Shelter Review 2006

Making Shelters Workable and Livable

By Cheryl Gerber MMT Correspondent
Although future support systems could be integrated with shelters in single, customizable units to meet military requirements for fast, easy transport and deployment, most shelter support today is specialized and as such, is still acquired separately.

However, at Fort Detrick, Md., the Army Medical Research and Materiel Command recently tested a prototype of the Future Medical Shelter System (FMSS), an integrated shelter and support system that was designed to be boxed in a single standard ISO shipping container and deployed in less than one hour. Once operational, it could replace existing Deployable Medical Systems (DEPMEDS).

“By integrating shelter components, there could be a life-cycle cost reduction and a smaller footprint for transportation, making it easier to get them out in the field,” said Jamie Lee, FMSS program manager at the Army Medical Materiel Development Activity (AMMDA), Fort Detrick. The major objectives of the FMSS are faster set-up times requiring fewer personnel, decreased life-cycle cost—primarily a fuel cost reduction, and a small transportation footprint.

However, there’s a tradeoff. “The integrated units are used at the price of floor space inside the shelter. The support systems sit inside the shelter as opposed to outside the shelter. It’s a double-edged sword, so we’re doing some testing this year,” said Mark Arnold, AMMDA product manager.  When standalone environmental control units (ECU) and generators sit outside the shelter, they make way for more space inside the shelter. The noise of support systems located inside a shelter is also a consideration, although most air conditioning, heating and generator systems have become quieter in recent years.

The Army has made suggestions to vendors about how much heating and air conditioning is required within an integrated shelter system and how to produce support systems that take accessibility and ease of maintenance, among other factors, into account. “We provide suggestions to make support systems more efficient, to conserve heat and electrical power,” said Arnold.

Integrated Support Systems

One FMSS vendor, Mobile Medical International Corp. (MMIC), received an Army contract in August 2006 to take its integrated shelter systems to the next stage of development. “Our systems are fully integrated with everything already in place, including the generator, ECU, NBC filtration system and wiring. It’s all pre-wired and fully self-sustaining upon arrival so you can literally turn on the generator as soon as you receive it,” said Rick Cochran, Mobile Medical International president and CEO. The company includes nuclear, biological and chemical protection in its integrated units.

MMIC offers a three-echelon family of small-to-large units, some of which also integrate a central medical gas system, modular storage cabinetry and lighting along with the self-contained power system. The 20-kW, acoustically-engineered diesel generator provides DC and AC capability and an integrated emergency power system. The integrated ECU provides 99.97 percent HEPA filtration with air plenum, NBC protection, is designed to operate in temperatures from minus 10 degrees F to 110 degrees F and is staged to avoid spikes in power consumption. Two units also include a communications system infrastructure.

DHS Systems also provides the Army with integrated shelter and support systems units that were designed to mount on one trailer. While most shelter support systems are still offered à la carte, the company sees movement in the direction of increasing integration. “Years ago the Army would have go to as many different vendors as there are components. And none of them was designed to work together so they were cobbling the parts together,” said Ron Houle, DHS director of federal systems. “Today, the Army seems to prefer shelter support systems that are easily transported on one trailer.”

The Air Rover Inc. integrates only certain support systems by tying together generators, ECUs, enclosures, heaters and trailers. The UL Series ultralight military ECUs for portable air conditioning provide extreme cooling in hot ambiences of up to 150 degrees F. All UL Series military ECU systems employ a .063-inch aluminum exterior cabinet that effectively reduces the overall weight by 23 percent.

ULCR models utilize a special refrigeration system that allows automatic bypass operation and a constant-run compressor to ensure no electrical spikes or surges when powered by a portable generator. An effective filtering system virtually eliminates dust contamination. The Air Rover Series consists of a trailer, up to 10 ECUs and a power generator integrated into one complete air conditioning and heating solution.

ECUs, Air Conditioning, Heating and Fan Systems

Most ECUs and fan systems are quieter, lighter and more fuel efficient than previous standard military sets. “We’re always improving our ECU’s and generators to make them lighter in weight and to give them a higher output with less fuel consumption, making them easier to start, to run and to maintain,” said Houle. “It’s all based on military customer feedback.”

DHS offers what it calls the DRASH D-1000 heater, which is a ducted and fuel-fired forced-air heater that provides 100,000 BTUs per hour of clean, dry heat at a rate of 850 CFM. The heater is rugged, lightweight, rust resistant and shock proof. It contains a nine-gallon tank, burns multiple fuels and includes an electronic control system in a rain-tight control box on the side of the heater. The control system monitors for high heat conditions and flameout. The heater’s molded polymer body is designed for stacking multiple units.

