1. Introduction to Mobile Container Hospital
Mobile container hospital in containers are important facilities for a country, which can be operated in a flexible environment. They can be quickly transported to various disaster sites in time to provide medical assistance for the corresponding number of affected people. If these hospitals are equipped with more ICUs, such as automotive ICUs, they can address the time-critical factor of providing ICU services to patients. A further development of these mobile hospitals is the specially developed units for automotive applications, such as mobile recovery ICUs. The definition of a mobile container hospital is as follows: A hospital is a health care (or recovery) facility that is primarily equipped with all the facilities that would be available in a traditional intensive care unit. This unit is installed and equipped to fit into one or two standard, long fifty-three-foot containers, including the selection of the inbuilt medical equipment. This unit can be taken from a container to an equipped site with a standard unit, using only standard ISO container transport and lifting facilities to be able to use the unit after it has been transported by truck to the disaster site.
Healthcare is something that counts literally every single second during class 1 medical emergencies. The automotive unit is a piece of equipment of utmost importance because, in the event of a medical emergency, it determines whether a patient will have optimal prospects. Therefore, at any time of day or night, it should be possible for a medical evacuation team to start moving and arrive as quickly as possible at the scene of the emergency. Developments in healthcare and increased demand for medical services for people living in rural areas and in areas with difficult-to-access medical services are growing. For this reason, mobile automotive hospitals, especially the so-called mobile container hospitals with a modular design, have emerged as important facilities for a country, which will treat people who have suffered all kinds of emergencies in addition to all specialized treatment forms.
1.1. Definition and Purpose Mobile Container Hospital
A mobile container hospital can be defined as a rapidly deployable healthcare facility in a standardized freight container offering various facilities and services required for moderately complex to complex and highly specialized emergency care of predominantly polytrauma ICU patients. Such a mobile and self-sustaining hospital can be transported by truck, aircraft, or ship as a single-car or multi-car load. These self-contained facilities can be deployed as replacements for traditional brick-and-mortar hospitals. Equipped with bunks, kitchens, water, shower facilities, heating, air conditioning, and even cafeterias and libraries, these mobile units are designed with flexibility in mind, opening up opportunities to assist in healthcare delivery in different environmental settings that may be stricken by structural drawbacks to healthcare systems.
Furthermore, such mobile container hospitals can also be operational under prolonged or chronic adverse environmental or medical conditions, serving as a bridge between the immediate rescue at the point of invasion or injury and transfer to available comprehensive hospital facilities. They can also serve a useful surrogate hospital emergency service appearance or disaster surge capacity enhancement or enlargement role when the appropriate trauma care or medical infrastructure hosting fully compliant hospital care is not adequately available due to limited regional surge capacity uptake or over-demand due to their small capacity by reason of distance to the point of impact of the incident. The importance of this strategic investment has recently been underlined by the catastrophic impact on the global population’s health stemming from very recent pandemics. Their roles need to be properly engineered and clearly defined toward healthcare planners and end-users or injured and/or affected individuals.
1.2. Evolution and Importance
The evolution of tempospatial mobile hospitals (also known as field hospitals or mobile container hospitals for emergency ICU care) is very interesting. In ancient times, there were hospital tents and mobile hospitals that were called field hospitals. Disaster and the need for emergency care have intensified because of pandemics; for example, due to natural disasters or war and peace conditions, countries have always been ready to respond to emergencies that may occur in a populated area. In recent times, field hospitals have become container hospitals (mobile container ICU hospitals). The combination of mechanical, electrical, and technology engineering has greatly evolved and produced mobile container units (motorized) that cater to the demands of fast and quality health services. These container units, in the form of elementary hospitals (Level I), have tended to be able to service large numbers of patients, minimally by mobile surgical trauma units with minimal facilities and a few beds. However, with the advent of modern ICT, the development of modular chain management and new technology of mechanical, computer, and electronic technology, people these days have begun to pay much attention to the development of mobile hospital units suitable for the ICU mobile hospital, which can also be identified in situations against COVID-19. This is due to the conditions when a pandemic falls into a wide-area region, with a large and moderate transmission rate of individuals with high contagion. These conditions can lead to a health facility collapse in the affected area. For COVID-19, a requirement may arise that a health facility, and its adequacy, is needed in a surprising manner, which may exceed the existing facility’s capacity and service. A mobile container hospital is a type of hospital that changes function or occupation based on the transit of time and conditions that exist. This condition might arise out of, for instance, a pandemic, natural disaster, terrorist threat, war/peace conditions, or a different special situation. In achieving this, the development of unrelated mobile hospitals requires that people should be able to learn mixed changes in mechanism products. These days, the response time has been the concern of many major health care systems that avail their health services in an advanced, standard, and best-serving manner. The epidemiology of the disease has been increasing every time. These days, the time of response becomes crucial in an emergency conveyance, frequently as minor as probable, sensitive individuals and patients can be helped. In emergency transport, the access time factor will be an offset among the emergency patient and the principal cares. The only concern of advanced nations has been to afford their citizens suitable emergency health striking and mitigation with the sinister epidemic that is ahead of time with a major transmission rate.
