Wash Time
The U.S. Army Medical Research Acquisition Activity has been looking for
a new portable surgical scrub sink to replace the old Army standard,
which is an old system that is no longer available commercially.
By Michael Burnett
The U.S. Army Medical Research Acquisition Activity (USAMRAA) has been looking for a new portable surgical scrub sink to replace the old Army standard, which is an old system that is no longer available commercially. To that end, USAMRAA issued a request for information (RFI) in August 2007 to potential scrub sink vendors, inviting them to bring sinks that meet a list of criteria to an industry day last September at Fort Detrick, Md., home of the U.S. Army Medical Research and Materiel Command.
The Army’s RFI for a commercially available portable surgical scrub sink sparked interest from several vendors who have been working on products to fit the military’s medical sink requirements. The August RFI detailed those requirements, listing a set of characteristics that the ideal surgical scrub sink would have.
“The Army is researching information for a lightweight, portable, self-contained scrub sink that provides hot and cold running water under different types of power and water supply conditions,” the RFI said. “This sink will be used in austere field environments, so it is essential that it be rugged, lightweight, transportable, and easy to use and maintain. It should also have standardized connections, consume minimal power and water and be usable both in the presence and absence of electricity and pressurized water sources.”
The sink must meet conditions required in military medical field settings for scrubbing hands in preparation for surgery and cleaning instruments and equipment used in operating rooms.
USAMRAA described the specific required characteristics, or key performance parameters, desired of a new surgical scrub sink, noting it must be lightweight, portable and self-contained with a basin, gooseneck faucet, pump, water heater, tubing and electrical components, and reusable shipping container. USAMRRA sought a sink made of stainless steel or “suitable plastic or other material of appropriate thickness that is resistant to chemicals typically used in surgical scrubbing and cleaning of instruments.”
The sink must provide hot and cold running water—where the hot water is not so hot that it scalds operators out of the faucet—via hands-free operation if necessary. The sink should provide an adjustable flow rate, according to the RFI, while proving capable of using water from non-pressurized and gravity-fed water sources, including the 5-gallon military water can, and pressurized water systems, such as the Deployable Medical Systems (DEPMEDS) Water Distribution System as well as conventional water supplies and systems.
The sink must operate under adverse environmental and temperature conditions, without electricity and on uneven flooring. The sink’s electrical components must operate on 120 VAC at 60 Hz, but USAMRAA would like the sink to operate on both 120/240 VAC at 50/60 Hz. The sink’s electrical system should have a ground fault circuit interrupter.
The sink also must interact well with standard Army equipment, including medical pans in the basin and standard garden hose fittings for the drain. The sink must also be corrosion-resistant with a self-priming pump mechanism that can run dry without damage. USAMRAA requires all components of the sink to be readily commercially available in case any need to replace them arises.
The shipping container must have carrying handles and casters to permit quick transport by two people maximum, fitting details of a package with the size and weight for a two-person carry under military standards. Those people must be able to set the sink up quickly and easily without tools; they also should be able to disassemble the sink quickly for transport. USAMRAA would like, but does not require, the shipping container to be an integral part of the overall sink.
USAMRAA has not finalized selection of a standard sink but several vendors told Military Medical Technology that the Army has shown interest in their offerings.
Dental Sinks
The U.S. Air Force and the U.S. Navy both use sinks from Aseptico Inc., based in Woodinville, Wash., for dental purposes in their field hospitals, Ken Goff, Aseptico government sales manager, told MMT.
“The U.S. Air Force uses them in their Emergency Medical packages or EMEDS. The U.S. Navy purchases them for fleet hospitals. The U.S. Army has been using an old sink, but I believe they are out of those now. They have bought some, but they haven’t made any major purchases yet,” Goff reported.
Goff, a former Army medic who served in Vietnam, saw firsthand the need for good dental care among deployed troops.
“I was in the bush for nine months,” he recalled. “My biggest problem in there was not getting shot. My problem was dental. I had a big dental problem. It was hard to get a toothache fixed. It’s always been a passion of mine to push the importance of dental, not only in the military but also in public health and homeland security. Your oral health is very important.”
Aseptico actually manufactures all portable dental equipment deployed to Afghanistan and Iraq, including dental units, chairs, lights, operator stools and the sink. The Air Force and the Navy have been very enthusiastic about the dental sinks, Goff said, which have been available from Aseptico for about seven years now.