DRS Technologies, which acquired Engineered Support Systems, Inc. (ESSI) this year, provides the Lightweight Environmental Control Unit (LECU), an all-in-one air conditioning system that cools, heats, filters and dehumidifies. Utilizing a non-ozone-depleting refrigerant, the portable LECU operates in temperatures ranging from minus 25 to 125 degrees F. The LECU weight and configuration were designed for strategic airlift applications. The standard system includes two auxiliary electric resistance heat banks of 10kW capacity each, for heating in conditions of extreme cold. Since the acquisition of ESSI, DRS has restructured into three divisions and plans to expand its shelter support offerings. “It is still predominantly LECU, but there will be other shelter support capabilities provided as well,” said Larry Cox, DRS director of communications.

Limco Airepair, Inc. leveraged its background in military airborne cooling systems and heat exchangers to provide ECS and NBC systems where heat removal is essential. The ECS operate at a range of 115-380V and provide from 3.5-28.1kW of cooling power. An isolated condenser for the optional NBC filter is standard. Limco’s NBC filtration system is a compact, heavy-duty, high-performance ventilation and filtration system, supplying clean air to a vehicle or ground shelter and filtered air at times of NBC contamination. The company’s collective protection technology provides a simple and fast—less than one minute—transition between ventilation and filtration modes.

General Shelters’ Port-A-Cool portable, evaporative cooling systems lower the temperature of the ambient air at an average of 18 degrees without the production of fluorocarbons. Direct evaporative cooling also adds moisture to the air. Since they require only tap water and a 220-volt power source or compressed air to run, their operating cost is low. Models include fans ranging from 16 to 48 inches in diameter. The company also manufactures emergency services cooling units (ESCU), which are self-contained and trailermounted. Each trailer is equipped with a 36-inch, three-speed Port- A-Cool, a 120V/240V generator and a 50-gallon water tank.

TAT Technologies Ltd. manufactures a comprehensive line of single-unit and split-type air conditioners for mobile shelters as well as positive-pressure NBC filtration and ventilation systems that prevent the penetration of contaminated air. All TAT AC systems meet the requirements of applications military standards, are NBC protected, EMI/RFI compatible and compact. Vertical, horizontal and custom units are available. The horizontal unit provides 36,000 BTU/H cooling capacity at an ambient temperature of 95 degrees F and features both a heating element and manually controlled fresh air intake.

Alaska Structures offers 5-ton and 2.5-ton, rugged ECUs that both heat and cool. The ECU’s are built to be stackable and mobile. They are easy to maintain and simple to operate. The Product Manager, Force Sustainment Systems at the Army Soldier Systems Center in Natick, Mass. developed a large Family of Space Heaters (FOSH) that are non-electric, clean-burning and multi-fuel, as they run on diesel, JP-8, JP-5, kerosene, wood or coal. They can operate in temperatures as low as minus 60 degrees F. There is a venting exhaust outside the tent that meets standard military requirements.

The Space Heater Arctic (SHA) and Space Heater Medium (SHM) operate inside the shelter and heat through radiation and natural convection, using a multistage, liquid-to-vapor combustion process that results in cleaner, more efficient combustion requiring far less burner maintenance. A patented multi-fuel control valve maintains a consistent flow rate among the various types of liquid fuels and temperatures encountered in the field. The space heaters have three circular recessed areas. One is for the gas exhaust, another is for a pot or pan for cooking and the third is for a thermal electric fan.

Aspen Systems Inc. manufactures the selfpowered thermo-electric fans for the SHA and SHM heaters to distribute heat inside shelters. Placed on the heater’s surface, the fan improves the heater’s performance by creating warmth throughout a larger area with the same fuel consumption. In cold climates, the Army has estimated that a single fan could save as much as 320 gallons of heating oil in one heating season. “The fans generate their own electricity from the heat on the stove,” noted Ron Wyck, Aspen Systems vice president of business development. “Without this fan, the temperature is stratified. The floor can be almost freezing while the ceiling is hot. The heat circulation from the fan causes the temperature on the floor to rise from approximately 30 degrees F to 55 degrees F,” Wyck said.

Generators

As with ECUs, generators have become quieter, lighter and more fuel efficient in recent years. To drive the point home, DRS Fermont even uses the word “quiet” in the name of its generator product. The company has been providing its 100- and 200-kilowatt Tactical Quiet Generator sets (TQG) for two years now as part of a production order in a development contract with the Army.

DRS Fermont added the larger, more powerful generator sets to expand its existing product line of 3kW-15kW generators it has been producing since 1999 under various DoD contracts. The Army Medical Group is the primary user of the 100 kilowatt TQG in Fort McCoy, Wis., said Mark Steele, DRS Fermont director of sales.

The 100-kilowatt generators provide electrical power for field hospitals and troop encampments. “They are 13 percent quieter than the old military standard generator sets, 10 percent more fuel efficient, and there is a 1,500-pound weight reduction on the 100-kilowatt,” said Steele. “Noise reduction really has to do with the packaging of the generator set to produce better air flow manipulation and better utilization of sound insulation material,” he said.