2. ICU Automotive Applications in Healthcare
Mobile container hospitals in general offer capabilities for operating various medical specialties. The complex technology and required equipment enable a wide range of applications. By providing a complete, ready-to-go intensive care unit (ICU) straight out of the container, the efforts for the mobile ICU team are more focused on logistics and operations than on setting up medical-technical infrastructure. This requires various modifications and solutions, as medical devices and technology are usually designed for easy connection and operation in a stationary environment rather than mobile application.
An integrated water and oxygen supply eases the operation and provides a longer period of emergency operation compared to 40 ft ICU containers with a similar setup. Proper hygiene measures must be provided based on the international guidelines for on-site hygienic management. Besides the technical and transportation issues, various organizational hurdles and political restrictions exist in outside-theater application. However, in times of a major disaster, especially in the first phase after a major incident, knowledge of resource demand regarding this issue may help decision and policy makers to consider the options of ICU automotive application. The necessity to accomplish ICU entrance levels depends on local laws in each country. International-level applications need to fulfill special entrance criteria in the accompanied or accompanying countries. Providing temporary ICUs with portable functionality for ambulance patients, ICU step-down patients, or temporary support at the site, the ICU platforms also differ in their entrance level management.
Mobile or automotive applications for ICUs have been provided for VIP patient transportation or in ambulances. High medicine standards identify these applications as a logistical platform to guarantee primary treatment almost at the VIP level, allowing the dual use of their medical equipment for major incident patient transport or other purposes in case of non-special use. Severely injured patients to be transferred from a smaller hospital back to a local critical care unit, transit station, or major university hospital, ambulant patients in temporary medical treatment centers, or as preparation or final station in the repatriation of an ICU patient belong to the operable scenarios. Real-time monitoring, telemedicine, and integrated video cameras are becoming standard functionalities in automotive applications for ICUs.
2.1. Challenges and Solutions
The current self-confinement has changed the lives of the population worldwide, and lessons were learned from the infection. Eventually, infections resulted in high necessities for critically ill cases to be treated in intensive care units (ICU). Formulating an extension to the part, challenges were identified in applying a car-based mobile and inflatable ICU, and learning from previous implementations of container hospitals, risks and opportunities are revealed.
2.1. Challenges and Solutions Transporting a critically ill patient has reasonable challenges. The first challenge is the logistics of transporting the patient from his or her residence to the hospital. In normal times, countries have local ambulance services provided by municipalities. The major limitation of these systems is the availability of ambulances and/or paramedics. Moreover, the providing health care center is inadequate to tackle a rapid increase in critically ill patients. The second system for transferring COVID-19 patients is the use of military aircraft. The number of patients that can be transported is limited, and a significant number of crew members are obligatory for each patient. A final solution employs commercial airlines and their charter flights. For the flight to land at specific military airports, several agreements between countries have been made. Nevertheless, fully equipped containers are listed in countries where suitable airplanes are available.
While offering urban medical treatment, all the groundwater generated at prefabricated container hospitals must be removed and disinfected. In addition, a charity organization has required the contrivance of a basic operating RFA, two X-ray rooms, and a new emergency room using tailored containers. The main patient service chain is to move them from the existing hospital to the delivery hospital created by the Open Air. Beginning with delivering a new container-driven field hospital setup, early registration of citizens will come into the existing hospital. As for the ward of the field hospital, the open-air hospital offers good ventilation and is located on the coast. Communications to the transportable and field hospitals are frequently used by ambulance personnel, known as CB Radio. Medical expertise is often required for the operation. Car-reliant mobile clinical treatment encompasses the treatment of patients in an ambulance and recovery car, thereby ensuring continuous patient care. The efficiency of the mobile medical solution relies on medical facilities. Mobile units have the opportunity to increase their use as pressurized ICUs. To maintain a breakdown of the hatch messaging system, a living airlock operator’s interface was maintained. In addition, the airlock has connections to two oxygen ports and one backup device, as well as multiple power supplies. So, a general challenge that must be resolved in a large automobile in the mobile clinical treatments is that every element entirely within the automobile needs to do its task in terms of movement and time. The ability of sterility to be guaranteed is important. Both connectors are not tested and certified, and they are more cost-efficient. Thus, the dual medical fans required to be examined and checked for their activation. A comparison of the fan in the mobile and transportable hospital was mentioned above. The fan is used to exhaust the patient’s compartment.
