DELIVERING POINT-OF-NEED CRITICAL

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DELIVERING POINT-OF-NEED CRITICAL CARE WHEN
NOTHING ELSE CAN
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CAPABILITIES
Force Multiplier 10 Bed Capacity / 72 Hrs. 500
Cubic Feet / 5000 Lbs. Modular /
Expandable Operational 1 Hr. Deployable Worldwide
24 Hrs. Critical Care
Casualty Collection Casualty Treatment Casualty
Evacuation Oxygen X-Ray Water Purification Power
Generation
Tent / Trailer / Room of Opportunity
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VISION

• Deployable worldwide 24 hours by all available
  platforms.
• Fully operational within one hour of touchdown.
• Provide a force multiplier/productivity enhancer
  to military and emergency response personnel.
• System must be Mission Adaptable, Not Mission
  Specific.
• System must provide medical care from triage
  through staged resuscitative surgical
  interventions.

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WHY?
Military Casualty Care Pandemic Influenza
Terrorism
Hurricanes Earthquakes Tsunamis
Large Public Gatherings
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CURRENT SHORTCOMINGS VS. FUTURE REQUIREMENTS

• Current Medical Response Systems require an
  intact infrastructure to respond.
• Current systems are greatly hampered due to size,
  configuration and logistical footprint thus
  making them manpower dependent.
• Future systems must be deliverable under the most
  extreme conditions without the need for heavy
  lift capability and large manpower requirements.
  
• Future systems must be independent for 72 hours
  before re-supply is required.

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SOLUTION

• Based on a highly compressed footprint, MERF
  provides optimal patient management from triage
  through staged resuscitative surgical
  interventions.
• MERF is deployable worldwide within 24 hours by
  all currently available platforms
• MERF is fully operational within 1 hour of
  touchdown.
• MERF is operationally independent for 72 hours
  before re-supply is required.
• MERF is a Force Multiplier designed to be
  Mission Adaptable, Not Mission Specific.

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ADVANTAGES

• Modular and expandable to mission requirements.
• All modules are of a plug and play design.
• All components have been designed with muti-task
  capability thus maximizing utility while reducing
  weight and cube.
• Deployment canisters are single man portable.
  They can be delivered by all available
  platforms(truck, trailer, planes, parachute,
  helicopters, walked in, etc.)

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DEPLOYMENT
MERF is deployed within the CH661 SERIES of the
Charlies Horse Deployment System.
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PATIENT MOVEMENT / TREATMENT MODULE
Properly accessorized, the SR701RT is a Mobile
Medical Facility within itself.
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PATIENT MOVEMENT / TREATMENT MODULE

• Each SR701RT can be configured as Casualty
  Collection apparatus Treatment apparatus
  Casualty Evacuation apparatus ICU Beds.
• Trendelenberg capability.
• Compatible with all NATO spec Litters/Stretchers.
• Quick attachment and release of
  Litters/Stretchers.
• Each SR701RT is capable of moving 20 cubic feet /
  500lbs. of medical supplies by a single
  individual.
• Nine SR701RT Wheeled Litter/Stretcher Stands with
  Adjustable Back Rests, Medical Accessory Towers
  and Cargo Haulers (SR 731). make up the Patient /
  Treatment Module.
• Five Accessory Kit A's (10 Adjustable Arm Boards
  10 IV Poles 5 Adjustable Mayo Trays 10 Medical
  Accessory Clamps).
• Five Accessory Kit C's (10 Welch-Allyn 150 Watt
  halogen Examination / Treatment lights with 10
  Medical Accessory Clamps).
• Disposable Fluid Captures with 6 liter absorption
  capability available as accessory if stipulated
  by end user.
• Final capabilities, configurations and equipment
  / supplies determined by end user.

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CRITICAL CARE MODULE
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CRITICAL CARE MODULE
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CRITICAL CARE MODULE

• Operational within one hour of touchdown in any
  shelter of opportunity.
• Compatible with all NATO spec Litters/Stretchers.
• One SR901RT Multi-Purpose Utility Table, fully
  adjustable to specific requirements within
  minutes. 6 inches of height adjustment 1
  Macro adjustments 1 Micro adjustment.
• Trendelenberg capability.
• All Medical Accessories designed to
  adjust/attach/detach quickly as necessary.
• Disposable Fluid Capture (6 liter absorption
  capability).
• PAX LED lighting, rugged, lightweight, compact
  and durable. Dual light spectrum.
• Equipment to run 1 O/R and 3 ICU Stations 4
  Impact Ventilators, 4 Impact Aspirators 4 Welch
  Allyn Propaq LT Monitors and 2 Halogen Head
  Lamps Magellan Anesthesia.
• Storage for 55 cubic feet / 1,500lbs. of medical
  supplies, within 6 drawers, 5 trays with clear
  poly-carbonate lids for easy identification of
  stored supplies (see Supply Module) and one large
  piggyback canister.