DRS Radian offers a 1-kW PEM stationary generator that is fueled by direct hydrogen for UPS applications. The compact RASP (Radian Silent Power) unit, which measures 24 by 20 by 32 inches and weighs 140 pounds, produces silent, low-infrared-signature AC power that is environmentally clean.

Unlike most generators, Energy Technologies Inc.’s lightweight, portable tactical power units produce computer-grade AC power. In addition, several of these units are designed to use jet (JP-8 and JP-5) and diesel fuels, which are more readily available in the field. ET’s patented catalytic fuel reformer changes the fuel’s properties so that it will vaporize at lower temperatures, allowing the generator to start easily at temperatures as low as minus 25 degrees F, and its patented catalytic ignition system burns fuel efficiently at all load levels. Each of the tactical power generators weighs less than 50 pounds dry and is available in backpack- and vehicle-mounted configurations. Multiple units can be operated in parallel.

The Dewey Electronics Corp. 2-kW diesel generator could be the lightest generator set in U.S. Army inventory. It is available under contract with Communications and Electronics Command, Fort Monmouth, N.J., in two configurations: the 120 VAC, which weighs 152 pounds with four hours of fuel, and the 28 VDC, weighing in at 140 pounds. Options include an electronic-control remote fueling kit, and an auxiliary power unit installation kit. The single-cylinder air-cooled engine is operable in temperatures up to 120 degrees F. Designed to meet the U.S. Marine Corps auxiliary power requirements for remote landing systems, the Goodman Ball 10-kW AC/DC Permanent Magnet (PM) GENSET is the lightest AC/DC PM generator in its class. It weighs 650 pounds, and can run for 10 hours at 50 percent power, generating 120 VAC, 60 Hz, 28 V DC.

Flooring

Developed by Bike Track, Inc., EcoTrack is a patented modular flooring system with a molded-in, perforated traction pattern and structural ribbing. It provides easily installed, heavy-duty surfaces usable in all weather conditions and a variety of ground conditions, including grass, gravel, asphalt, sand and mud. Panels are made of durable, high-density polyethylene with a high strength-to-weight ratio, and are slightly resilient to lessen fatigue. Perforations provide drainage, eliminating puddles, and a traction pattern reduces tracked-in dirt. Friction holds the panels in place; no additional connectors or tools are necessary for installation.

The BikeTrack in-floor wire channel system is designed to integrate wire and cable distribution within the floor. Constructed of 1/4-inch-thick ABS plastic, each module consists of a base section, which attaches to abutting flooring sections, and a friction-fit cover. Power, LAN or other cables can exit/enter the channel every two feet.

Signature Flooring manufactures three interlocking, modular flooring systems suitable for temporary shelters and access ways. All can be deployed rapidly and transported compactly. These hard flooring systems are used as a base for equipment, vehicles and personnel, and are chemical and weather resistant. Unlike plywood, they will not warp, rot or crack, and can be used repeatedly.

EventDeck is a rollable flooring and pathway system based on an interlocking module. Each module is manufactured using a UVstabilized, high-impact, polypropylene copolymer that is chemical resistant and features a UL 94HB flammability rating. Interlocked sections are flexible enough to be rolled for storage.

Signature’s beefier UltraDeck can handle a wide range of uneven ground surfaces. Ribbed reinforcements provide added strength and weight loading capabilities, for a maximum load of 20,000 pounds per square foot. The underside of each interlocking module features a specially designed multidirectional cable channel to thread power and communications wiring.

HexaDeck features reinforced heavyweight construction suitable for large vehicles and equipment. Unlike square modules, Signature’s HexaDeck’s hexagonal design avoids the structural weakness associated with a two-directional joining system. Each high-density polyethylene “tile” incorporates multidirectional, concentric, structural support ribbing, and can support up to 30,000 pounds per square foot static load. The tiles feature a diamond plate finish, for added slip resistance; drainage holes; and channels for power and communications cabling.

Protection Within Protection

There are situations when full exterior protection is not needed, and only the necessity and benefits of bio-isolation are required. Constructed buildings lack the flexibility to quickly and easily adapt to the problems related to a pandemic. In such a situation, even field tents are a costly and cumbersome solution. One solution is the Iso- Ark, by Collective Protection, a stand-alone negative air-pressure unit which can quickly turn any conveniently available space into a bio-isolation facility. Standard patient rooms, hallways, auditoriums, sheltered parking areas, domed stadiums, arenas, warehouses and concert halls can all be quickly converted to receiving centers for infected patients. The Iso-Ark is also ideal for set-up in a penal environment, where the spread of tuberculosis in the inmate population is of serious concern.