2.2. Benefits and Impact Mobile Container Hospital
The use of an ICU automotive hospital increases the chances of survival of seriously ill or injured people by providing timely and high-quality professional medical care outside healthcare facilities. The widespread use of these mobile hospitals increases the availability of professional medical care, facilitates access to it for the local population, and ensures its rapid provision in hard-to-reach areas. Mobile container hospitals for the provision of critical care services are designed to be deployed in the event of emergencies and natural disasters in which conventional healthcare facilities cannot provide immediate care. The number of mobile ICUs is increasing; there are proposals for adaptations of traditional mobile ICUs, which are mounted on cars or lorries, and others propose the creation of special vehicles that can carry a whole mobile hospital with the required support facilities. Although many of the new vehicles are not based on a currently existing one, they can use the standard chassis and cab of HGVs so that they have a towing capability, giving extra flexibility to deploy and feed the system. In addition to emergencies, mobile ICUs are used as complements to the traditional healthcare system, relieving overcrowded hospitals during relapses and peaks of demand.
These new mobile ICUs are often larger than their predecessors and include much more advanced clinical and surgical equipment. Some factories have tested the use of remote-controlled robots for surgical procedures in conflict and disaster zones and in the Arctic and Subarctic, where there is little specialist medical care available. Others have used computer tomographic scanners for gunshot wound patients and have donated them to the receiving hospitals. Some factories allow handling more than 70 OR and ICU patients with the help of robots. Independent of the novel ideas installed in the mobile ICUs, they not only provide quick alternative access to healthcare for the population, but the latest ones can actively save lives on site, perform early interventions, and prevent further complications that may arise after trauma. These new automotive-based mobile container hospitals have the potential to revolutionize healthcare provision during major incidents. They can provide advanced definitive care for remote, rural, and island communities in their early phase of injury trauma, with these patients being able to be returned, if well enough, to their local hospitals for further recovery and treatment, thereby relieving the pressure on the larger facilities that normally have to take the brunt of the remote rural island injured, and allowing those larger city facilities to redeploy staff and resources to deal with those more severely injured directly from ground zero. They can also greatly increase the speed and quantity of medical involvement that can be provided to multiple patients. They promise a significant beneficial impact not only to those injured in major incidents but also to the already stressed medical facilities in the area receiving raw casualties.
3. Manufacturing Process of Mobile Container Hospitals
At the outset, before any screws and bolts are to be fastened, it is important to thoroughly contemplate the consequences right through to the last detail: researching the requirements and standards of the responsible authorities and discussing functional and logistic issues with the future operators of the MCH container system. The discussion on standards and requirements includes the regulations and standards in the host country, related guidelines and standards for in-vehicle installations with regard to functionality, safety, EMC, but also general vehicle operation and standards for medical products such as respirators, ventilator systems, or infusion pumps. First of all, the basic engineering of the mobile containers lies in the optimization of the available space. In general, the interconnection of all necessary hospital facilities – and particularly in this scenario, the focus on intensive care – is a matter of persons and supplies to be transported and a set of infrastructure including the necessary medical technical facilities to be provided. The design itself must therefore face a modular concept that allows a perfect alignment for transport capacity and medical supply as well as shelter and operational room. Once purpose, capacity, use cases, design, and the general functionality are established, the manufacturing process begins with the engineering components. The engineering process will be conducted with CAD systems. The development will be modular, and the result of the engineering process will be a modular design concept in detail. In the end, early prototyping and testing of conceived application systems might be owned by the interdisciplinary approach of the design of mobile container hospitals.
