability, the choice to make a mechanically deployable tent to ensure multiple deployments without causing strain on the physical material, and a structural frame which is modeled from the structure of a durable shipping container were all considered. There also had to be features included to increase the ease in use such as a lever to crank the fabric back into the roll, the walking space within the unit between the supplies, and the footing to assist with the circulation within the site.

The floor plan further clarifies the organization of the components within the unit.

The elevation expresses the location of the utilities with respect to the hitch. To ensure more stability during transport for the utilities, it is located directly above the hitch. The flag is placed to signify the triage category which is being addressed at that time.

The sections express the relationship between the treatment areas and the supplies. Creating the walkway within the unit allows the treatment areas to connect and bleed into each other.

The loads affecting the unit were addressed when the structure was being created. The tension cables at the ends of the telescopic structures are incorporated to offset the wind uplift.

The overall system can be created using multiple units.

CRU is designed to be able to be walked through and create a continuous circulation within the site for the staff. The circulation flows through the supply corridor of one unit into a covered treatment area in front of the storage space with portable utilities.

The CRU system could also be utilized in case of a larger mass casualty situation such as a flood or fire. A makeshift clinic can be created using these units.

The layout of the supply and storage zones determines the types of treatment areas. Critical treatment areas can be created where the supply and utility zone is located adjacent to the storage zone as that area has access to resources available in both zones of the unit. Other treatment areas are adjacent to only the supply & utility zone.

This creates a grid like organization on an otherwise chaotic site. While patients travel along this grid.

The staff can travel along a different grid utilizing the corridors within the unit.

CRU strives to be able to provide an effective area for treatment and create some organization on an incredibly chaotic site.

By establishing this organization, it is easier for medical staff to be able to triage critical victims quickly and administer emergency stabilization.

The response time which could otherwise be wasted attempting to transport each victim to a healthcare facility to then await triage in an overwhelmed facility, is now cut to a fraction by providing an organized space to conduct that triage initially on site.