Two model types of the Iso-Ark are available The Iso-Ark shipboard solution is packed in soft transport bags, having a zippered soft airlock and a moderate airflow capacity filtration system The second is the Iso-Ark hospital solution, available in several sizes ranging from 5 feet by 7.5 feet up to 12.5 by 10 feet. It has a rigid-frame airlock. high-volume filtration unit and is packed in two steel shipping and storage containers. The larger box contains the complete tent unit, packed on a convenient rolling cart, which will fit through any space large enough for a hospital bed to pass through. The smaller box contains the filtration system, on casters for mobility. In both model types, the modularelement filtration system, besides being 99.995 percent effective at 0.3 microns, contains a strong ultra-violet source, to eliminate the build-up of live organisms inside the filter.

There is a snap-out panel for a set of gloves to handle routine patient monitoring activities without the need for dressing- out and entering the tent. An Xray head access panel is available to fit the particular type of portable X-ray unit which is used at the facility where the tents are set up. Other options include panel racks for mounting life-support and monitoring equipment, a bio-isolation trash chute that allows for the bagging and safe disposal of contaminated items, and an airpressure monitoring alarm. Several isolation sleeves are built-in, which allow safe cable and hose pass-through into the interior.

Communications Systems

Some companies are beginning to integrate basic communications systems as part of shelter support in a single unit. Mobile Medical, for example, includes a basic communication system infrastructure with its Mobile Surgical Unit II, including an external connection for high-speed local area network lines and wireless connectivity within the complex for data transfer and digital voice communications.

However, for a communications system in the field, Television Equipment Associates provides the Rapid 40 Field Phone System, a self-contained digital network that can be up to 10 kilometers long and can accommodate up to 40 handsets. “It allows ten simultaneous private conversations and three conference calls contained on a single military field cable that prevents media eavesdropping,” explained Bill Pegler, president and CEO. The waterproof, shockproof Rapid 40 was developed based on military specifications to meet a requirement for secure communications in a command-and-control infrastructure. The system provides users with communications that are similar to a modern office telephone system but without the need for a central switchboard or operator.

The system provides up to four simultaneous data calls, priority break-in ability and simultaneous broadcast calls. It uses general purpose 3-line interfaces, can be linked up to radios, field switches, tactical trunk networks, PSTN lines, external modems, fax and can be interfaced over long distances to form networks. “The Rapid 40 can easily and quickly be transformed into a local area network by simply plugging the wire into laptops,” Pegler noted. “There are numerous interfaces to radio and other wireless or wired telephone systems,” he added.

Lighting

Mobile Medical also integrates LED lighting in its single unit shelter with support offerings. The company offers customizable, low-profile (less than one inch) general illumination 60 to 110 foot candle (FC) background lighting with the ability to expand the grid to a fixed central ISO power for normal and emergency operations. There is an interface with DC power systems, blackout capability and dimming capability included.

Mobile Medical also offers custom-designed, soft shelter, 30-FC LED lighting that has blackout capability, can interface with DC power systems, can be permanently mounted and can withstand the vibration and shock expected within a mobile military container. In addition, it offers custom-designed, surgical 240-FC LED lights that are ceiling-mounted and detachable with a 120-V, 60-Hz AC line. The lights are blackout capable with lightweight unobtrusive fixtures and were designed to reduce shadows.

Jameson offers two rugged fluorescent lights: the EMI (electromagnetic interference) hardened light and a general purpose light. The EMI produces the pure white light that is important in surgical areas. The light is shielded to prevent electronic frequencies from interfering with communications and sensitive medical equipment and to make it difficult for the enemy to pinpoint the exact location of troops due to the reduced noise level. The general purpose lights are similar in construction to the EMI lights but without the EMI shielding.

“We take regular fluorescent lights and add a honeycomb-like metal shield around them, a filter and other devices to contain the frequencies,” said Herb Koelble, Jameson director of sales. The EMI lights are currently in use at Fort Detrick at Air Force Medical Logistics, the Army Medical Materiel Command and the TATRC (TeleMedical and Advanced Technology Research Center), he said. “We can run a Humvee over these lights without breaking them because of the construction of the light with both interior and exterior  shock absorbers,” Koelble added ♦
 

Building a Better Shelter

By Mickey McCarter
conflict in the Middle East has worn on, so has it worn on the deployed warfighters and equipment. Protecting the people and assets to fight the war has fallen to military shelters. To some, a tent is a tent, and they give little thought to the technology or evolving art of designing a shelter that protects against the heat, the cold and other elements that Mother Nature throws their way.

Enter a host of companies who have been studying the problem and applying the best commercial technologies to military shelters. These companies have grappled with protecting warfighters from the heat and sand blasting throughout the deserts in Iraq and Afghanistan, providing weary soldiers with a comfortable place to rest or to perform important parts of their jobs—deskwork even—requiring electricity and lights.

And some of these shelter efforts are aimed directly at protecting equipment. Take the efforts at U.S. Air Force 84th Combat Sustainment Group, Tactical Shelter, Radome, and Tower Program Office to improve hard-wall tactical shelters. These tactical shelters house communications electronic gear under configurations as command posts, briefing rooms and medical facilities, according to the office.