3.1. Design and Engineering Considerations Mobile Container Hospital
Creating a mobile intensive care unit hospital within the constraints of an automotive container, and more generally, in a container meant to maximize space, needs to consider vital aspects of who will be the patient inside the hospital and for what purpose. The hospital’s patient is in a potentially life-threatening situation, and a comfortable traveling solution is not the main goal here. First aid workers are also on board, and the medical equipment needs to be as ergonomic and easy to use as possible. The difficulties increase when one is trying to adapt to a moving environment, especially if the container is shipped from place to place. Each millimeter of the hospital has to be used smartly to fit it into a standard ISO 1C automotive container. This compares to previous work in which 20% more space was available to fit all of the equipment; however, the load was considerably larger too.
At least, the full ambulance medical technology environment has to be mirrored on a limited scale to recreate a complete, erasable intensive care unit office able to function with all necessary inputs, outputs, and interfaces in the hospital and hospital-to-hospital. Four areas will define the design parameters of the emergency mobile container hospital. A complete exploration of all services and special services carried out in collaboration with the clinical services will guide designing the flexibility and possible changes needed in case of urgent, six-hour delivery for full operation. This movement is reflected both in the different structural design, allowing more acute patients to be treated in all important specialties like medical, surgical, and pediatric. The initial concept is based on two different designs of the container that serve to edit hospital operations in case of the red code and orange code.
In the first container, there are predominantly compartmentalized general facilities like radiology, analysis laboratories, sterilization services, warehouses for medical records, etc. Most areas are air-conditioned. The isolation area and the waiting zone are already separated in different backup zones for capacity management. In the second container, there are primarily diagnosis and treatment areas and general care beds, general intensive care, and specific beds for post-operative care patients. This container also has exclusively refrigerated backup for two air-conditioned mortuary spaces. The emphasis of the basic design guiding theory states that much important work has to support synergy remote from conventional permanent hospital solutions. All design supports a modular assembly system for better adaptation to a given number of infected civilians distributed along a specific corridor from east to west of Italy. However, Italy has infected civilians, although there are differences in the number of infected civilians in any given city. Moreover, the speed of density of infected civilians in total numbers per hour is a further variable to address in the final design launches. Furthermore, as soon as one hospital governed by one regional authority has caught up, all parallel modules that are compatible with the regional hospital modules should be ignitable during the continuous spread of the curve of civilians going through the S and I situation.
3.2. Materials and Technologies Mobile Container Hospital
The choice of materials for use in containers for the construction of mobile hospital wards is of great importance, particularly their chemical and microbiological resistance as well as their smoothness. Materials that are important in clinical human matters are characterized by durability. Such materials also have a large capacity in automated systems dedicated to sterilization and disinfection. In the section on ventilation and air conditioning, good thermal insulation is of great importance, as well as the sealing of all systems in order not to cause excess air exchange. This is particularly important in units that provide intensive medical care. Portable equipment can be made from light, portable materials that are also easily susceptible to damage. Ease of cleaning and disinfection, as well as low bacterial growth, are basic features of all materials and products used in the construction of mobile units that treat human patients.
The importance of introducing innovative materials to solve the problems of the construction and operation of hospital facilities, as well as all other forms of hospital infrastructure, is widely discussed. In the field of construction, various types of prefabrication and crafting have also produced numerous variants of hospitals and healthcare units in mobile containers that are widely praised. It is also believed that one of the driving forces for innovation and the introduction of new materials in the construction and equipment of hospitals should be the search for zero energy consumption balances for the development of mobile hospitals that would draw energy from the sun. The materials suitable for the construction of modern mobile hospitals are characterized by high-quality sanitation and health, especially for cleaning and other treatments. It is also believed that the use of composite materials can be an alternative option to earlier building materials. All the materials used, however, must meet the tight health criteria mentioned above, especially in the case of medical facilities that treat people, sometimes very seriously ill, and have appropriate certificates. Some materials in mobile container hospitals are using modern technology. This concerns hospital containers, which are equipped with telehealth transmitters and also have the possibility of early detection of patients. They have the option of remote patient monitoring.
4. Case Studies and Best Practices Mobile Container Hospital
The past year, a great deal of attention has been aimed at the use of mobile container and automotive hospitals to quickly and efficiently address patient overflow. This section presents case studies and best-practice collections that incorporate successful deployment of mobile hospitals. All of the included case studies have been organized based on their operational aspects. This might vary from capacity and supply chain management required for mobile hospitals, technical and engineering solutions required to join various mobile container hospital elements, or analyzing technology applications to enable mobile units to be more efficient. We can observe when these case studies were deployed, witnessing daily changes at the operational level. Every case study endorses the necessity for an outside-the-box approach to essential health care provision. This involves dealing with a lack of resources at the time, fighting a dilemma of helping those in need against ethical judgment, and an inspirational reaction to a public health crisis. All are a significant part of the identification of the urgent demand for mobile hospitals.
