1. Introduction
Mobile Health Vehicles have been in existence for over fifty years. While they have been utilized primarily to deliver health promotion and disease prevention interventions, several private mobile-sector entrepreneurs are using the van to provide clinical diagnostic and treatment services to underserved areas as well as to underserved individuals, regardless of where they are located. This paper describes the design of a mobile health van and its features. It also briefly discusses the risks of overlapping local health services with community-based outreach and promotion services.
Since the 1960s, the mobile health vehicle has been a means of delivering a variety of health promotion and disease prevention interventions to communities via services offered by organizations across the United States. While the types of programs and services delivered from these vehicles have historically focused on the intended goals of health protection and improving the health of communities, a general category of mobile health vans (vans) that delivers services unrelated to either education, promotion, screening or referral to off-site care are called ‘specialty’ vans. Specialty vans deliver care via on-board clinicians and provide the same services that are delivered at conventional fixed clinics; sometimes even at the same costs. The focus of many of these vans is on the care of one or more types of chronic illnesses.
2. Technical Equipment
The mobile health vehicle is equipped with a Siemens Arcadis Varic C-Arm. This X-ray equipment provides the vehicle with crucial support for imaging procedures by allowing x-rays to be taken at the patient’s bedside. It provides soft photon radiation (20 – 150 kV and typically 0, 1, 5, 15, 20 mA), fluoroscopy (0, 1, 5, 15, 20 mA), and is also compatible with digital imaging. C-arms have been exploited for a number of image-guided procedures, primarily in the areas of cardiac and vascular interventions, cerebral angiography and neuro-stimulation cases such as the placement of deep brain electrodes in a patient with a movement disorder.
The vehicle is equipped with a general X-ray radiography machine Siemens Multix Pro, which covers a full range of X-ray procedures including lungs, bone, skull and abdominal exams. The examination table can carry weights up to 200 kg and features a large maximum projection area. Orthopedic patients and trauma patients can be X-rayed in a standing or sitting position.
3. Operating Room
Mobile Health Vehicle; The design of the vehicle combines features of an intellectually functioning modern medical diagnostic center with the characteristics of an integrated and continuous telehealth and telemedicine consulting service that includes preventive medicine measures for outdoor deployment and disaster relief. Descriptions are given of four mobile vans in this special issue that serve different purposes in location scenarios. The Mobile Health Vehicle (MHV) design described in this chapter is of a medium capacity van that may be positioned in direct contact with disaster sites, referring stabilized victims (after primary care by first-line aid personnel) having specific and known diagnostic problems, and includes an Operating Room (OR). The vehicle is an example for a mobile disaster relief center with familiarity of operations and services provided.
The MHV was designed, and is utilized, for several other purposes outside disaster sites. Periodically in peacetime, it was serving the remote vast desert and semi-desert regions of the Negev, Israel, similar regions elsewhere, some areas in need of similar services that can be driven to in the certain time and temporary public events and gatherings. While responding to large-scale disasters (e.g., Haiti Earthquake 2010) is infrequent, the MHV frequently serves in peacetime in locations which are remote or challenging to access in emergency situations, or during major public events, which become stressful concerning health problems such as thrombosis, cut injury open wounds induced by robust physical activity due to volcanic ash. The occupancy rates during non-emergency situations are used in a flexible manner in order to achieve both long and short-term goals that are encountered during annual iterations. Ongoing operations, including research and periodic intermittent training, are designed to be illness and injury free; the van is utilized for preparedness with a stress of unlighted surround disinfection illumination.
4. Sterilization and Intensive Care Rooms
These two rooms are reserved for special cases, and the concentration of negative pressure can be adjusted. Here, isolated cases can be placed, and either mild or stricter negative pressure can be provided. Sterilization in this room is provided with a special disinfector, guaranteeing a rising humidity of 90%. The sterilization is done with ion and ozone. The improved air-supply systems are operated in accordance with the recommendations set within the valid regulations, and the scheduled parameters are all automatically recorded and checked. The supply and exhaust rates are linearly regulated, and they are decreased or increased within the given limits.
The so-called mixed regime ensures that the contaminated air is not eliminated; instead, it is absorbed to a certain degree. The heating and cooling of the vehicle is done with the special VDA system. The unit used in mobilized military medical squads was particularly developed for this specification. It can sustain the requirements for the equipment as well as provide the necessary protection. In functioning, it should also meet certain criteria for the motor vehicle in operation. Its peculiarity also lies in the side products, which are the noise, pollutant emissions, and vibrations. The intensity of these products results from the force of the engine and the system driving the motor vehicle in operation at a certain level.