To that end, the 84th Combat Sustainment Group has been working to insert a new composite material into hard-wall shelters. The new material would reduce costs and maintenance required by warfighters. According to the program office, the material costs less, weighs less, corrodes less, and is recyclable, plus it’s tougher than the old hard wall. The first production run will be handled by AAR of Wood Dale, Ill., and Triton Systems Inc. of Chelmsford, Mass.

The U.S. Army, meanwhile, has been working on its 21st-century military hospital system, recently adding more than $7 million to a contract for Mobile Medical International Corp. in August.

Applying CONUS Standards

Field surgical teams face a tremendous challenge in providing first-class medical care under battle conditions. Mobile medical shelters have come a long way, but Mobile Medical International Corp. (MMIC), based in St. Johnsbury, Vt., is a company dedicated to taking U.S. medical care standards into the battlefield.

Rick Cochran, president and CEO of MMIC, told Military Medical Technology that his company truly began tackling the problem in 1998. “In the early days, people said there is a difference between field surgery and that found in the continental United States where we have definitive care,” Cochran recalled. “I said, but why can’t we take this care to the forward battle lines? Everyone was in full agreement that it makes sense if you could do it. That was the challenge. Ultimately, I think we have delivered very successfully on that commitment by taking our experience on the commercial side and simply applying some of that technology in military shelters. So for the first time ever, we can take U.S. standards to the forward battle lines. That’s a whole new paradigm shift.”

Working with the U.S. Army Medical Department Center and School, U.S. Army Tank-automotive and Armaments Command, and U.S. Army Medical Research and Materiel Command (MRMC), Mobile Medical International began developing requirements and definitions for the next-generation field hospital in 1998. The group also collaborated with the Air Force, the Department of Veterans Affairs, and public and private physicians.

The company’s association with the military truly began when retired Lieutenant General Paul K. Carlton started working with a MMIC commercial unit at Wilford Hall Medical Center at Lackland Air Force Base in San Antonio, Texas. Carlton was impressed by what he saw, and MMIC began examining how to apply its civilian technologies to military medical readiness.

“My previous background was in setting up permanent-based surgery centers and helping with that part of the ambulatory development process,” Cochran elaborated. “I took that experience and leveraged that into the mobile medical field. We are the first and only company in the U.S. that has a mobile unit that has been state-licensed, Medicare-certified and Joint Commission-accredited.” Cochran believes a true shift in military medical thought began when retired Lieutenant General James B. Peake, the former U.S. Army surgeon general, began to speak of equivalency of care—particularly the ability to apply U.S. hospital standards to battlefield hospitals. “That’s certainly more the thinking of the Army than it ever has been in the past,” Cochran observed.

Single Pallet Solution Cedar Spring, based in Irvine, Calif., serves as the exclusive U.S. government distributor for MMIC. As such, Cedar Spring—a woman-owned, native American-owned, SDB and HUBZone certified small business—sells Mobile Medical International’s products directly to DoD. Lee Standard, vice president at Cedar Spring, said that the Mobile Single Pallet Unit (MSPU) is unique among shelter solutions because of how transportable it is.

“The entire solution fits on one military pallet,” Standard described. “It can be sling-loaded from a Black Hawk. Or on top of the pallet is a light tactical trailer so you can pull it with a Humvee, a Suburban or a truck. There’s no other solution out there where the entire solution fits on one single pallet.”

The MSPU inflates to full size (20 feet by 20 feet) in less than 10 minutes and is complexable with other shelters. In fact, their ability to form complexes is universal, Standard noted, as the Mobile Single Pallet Units are capable of attaching to any other shelters within the U.S. military’s inventory.

The shelter is also unique in that all critical systems are integral, Standard added. The inflated shelter contains complete lighting, electrical, HVAC and HEPA filtration systems already installed. It also has nuclear/biological/chemical protection features such as a protective liner and additional filtration.

A variant of the MSPU called the Universal Support System (USS) comes in a “battle box” ISO container. The system provides a lot more square footage than the MSPU in one complete package. Two soft shelters inflate from two sides of the container; each softwall shelter measures 20 feet by 30 feet. The total square footage is approximately 1,800 and is attained in less than 30 minutes. “When this thing is stored, those shelters go inside that single ISO—described as a 2-pallet position box,” Standard explained. “So it’s very compact when it is being stored or transported. With a push of a button, the ISO automatically levels. I have heard a lot of stories of individuals that have had to set up ISOs in the past, and it takes hours and hours to get the thing to level. It’s a very labor-intensive and manual process. This is a huge breakthrough in ISO containers that it automatically levels.”

As with the MSPU, lighting, electrical, HVAC, HEPA and NBC, and other systems are completely integrated—meaning no set-up is required. Universal complexability is also part and parcel of the USS’ unique design.