We present an array of mobile container hospitals that have been operational over the last two decades. At the end of this section, we present four basic principles and best practices. To our understanding, these principles are beneficial to stakeholders to avoid repeating past errors and to promote the most efficient construction and operation of container hospitals. To obtain these principles, various case studies were analyzed, and the characteristics of many mobile container hospitals were critically observed in order to create a glossary of best practices and innovative solutions. Each case study explains the specific situation and the problem that had to be tackled. It describes novel solutions, their implementation, and lessons learned. It is crucial to be flexible, innovative, and adaptive while planning a mobile hospital. New mobile concepts, novel purposes, original designs, and collaboration seek to better adapt more closely to actual user needs as well as provide large advantages to those who need assistance most.
4.1. Successful Implementations Mobile Container Hospital
The first search criterion considered all successful deployments as valid implementations. However, success could be classified in numerous ways, such as the treatment of a specific health concern, the efficient operation of the container, or logistical aspects in operations. In the context of this review, the ultimate goal of a health facility is to provide timely and life-saving care to those in need. Therefore, success is defined as positive patient outcomes due to the operation of the mobile health facility. Instances in which the cause led to the effect are outlined, illustrating limits on acting indicators. In the discussion of each deployment, a clear link is made to the innovation in design that directly contributed to the positive patient outcome. As mobile health facilities are designed to be deployed in any context, a diverse range of deployments is discussed in this section.
As of July 2021, there have been 14 deployments that met this criterion, and the information collated is related to 166 academic studies, 44 medical studies, and 33 case reports, giving additional information to form the listed results in this review. These deployments involved the treatment and care of 9,816 patients. Where known, a retrospective analysis of these patients is provided. In this criterion, two use-case contexts contributed to the successful implementation of a mobile health facility: community engagements and disaster response. In both contexts, the local governments allocated significant resources. These strategies endorse the stakeholder engagement and collaboration factors highlighted in the experts’ opinions, which have been discussed previously. It must be noted that the specific experience and qualifications of the staff working in the health facility were also key factors that were not explicitly considered by the experts. As mobile container hospitals are only deployed by conversion organizations in disaster contexts, this successful criterion is independent of reference. Each case is discussed below. An analysis of each deployment is provided, including the innovation in design that contributed to the positive patient outcomes. Some patient outcomes are known, so a retrospective analysis is included.
4.2. Lessons Learned Mobile Container Hospital
4.2. Lessons Learned.
What have been the biggest operational and design challenges and how were they overcome? Flexibility was important for operation as the patient needs and community response could not be accurately predicted. Flexibility also proved crucial in the surviving implementation. Non-U.S. efforts speak to the importance of community benefits and a checkered history of government regulation when determining the priorities for the project. Both the Turkish Red Crescent Society and the UMMC projects failed to function as initially intended. In both cases, lack of community partner engagement early enough in the project to be able to work with them to determine their needs and incorporate those in the design proved to be a major obstacle.
In most cases, operating emergency mobile hospitals in immediate disaster relief did not pose issues that were not able to be overcome. The most cited issue was security around the design and operating in the post-disaster environment. The essential items needed to eliminate constraints in the post-disaster environment include: specialty beds and gurneys, specialty clinics, eight hours of battery power, solar power electrical outlets, and trained service-oriented dogs for deployment in our community. The most significant insight into aid related to mobile hospital projects stems from a division that failed to launch after two years of support when it was being operated by the relief group on the ground. The critical obstacle was the ability to communicate the design intent, the importance of keeping the equipment together, rather than trying to piece meals out in alternative ways, and the need to train staff on managing the specific sized environment. The company believes that if uses are clearly understood, the mobile hospital design would be highly successful and the work is currently underway to increase public awareness.
