Medical and Health Care

Need for Medical Capability

Due to the isolation of the SeaScape (at least part of the time), evacuation of the injured may not be feasible. Further, the potential for a medical disaster such as a fire, or aircraft crash, must be considered. Hyperbaric oxygen therapy should be available for treatment of diving injuries and other appropriate injuries.

For example, if the SeaStead was off the coast West Africa (say, Angola) the nearest large cities would be Luanda, Angola; Kinshasa, Congo (Zaire); and Windhoek, Namibia - none of which could handle a severe accident or illness, at least not with first-world medicine. Further, it's possible that all three cities would be beyond flight range of any aircraft onboard. For this reason, the SeaScape needs to be self-sufficient medically.

Health and Medical facilities, and care, will have to adapt to the numbers of people in the SeaStead, and their relative risk factors (ie, workers will require more trauma than retirees, who will require more long-term monitoring).

Potential for Revenue Generation

One potential income stream for a SeaStead is specialty medical treatment clinics, a sort of medical tourism. Facilities for this would fall into the commercial realm and are not discussed here.

General Requirements

Medical facilities should be located centrally, but don't require prime locations such as ocean views. If possible, they should be located where motion of the structure is minimized. Power requirements will have to be accommodated, for imaging technologies (Xray, CT scan, MRI, etc) and airflow must be controlled to afford isolation in the event of an infectious disease. Dental care will be required in addition to medical care.

Disposal of medical waste (biohazards) will be required.

All willing residents would be examined (including blood-typing) in the event that blood transfusions would be necessary. Rather than stock (and dispose of unused) blood products, the use of 'walking donors' will provide the required levels of blood.

Technology

Electronic records exclusively will be maintained, so no chart storage areas will be necessary. All medical spaces will require network access. All medical personnel must be available by page at all times in the event of an emergency. Suitable workstations (tablets, micro-computers, interfaces to monitors and pharmacy dispensing machine (pixis), access to imaging studies (pacs), access to lab reports, etc will be necessary, but will also have to be secure. An automated inventory system for medical supplies, with interfaces to a resupply (ordering) system is needed.

Automated lab equipment would provide a low-manpower method of blood and urine chemistry, microbiology lab services, etc.

In addition to the on-site medical personnel, high-bandwidth connectivity with 3-D cameras should be available for telemedicine. While various imaging modalities will be available (X-ray, CT, MRI, Ultrasound) these will be examined by qualified radiologists via telemedicine.

Required Staffing - Full Time

With an estimated 10,000 person population, the following medical professionals might be needed:

Family Physician (Internal medicine, OB/GYN, Pediatrics)

Emergency Physician (doubles as general physician), hyperbaric medicine qualified.

Physician Assistants (2) (General Medicine)

In addition to the full-time staffing certain specialties may be needed only sometimes (say, for a two-week period every quarter). Such specialties include Cardiology, Nephrology, Dermatology, Ophthalmology/Optometry, etc.

Surgical Staff

Because there would (hopefully) not be a need for extensive surgical coverage, full-time resident surgeons would be difficult to retain (due to lost skills from inactivity). However, surgical coverage is necessary at least part-time, when the SeaStead is out of range of acceptable medical facilities. This coverage would necessarily include:

A general (thoracic) surgeon, who could also assists on orthopedic surgery, and an

Orthopedic surgeon, who could assist on general surgery.

Also required would be two anesthesiologists (MD) or nurse-anesthesiologists (CRNA), and two surgical nurses. Should surgery be necessary the other physicians or physician-assistants could assist as necessary.

Dental Care

A patient population of 10,000 would require two full-time dentists, with an assistant each, and dental lab capacity. Dentists (2)

Dental Assistant (2) with lab capabilities

Other Medical Staff

General Nurse (phlebotomist, X-ray tech)

CT / MRI Technician

Pharmacy Technician (operating under a physicians license)

Medical Assistant (4)

Firefighter / Paramedics (6-8) with expanded or full scope of practice. These can be dual-trained firefighter/paramedics with specialty training in dive rescue/recovery. All should also be qualified as hyperbaric chamber attendants and at least three should be hyperbaric chamber operators

Medical Administrator / Office Manager

Medical Space Requirements

Waiting Area

Medical Exam Rooms (2)

Medical Procedures Room

Birthing suite (dependent on population)

Casting room (it's messy)

Dental Exam rooms (2) and Dental Xray room, Dental Lab (also very messy)

Optometric exam room (with slit lamp, etc).

X-Ray (should be portable and digital)

CT scanner (requires shielding)

MRI scanner (requires shielding)

Hyperbaric Chamber (at least 4-place)

Laboratory (wet lab equipment)

Pharmacy

Surgical suites (2)

Scrub room

Surgical changing room, rest room and shower

Surgical supply room

General supply room (in medical area) with space for mechical systems (medical oxygen concentrator, medical suction, etc) and storage for rapidly needed supplies.

Rest room (male, female)

Ward areas (two, five beds each, with rest rooms including shower and bath)

Utility Room (contaminated storage)

Storage area (inactive storage of approximately 3800 cubic feet (107 cubic meters)(approximately the size of a large ISO shipping container) - SWAG

External Links

WHO List of Essential Medicines