Both the MSPU and the Universal Support System use a special acoustically engineered generator that reduces noise tremendously (55 decibels at 7 meters). Warfighters could sit on the generator and talk on radios without disturbing their conversations, Standard said. The shelters also are rated at a medical grade equivalent to burn units, the highest level of care a medical facility can offer. That burn-unit rating means that the shelters are certified for housing any medical procedure that field surgeons can perform.

Army Standard

Base-X Inc., headquartered in Fairfield, Va., has long been a leader in expeditionary shelters. Base-X shelters remain the standard shelter of the U.S. Army and are in use by the Army forward surgical teams, said Brian Dearing, Base-X vice president of sales and marketing.

The shelters are used by U.S. Marine Corps in its forward resuscitative surgical suites, Dearing added, while the Navy Fleet Hospital, Navy Expeditionary Medical Unit and Navy Field Deployable Preventative Medicine Units all use Base-X shelter infrastructure.
 
“That’s been a tremendous advance in medicine, especially trauma medicine, in the last three years in Iraq and to a lesser degree in Afghanistan,” Dearing commented. “We have leveraged that, and we are doing an awful lot on the civilian side as well, in providing turnkey medical packages not only for trauma medicine but also for vaccinations and isolations against contagious disease. All sorts of different turnkey packages for the civilian side of the medical world are really a leveraging of our military experience.”

Dearing notes that the company is also a leader in the collective protection arena, where many companies have been offering protection against chemical and biological agents that does not truly measure up to the military’s needs.

“We like to think that we are probably in the lead on having technology for the collective protection arena that is truly multi-mission,” Dearing contended. “It is closer to the holy grail, if you will, of using your collective protection liner as your normal tactical liner, and then when or if the need arises you can simply plug in your chemical and biological filtration gear.”

Many other fielded solutions are simply separate add-ons, he added, leaving warfighters to strip out standard shelter liners to replace them with a new set of equipment. “Nobody wants to do that logistically or cost-wise. So really the end game for everybody in industry is to get something that is truly multi-mission capable,” Dearing said.

Base-X also leverages its relationships with its sister companies—Hunter Manufacturing and Power Systems. Hunter Manufacturing provides the entire Defense Department with chemical and biological filters, ranging from tanks to ships to facilities, according to Dearing.

“A spectrum of multi-mission-capable tactical infrastructure makes a lot of sense,” he remarked. “So from a one-stop shop point-of-view, if you are a tactical or military customer or if you are a first responder or homeland security customer, you can go to one stop and get a fully integrated product suite that is engineered to work together, not merely just integrated but engineered to work together in a way that nobody else in industry can.”

The ability to make one-stop purchases of this magnitude also reduces the logistics burden on warfighters while saving money, Dearing argued.

Air Force Standard

Alaska Structures Inc., headquartered in Anchorage, Alaska, supplies the Air Force with shelters used in the service’s Expeditionary Medical Support (EMEDS) program. Alaska Structures is the largest supplier of shelters to USAF and USSOCOM, Gerrit Boyle, executive vice president of government programs at Alaska Structures, told MMT.

“The feedback that we get, especially from the SOCOM guys, is that they don’t know where they are going to go. They could go anywhere in the world, and they know that the Alaska shelter is going to work anywhere in the world—and it does,” Boyle said. “It is the most durable shelter available to the DoD. It’s the most tested. We have more than 10,000 shelters supplied to the Air Force, Army, and special ops command that are used right now in the CENTCOM AOR [U.S. Central Command area of responsibility]. We supplied all of those shelters within the last six years.”

The U.S. military has demanded the shelters for use in Iraq, Afghanistan, Oman and Kuwait in recent years, Boyle added. Meeting this demand has meant that Alaska Structures has produced up to 600 shelters a month for more than 18 months. USAF employs the Alaska Medical Shelter, at 650 square feet, for its surgical shelters as well as administrative offices, billeting, dining hall and storage facilities. The Air Force also employs the shelters as its Bare-Base (BEAR) program—the USAF program that enables set up of airfield operations quickly where none existed previously.

The U.S. Army Medical Department has been using Alaska shelters in its interim combat support hospital program, Boyle reported. Alaska Medical Shelters have been replacing traditional tent extendable modular personnel (TEMPER) tents. The Army has used a 20-foot by 65-foot shelter to replace the old eight-section TEMPER, and a 20-foot by 19.5-foot shelter to replace two-section TEMPER tents over the last several years.

Composites

Fairbanks, Alaska-based Alkan Shelter LLC has been applying high-performance composites and architectural engineering to tactical shelters for more than a decade. Its International Standards Organization (ISO) Shelter, for example, is the only known shelter made entirely of carbon-composites and certifiable for up to 10-high stackability. Its internally-operated, automatically selfleveling jacks mean this patented and patent-pending monocoque shelter is easily deployable in any number of ground conditions.