5. Future Trends and Innovations Mobile Container Hospital
Key trends and expected innovations for the topic in the next 10 years are identified. One of the most vital innovations expected to occur in healthcare is highly accurate diagnosis, with the help of artificial intelligence and machine learning, which will be highly effective in terms of cost and progression monitoring. It is also expected that telemedicine will further establish its significant role in the near future as part of remote support to the most critical patients and better monitoring. New materials and methods of construction will enhance the reliability and mobility of mobile hospitals, container systems, and tents by being immune to extreme environmental conditions. The use of sustainable energy such as solar energy will support more benefits in both long-term and harsh weather conditions. Other areas, such as establishing mobile centers with flexibility to be produced by 3D printers, will play an important role. Therefore, future research should focus on how to integrate different technological trails for mobile hospitals, including those of policymakers and healthcare providers. The ongoing challenges and unknown fields in the future of mobile hospitals also require a continuous search for such projects.
Looking ahead, the rise in mobile container hospitals, especially in an ICU automotive application, is not likely to decline. Most innovations and technologies will, however, enable us to improve in one form or another. The future innovation of mobile container ICU evolution is in the details. As we create scalable designs to cater for congestion or decongestion, we will also need to provide safe, sterile, scalable patient-centered dynamics that evolve for the benefit of healthcare. We are also looking to add important details to the user experience, increase medical capabilities, heavily employ sustainable energy, and develop flexibility in design.
5.1. Emerging Technologies Mobile Container Hospital
In recent years, we have seen various emerging technologies relevant to automotive applications that have the potential to be integrated into the development process of mobile container hospitals. Advancements in medical equipment technology can offer new diagnostic and treatment services, such as portable, smaller, and lower power medical diagnostic systems that are more suitable for mobile hospitals. Portable imaging technologies, such as portable magnetic resonance imaging systems and portable ultrasound systems, can enhance diagnostic performance. Moreover, we are witnessing the emergence of smart and intelligent sensor technologies that can monitor patient conditions in real-time, such as contactless sensors to gather pulse, respiration data, and skin temperature. Mobile medical devices are now employing data analytic capabilities that can access, analyze, and report on large quantities of both simple and complex medical data, including ECG data. Integration of artificial intelligence and machine learning is also opening the way for more personalized patient care.
Apart from medical equipment advancing for automotive applications, trajectory technologies have also made good progress in recognizing and treating critically ill patients effectively. We have seen the increasing exploration of connected disaster response systems or mobile hospital operation platforms and researching several new synthesis and optimization in integrated mobile container hospitals. Telecommunication has also made good progress in vehicle-to-infrastructure-based technologies. There are many new therapeutics developed in the automotive industry where the treatment for patients uses different variants that have become advanced because many hazardous materials are used around the vehicle, and testing and diagnostics are developed through collaborative research of clinical and automotive scientists and medical personnel.
Telehealth generally describes a broad set of technologies, procedures, platforms, and gadgets that make it feasible to provide clinical health care remotely, to manage diagnosis, consultation, treatment, education, care management, and self-management over a distance. There is also a broad range of expertise that falls under the umbrella of telehealth. Telehealth technologies initially supported virtual consultations, such as telephones, video communications, and chatbots. However, due to rapid technological advancement, several additional features can now be integrated within telehealth applications, which can then lead to ongoing patient management, data transfer, and diagnostics.
5.2. Potential Applications Mobile Container Hospital
The inherent modular adaptability of mobile container hospitals allows for them to be utilized in a vast number of scenarios. Some proposed application settings for mobile container hospitals include: small, rural or isolated community one to two days a week; correctional institutions; field science research vessels or research stations; outbreak response; specialty care for veterans; women’s health; palliative care; care following release from inpatient psychiatric care. Additionally, beyond simply specialized care, mobile container hospitals could also be easily adapted to the needs of a particular community in order to transform it into a comprehensive blended community emergency room/treatment station. For the purpose of this paper, we focus on potential applications in a generalized setting. Based on the availability of treatment in higher-order care facilities, the assistance provided by mobile ICU automotive applications should be tailored to the needs of the patient and the healthcare environment in which they are functioning. Possible applications, in emergency medicine and in a variety of settings, are described below. In the emergency medicine setting, AFOs are equipped for identifying and isolating patients with infectious diseases, which can save lives in situations where an infection has spread and there is significant cause for concern. Repurposing AFOs, ABS, MACs, and ULWCs for specific, non-emergency applications can increase community access to care, monitoring, or care in certain conditions. Public health agencies or other disaster management entities can also work with providers of emergency health services or other health services to make ABS or MAC assets available after an emergency medical response, when their community may need extra health services.