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SUPPLY MODULES
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SUPPLY MODULES

• Modules can be configured to specific
  requirements of end user.
• Adjustable legs can be added to all lids when
  space allows providing additional tables or
  administrative desk space.
• Five Supply Modules are standard within MERF
• Modules consists of 5 Lids (CH661-18L) with 6
  Drawers each (CH661-DRAW) 5 Bottoms (CH661-BM4)
  with 5 Trays each (CH661-TRAY-5) 4 Piggyback
  Bottoms (CH661-PB12) with 6 Trays (Two sets of
  CH661-TRAY-3) 4 Piggyback Lids (CH661-L4) with
  Adjustable Legs (CH661-LGS) 16 PB Hold Down
  Straps.
• All Drawers and Trays have clear poly-carbonate
  lids for easy identification of stored supplies.
• Five Supply Modules provide 200 cubic feet /
  5,000lbs. of deployable storage space deployed
  within 5 Charlie's Horse Carts (CH401M4) by 5
  individuals.
• CH401M4's can be utilized for Casualty
  Collection/Treatment when properly accessorized
  with CH411 Accessory Clamps.
• Final capabilities, configurations and
  equipment/supplies determined by end user.

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OXYGEN CONCENTRATOR MODULE
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OXYGEN CONCENTRATOR MODULE

• Increased flexibility and safety - PVOCS HF
  affords a safe low-pressure point-of-use approach
  for production and delivery of respiratory gases.
• Availability of Medical Grade Air and Oxygen
  afford the medical practitioner unparalleled
  flexibility for respiratory treatment in the
  field.
• Significant reduction in the deployment footprint
  (weight and cube). One PVOCS HF supplying 30
  liters per minute of oxygen and medical grade air
  for 72 hrs. can replace 37 H-size cylinders and
  provide a 5,000 lb. weight savings.
• Continuous performance monitoring - PVOCS HF
  continuously monitors critical performance
  related functions inlet air temperature and
  pressure oxygen product concentration and
  pressure and medical grade air delivery
  pressure dew point and carbon monixide levels.
• Interface with deployed systems --PVOCS HF has
  been fully validated and is compatible with
  ventilators and anesthesia machines in the
  current inventory.
• Ruggedized for field deployment - tested to U S
  Military (MIL-STD-810E and MIL-STD-461E) and
  International (IEC 60601-1) requirements.
• PVOCS HF is a new standard in point of use oxygen
  and medical grade air generation rugged,
  lightweight, portable, and safe.

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OXYGEN STORAGE MODULE
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OXYGEN STORAGE MODULE

• 25,000 Litter Oxygen Delivery/Storage System
• Five lightweight, high strength, high pressure,
  composite wound, brass lined cylinders mounted
  within the Charlies Horse CH661 canister make
  this capability possible.
• Composite carbon fiber wound brass-lined
  cylinders prevent combustion and do not fragment
  or explode on ballistic impact (.50 caliber
  ballistic tested).
• System has been designed to be deployed by a
  single individual without the need for heavy lift
  equipment.
• Used by both military and civilian disaster
  response teams to quickly supply oxygen when and
  where needed.
• Deployed with three LSI Mass Casualty Oxygen
  Manifold Systems (optional), 24 patients can be
  ventilated at 15 LPM simultaneously within 10
  minutes of arrival at scene.
• Refillable from any high pressure oxygen supply.
• Stored oxygen as compressed gas without loss.
• Complete with all hoses and regulators for 10 bed
  distribution.

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X-RAY MODULE
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X-RAY MODULE

• Mobile Computer Radiography
• Complete Digital Radiography Department designed
  for field use.
• Provides a simple plug-and-play CR solution for
  integrating x-ray studies into PACS, Mini-PACS,
  Tele-Radiology, Centralized Reading, Image
  Distribution, and Archives.
• System lets user acquire, process, and send
  images to DICOM destinations on a Local or Wide
  Area Network (LAN/WAN).
• High quality radiographs produced without film,
  wet chemistry or darkroom.
• Reusable phosphor plate takes the place of the
  x-ray film in the x-ray cassettes. Plates can be
  reused for 7,000 exposures.
• System is designed to reduce costs, size, weight
  and environmental hazards, while improving the
  quality of patient care.
• Processing time is efficient at one minute per
  image. Digital images can then be burned onto
  CD's or transmitted over a network for diagnosis.
• Installation and training require less than one
  day.
• System weighs 750 lbs. and is deployable by one
  individual without the need for heavy lift
  equipment.