“Composites are the lightest, strongest materials that can perform in virtually every environment, said Gerald Myers, CEO of Alkan. “The composite advantages of Alkan’s ISO Shelter are further enhanced because it has no embedded metal parts susceptible to rust, corrosion and heat transfer. You never want to limit the capabilities of your response system, and composites offer the protection, versatility and stable comfort that make that possible,” Myers said.

The company’s Composite Modular Extendable Rigid-Wall Shelter (CMERWS) is well-suited to medical operations. Starting at 18 feet by 18 feet, Alkan’s CMERWS can be extended in 6-foot modules to up to 1,000 square feet. The lightweight composite panels are designed to strike and erect with four military personnel, and all modular pieces fit on a standard 463L military pallet.

“The 18-foot CMERWS takes only about 30 minutes to strike and erect,” said Klaus Hoehna, Alkan’s vice president of operations and programs. “Plus, its internally operated jacks allow it to operate on unimproved sites. Our composite floors are tough enough to accommodate the heaviest medical equipment and are easily cleaned and sanitized. Basically, the CMERWS is designed to operate under extreme climatic conditions. We’ve designed and engineered this state-of-the-art shelter for ease of set up and to provide optimal internal working environments. You don’t have to worry about dust, temperature instability, inadequate lighting or high noise levels in the CMERWS. Medical personnel shouldn’t have to worry about how to set up a shelter or how it will perform in the field—they have a critical medical mission to focus on!”

Alkan’s built-in, collapsible CMERWS medical configurations include in-wall medical equipment; patient beds; integrated HVAC, lighting and electric systems; and separate administration, screening and/or operating areas. Many of these customized interiors are also designed with lightweight composites, making them easier to transport and erect and as likely as Alkan’s shelters to last for decades.

For heavier medical equipment, Alkan’s CMERWS flooring bears 100-pound-per-square-foot loads. Its roof-load capacity, meeting Anchorage, Alaska, snow-loading standards at 55-poundsper- square-foot, keeps this equipment protected from even the most extreme elements. The CMERWS ships in ISO containers or on a 463L pallet, so it’s transportable to the remote, often undeveloped sites where these extremes exist.

Command and Control

Other shelter companies have introduced additional innovations in recent years. Chief among them is DHS Systems LLC, headquartered in Orangeburg, N.Y., which has focused on military needs with its line of Deployable Rapid Assembly Shelters (DRASH). DHS Systems offers 46 models of shelter systems that can be taken down or set up within 15 minutes, said Naeran Rubio, communications coordinator at DHS Systems.

“They are truly quick-erect shelters that are very durable,” Rubio said. “They do not bow under the pressure of wind. They come with a generator system that also carries the shelter and transports it to different places via a trailer. The generator system is able to keep the shelter at a comfortable temperature in extreme weather conditions.”

All of the shelters, which range from 400 to 1,100 square feet in size, have been tested from minus 25 degrees up to 125 degrees F. Some have been tested at even more extreme temperatures.

“A big point with some of our shelters is that they are very comfortable,” Rubio explained. “It’s 100 degrees outside, and you come into one of these shelters and then it’s a nice and comfortable. You can sit around on the furniture. There is lighting. You can look outside because it has see-through windows. They are not covered up. You can actually look outside and natural light comes in if it is daylight. So it is kind of like being in a house.”

The DRASH shelters are also tough. The shelter is made of a patented material called titanite, which is 270 percent stronger than aluminum for the same diameter, according to DHS Systems. The shelter cover is made from a material called Xytexa coated polyester fabric also developed by the DHS company. Xytex is fire retardant, mildew resistant, water repellent and has high abrasion and UV resistance.

The company also has been aggressive with integrating its shelters with support systems. Its trailer systems are designed to transport the shelters and also provide them with complete power generation once the shelters are set up. Meanwhile, the deployable command and control system, a new company initiative, provides a screen from which field commanders can monitor various communication feeds and prioritize those communications. “So basically, it is a really great way to see everything and make decisions quickly. The system also helps audio communications, so if someone needs to send an audio feed, they can do that right then and there and it also reaches the commander at the same time,” Rubio said.

DRASH shelters also can attach to one another, enabling medical personnel to create large complexes, Rubio explained. “Because they can be connected to each other, forward surgical team brigades have created command and control areas,” she said. “Some of our larger ones are being used as logistics operations centers. You can fit quite a number of beds in life support areas and you can connect them. You can have a recreational room connected to a mess hall to a sleeping area. You can create a huge city.” ♦

 Clinical Options for Patient Isolation

Building a medical preparedness model.
 