“Right now, our sinks are used for dental primarily,” Goff explained. “but there are really no field sinks out there for medical either. We have received a request to make a larger sink for medical. We are in the process of doing that right now. Creating a larger sink for medical purposes is on our engineering task list.
“USAMMA [U.S. Army Medical Materiel Agency] said we need a larger sink for medical purposes. So we are building it. We aren’t receiving any funds from the military or anyone else. We are doing it on our own, realizing there is a need for it out there,” he added.
The Aseptico sinks are dual-voltage (110/220), automatically sensing whichever circuit they are plugged into. They have a stainless steel basin, as Aseptico believes that stainless steel is vastly preferable to plastic for medical purposes for easy disinfection.
The sink can use the military water can, pumping water out of one can and depositing waste into another, Goff described. They also can use water buffalos and standard water sources. The sink provides hot or warm water, and it folds up for easy transport. Its legs detach and collapse into a container.
Aseptico first made the sink at the request of the U.S. Marine Corps, which described a need for the dental sink to the company. Aseptico built the sink, but the Marines never purchased any. Since then, however, the sinks have found widespread use among the Navy and Air Force hospitals as well as small-scale use within the Army. The company also has targeted the sink for use with homeland security organizations.
“Dental is becoming more and more important in homeland security purposes for forensic purpose. Most of the items used for forensics are dental items,” Goff noted. “They need dental care for victims and victim identification if they are deceased. They need it for the casualties and for first responders as well.”
Sink Improvements
Tony Lee, owner of AT Analytical Inc., based in Renner, S.D., also exhibited his sink at Fort Detrick. The Portable Automatic Wash Station (PAWS), not yet procured by any military branch, drew considerable interest from Army officials, Lee told MMT.
“In our last presentation in Maryland, they expressed interest in our mini-PAWS system, which is literally a suitcase sink system,” Lee remarked. “It has an extendable handle and wheels right on the case. You simply extend the handle, wheel it into position, connect your utilities and you have a field sink with less than a minute of set-up.”
The interest in the mini-PAWS has prompted the company to focus more on its development. Lee, himself an Army veteran, trimmed the 80-pound PAWS sink down to a 40-pound mini-PAWS sink by reducing and eliminating parts.
“I really saw the need when I was in the Army for a good reliable, easy-to-use sink system. That is really what fueled our design and desire to make PAWS,” Lee declared.
The sink has a number of superior characteristics over the old Army sink, called the Rampage, Lee described. The Rampage was compact and light but cumbersome to assemble. Its pump would burn out right away if it ran dry. Lee adapted some of the concepts of the Rampage into a bulletproof basin that is easier to assemble. The standard PAWS sink has a three-minute assembly time. Lee and his team have focused on making the sink durable and easy to use with a focus on ease of maintenance and repair.
PAWS has a run-dry pump, which can run out of water without damaging the pump. Should it run dry overnight, soldiers would not have to worry about damaging the unit, as it has been tested to run dry up to 28 hours. The pump automatically resumes normal operation once a water source is added.
PAWS offers solid-state control, anticipating water demands as soon as water starts flowing.
“Each unit has the equivalent of an old 486 computer onboard,” Lee commented. “Everything is microprocessor controlled, solid-state controlled. You are not actually waiting for a temperature probe or sensor to sense temperature. It immediately starts anticipating the need for heat when your cold water comes in.”
Both the PAWS and mini-PAWS systems use a patent-pending plumbing system, Lee stressed. The system uses a recirculating design, providing instantaneous hot water (preset at 100 degrees F) to military operators.
“The recirculating design is beneficial because with every other sink on the market, you have to wait for the water to heat up and you are consuming water as you wait for it to heat up,” Lee said.
AT Analytical also focused on water conservation when developing the recirculating design for the PAWS sink. Field environments require warfighters to bring potable water in and move bad water out. The PAWS sink consumes half a gallon of water per minute while providing a forceful spray.
“We operate our plumbing system in the recirculation mode at 40 PSI. When the operator demands water, we crank up that pressure. We use a good aerator to give a good forceful spray to the operator,” Lee said. “That was another big pushing factor—how can you wash your hands more effectively? A hose or a faucet with water running out of it or a good forceful spray like you would have available at any commercial office bathroom or anything of that nature?” ♦