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WATER PURIFICATION MODULE
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WATER PURIFICATION MODULE

• Comprehensive one-touch total automation.
  Micro-processor controlled electronics provides
  state-of-the-art technology and reliability with
  manual override. A Simple-to-use touch screen
  displays pictorial images of all operating
  conditions. Digital and bar graph readout of all
  system conditions in US Standard or Metric.
  Computer interface ready.
• Self adjusts to any feed water condition.
  Automatic shut down, either time duration or
  product quantity. Hour meter for keeping
  accurate logs scheduling of preventative
  maintenance.
• 316 stainless steel pressure transducers for
  accurate measurement of system functions. New
  solidstate electronic flow meters for visual
  monitoring of the product water and feed water
  flow used to calculate production rates of the
  system. A fail-safe product water diversion
  valve. Digital and bar graph salinity meter
  shows actual product water quality an essential
  tool for product water monitoring.
• Dedicated heavy duty latching relays for each
  motor integrated in the system. Unique low
  voltage control circuitry, shielded terminals,
  and covered high voltage components for end-user
  safety
• High efficiency 316 stainless steel booster pump
  for extended pre-filter life. Patented high
  pressure quintiplex axial plunger pump is water
  lubricated, does not require oil changes and is
  rated to operate 8,000 hrs. between required
  maintenance.
• High rejection/high yield membrane element that
  produces higher quality product water. Clear
  viewable sea strainer with cleanable monel mesh
  screen filter.
• Fully self-contained when deployed within the
  Charlies Horse CH661 canister and cart 1,800
  gals. per day/18,000 gals without refueling.
  Spares and hoses included in piggyback container.
  Set-up in less than 45 minutes.
• Low emission, high efficiency electric start
  Kubota diesel engine.

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POWER GENERATION MODULE
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POWER GENERATION MODULE

• 2-Pole Single Phase with 11kW Output.
• Generator and engine are direct-coupled to ensure
  a more reliable power supply with minimum power
  loss. Eliminates the cog-belt, therefore, no
  need to replace or adjust.
• Waveform distortion is kept to a minimum by the
  skewed rotor, while the damper winding protects
  the generator during short circuits, regulates
  voltage fluctuations during condensive loads, and
  withstands load fluctuations during condensive
  and non-linear loads.
• 50A receptacle providing up to 42A from a single
  socket, and 83A in total from multiple sockets.
• One-side maintenance realized, reducing the
  operator's work load. ( Maintenance checkups on
  oil, fuel, battery and cooling water levels.)
  Large-capacity oil pan to stretch oil change
  intervals up to 200 operating hours.
• Double circuit protectors. In addition to the
  overall circuit protector, each receptacle has a
  circuit protector that will shut the engine down
  to prevent it from overcurrent damages.
• Automatic shut down should water temperature rise
  excessively or oil pressure drop below safety
  levels. Starter safety relay to prevent the
  starter from engaging again after engine starts.
• Large capacity dual fuel tanks (36.5 gals.)
  enables longer continuous operation. Fuel
  consumption at full load 1.08 gals. per hour.(
  33 hrs. of operation before refueling is
  required).
• Double element air cleaners for heavy duty
  applications.
• Low Sound levels (68dB) at 23 feet.

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MERF TRAILERS
Trailers can be set up to end users final MERF
configuration requirements. The standard MERF
trailer is 40 feet long with sleeping
accommodations for 6, showering, and lavatory
facilities. Available command control center at
the front of the trailer can replace sleeping
accommodations. Other uses/configurations
available based on customer requirements.
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MODULES IN DEVELOPMENT
FUELING MODULE REFRIGERATION MODULE COMMUNICATIO
NS MODULE ENVIRONMENTAL CONTROL MODULES
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MERF PROTOCOL vs CURRENT PROTOCOL
ISSUES Surge Capacity Staffing Deployment Casualt
y Collection Casualty Treatment Casualty
Evacuation Chemical/Biological Impact
Major disaster Existing HCFs overwhelmed by
walk-in patients.
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Current protocol Bring in large deployable
(Fleet-type) health care facility (100 bed).
Cost of approximately 8,000,000 / 10,000,000
per facility with appropriate capabilities.
Surge Capacity has been addressed other issues
remain open.
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CHEM/BIO impact on deployed facility. Probable
loss of 100 of Mobile Response.
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Deployment of 10 MERFs _at_ 750,000 / 950,000
each 10 beds per MERF with full Surgical and ICU
capabilities in each, total 100 beds. All are
linked to each other and externally to, for
example, NORTHCOM. Total cost of 7,500,000 /
9,500,000. All issues are resolved.
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CHEM/BIO impact as suggested above, only 10 of
capability is impacted.
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As situation stabilizes (72 hrs.) MERF units are
re-supplied and relocated to treat additional
casualties or consolidated to establish a more
permanent 100 bed facility.
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SUMMARY

• Response resources are dispersed to
  pre-determined locations based on a demographic
  study prior to disaster assuring survivability.
• Response times of personnel to each location have
  been reduced.
• Casualty collection and treatment times have been
  accelerated.
• Medical treatment is being dispersed
  simultaneously to hundreds.
• CHEM/BIO impact on response resources has been
  greatly reduced.
• Response resource will be operational under all
  scenarios with what is available at time of need.