By Sandra S. Cabot and Daniel J. Kreske
Bioterrorism preparedness has become the dominant force impacting the field of medical planning in recent years. Mounting concerns over potential bioterrorism events and contagious disease outbreaks from a possible pandemic influenza have generated a new focus on the need to build medical surge capacity in communities across the nation. Surge capacity encompasses four major components: additional medical facilities,equipment, staffing and training/exercising of the surge logistics and functions.

Both bioterrorism and infectious disease incidents pose a severe threat not only to public health but also to social order and economic stability. For purposes of medical response planning, they share these similarities:

• Unique requirements for security, isolation and treatment of affected persons
• Casualties will continue to increase after the original incident
• Rapid assessment, response and containment will be critical to prevent further loss
of life
• Added resources will be required for distribution of antidotes or vaccines
• Need to protect and preserve integrity of existing medical infrastructure

A Government Accountability Office study following the anthrax and SARS events of 2001 and 2003 identified “significant gaps” in public health preparedness for largescale infectious disease outbreaks, together with a general lack of regional planning and coordination of efforts. “Most hospitals lack adequate equipment, isolation facilities and staff needed to treat a large increase in the number of patients for an infectious disease such as SARS.” Two options traditionally considered for creating surge capacity, namely surging in place (adding/reallocating beds inside the hospital) and surging to a shelter of opportunity—such as a hotel, convention center or school—offer limited utility in a bioterrorism or pandemic disease scenario. These limitations include the potential for cross contamination, inability to separate and isolate building ventilation systems, limitations in scalability as casualties rise, expense/efficacy of decontamination of the facility after the event and the long-term public perceptions of the facility as the “SARS hotel” or school, etc.

As a result, the Centers for Disease Control (CDC) developed guidelines for Type C isolation facilities, including:

• Non-shared HVAC system, ideally venting all exhaust through a HEPA filter
• Adequate water, electricity and closed-window ventilation to support daily living
and medical care
• Reliable communications both within and outside of the facility
• Level-of-care support to include basic lab functions, portable radiology, IV fluids,
oxygen, resuscitation and vent support

Military Models

Some of the most useful models for provisioning of patient isolation and treatment lie within today’s military systems, such as the Army’s combat support hospital program and the Air Force Medical department’s Expeditionary Medical Support (EMEDS) program. The EMEDS program consists of self-contained portable medical facilities with specialty medical equipment sets designed to be rugged and lightweight while maintaining the highest medical support capabilities. EMEDS units, and similar deployable medical packages in other branches of the military, have revolutionized military medical support in the field, reducing combat casualties and non-battle injury rates by providing immediate access to high-quality medical support close to the incident scene.

Some civilian medical planners have already embraced the Air Force’s model as a flexible solution for creating added medical surge capability in disaster response scenarios. These types of advanced portable medical structures, equipped with appropriate ventilation and HEPA filtering systems, may provide the missing link in creating isolation and treatment facilities for pandemic disease and bioterrorist incidents. Through a research initiative conducted by the Air Warfare Battlelab, the AFMS is investigating the development of a contagious casualty management capability to assist in meeting bio-defense requirements. This leading edge program may become the source for further technology transfers to the benefit of domestic disaster preparedness.

Given the strategic advantages of a mobile medical response facility, it follows that functional standards will soon be established in this category. In addition to meeting the CDC guidelines for Type C isolation facilities previously described, desirable public health and safety attributes for domestic development of portable negative pressure isolation facilities include:

• Structural integrity and reliability
• Sufficient medical treatment space
• Appropriate environmental controls
• Robust electrical and lighting systems
• Ability to operate on or off-grid
• Lightweight and compact; mobile
• Easy to decontaminate, ability to dispose
of if necessary

In developing response capability to meet the unique requirements surrounding biological weapons and contagious disease scenarios, it is important to consider flexibility of assets to meet other public health and medical surge needs. It is conceivable that mobile medical response facilities could also serve as advance triage units, alternate ward space for hospitals damaged in natural disasters, auxiliary morgue capacity, distribution centers for vaccines and antidotes, and special needs shelters for elderly, pediatric or handicapped patients near the disaster site.

This will require the facility to have some flexibility in its set-up configurations and be capable of being set up on a variety of paved or unpaved surfaces. Again, medical planners and public health authorities owe much to models tested and developed for use in forward military operations across a variety of terrain and climate.

Civilian and Military Models

Although the civilian medical response systems and plans being developed may be specialized to meet the unique requirements presented by bioterrorism and pandemic threats, it is generally understood that these same resources will strengthen our nation’s ability to respond to natural disasters more effectively. The military models offer much hope for success in this regard.

It does not require a great deal of imagination to see that biological attack is a real possibility, but it will require vision and conviction to achieve appropriate levels of medical preparedness and protection. In order to successfully prevent further loss of life and contain the spread of disease in a real-world event, any solution for hospital surge and patient isolation should be tested, proven and exercised at all levels. Success will inevitably require strong national leadership, regional planning and inter-organizational cooperation ♦