It's Another SDN Bunker Thread (But Not Just the SDN Bunker)

[Broomstick]

In case you're late to the party, here are earlier ones on the topic:

"The Bunker" - who would you save?
Building the SD.Net Bunker (RAR)
The SDN Bunker Revisited

Anyhow, just for the record, I'm not actually a long-term prepper in real life. I am totally in to having about 2 weeks worth of food in the house and being prepared for likely problems for my area like severe winter weather and tornadoes to the extent practical, but I'm not entirely convinced that hiding in a hole in the ground for several months is the answer to all conceivable disasters. Nonetheless, I have fun with the concept. And with building elaborate underground habitations (more on that in a bit).

This week I've discovered Doomsday Bunkers, a show brought to us by the Discovery Channel which isn't so much about preppers themselves as about the people who build bunkers for preppers. The series apparently only had three episodes, and is now available on Netflix, which is where I watched it. You might also be able to get it on the Discovery Channel website, haven't checked that out myself. The company featured is Deep Earth Bunker which, for whatever reason, is not presently taking orders. They have several categories of shelter from “pyramid pod” to “tsunami pod” (I'm really wondering how that one would fair under actual tsunami conditions, but I am not eager to test-pilot it personally) to “underground condo”.

Meanwhile, while browsing the internet, I found this:

You know, aside from it being an underground bunker, it's nicer than some deep woods cabins and single-wide trailers I've been in. It wouldn't make a bad vacation getaway. And, of course, they have their own website. One thing I particularly like about their shelter is their “escape tunnels” - it gives you a second exit, which seems like a good idea to me.

Frankly, I like a little concern for comfort. If you're planning to spend any signficant length of time in a bunker, underground or otherwise, you don't want to go barebones unless you absolutely have to. Psychological needs are important too in survival situations.

Clearly, there are some entrepreneurs making money by supplying preppers. Maybe I should get a job designing the interiors for these things.

Next post by me will be an update on the SDN bunker.

[Mr Bean]

Been a fan of these threads. Mostly because an underground bunker is two steps away from villain lair/what if outer space underground moon colony.

Doomsday Bunker is a show I have planned to catch since it hit Neflix.

[Borgholio]

I see some batteries there under the mattress...not gonna ask what they're used for.

Really?

[Raw Shark]

10" X 51"

"It's in danger of being trod on by a dwarf!" [/Spinal Tap]

[RogueIce]

You know, aside from it being an underground bunker, it's nicer than some deep woods cabins and single-wide trailers I've been in.

Shit, it's nicer than some apartments I've seen.

[Broomstick]

To start off this round of pics I'll start by quoting a prior post by Mr. Bean:

I promised low quality and I deliver

Sleep are the nurse/doctor sleeping pods, typically it's two to four beds (bunk), a small center desk and cabinets for personal effects. Normally it's a single bed in one for the doctor and four bunk beds for the nurses in the other room. The Break room is what you'd expect, two or three tables a TV on a hanging stand, cabinets and a refrigerator. Plus the medical refrigerator which to avoid hijinks is typically a different color and either keypad locked or key opened along with being labeled.
Isolation are isolation rooms with doors and sometimes an internal door to suit up in.
Patients are patient rooms, in a normal hospital there will be a small desk and someplace to hook up a laptop, in a children hospital there will be a twin bed with an even smaller desk to hook up a laptop. Some places every patent room contains a bathroom and shower others only a bathroom with a common shower room elsewhere.
Modular is hospital to hospital to some it's just more patent rooms. Others it's larger doc offices, some it's some combination of patient rooms, a personal exam room, or playrooms in children's hospitals.

First off explanation, hospitals in different countries are built in different ways with room orgs set up differently so I've see it done about eight different ways but there are common elements. Isolation rooms are typically within line of sight of the nurses desk. The entrance to the drug room in each ward has a door within visual contact of the main nurses desks. Doctors offices are tucked away in the back behind all the patients. Equipment rooms are typically paired with drug rooms, and equipment rooms are typically stuffed with spare medical machines, computers, cleaning supplies but NOT medical supplies. You'll find spare EKG's, extra rolling bag stands, spare chairs and wheel chairs, bleach normally a small sink but not a single bandage or bit of Aspirin.

Next rooms are typically door free, unless it's an isolation room you get a curtain and that's it. This is to facilitate the beds being able to be rolled directly into the room from surgery or out of the room for some new surgery. As well as from the emergency room after being given triage.

Last rules of thumb. Hospitals break down into the children, the general, the specialty and the teaching/research hospitals. Childrens hospitals have rooms with bathrooms, showers, the parent bed and parent desk. Modular areas are set aside for a playroom, a personal exam room and depending on the type of ward (Disease VS Long-term VS General) will contain something related to that condition.

General hospitals by contrast will contain a bathroom with just a toilet no shower with the modular area containing one shower room per hallway and the rest being just more patent rooms with everything kept locally in a children hospital moved elsewhere for centralization. Bethesda for example keeps physical therapy in a separate wing from most of the patient rooms in a bit of irony. Last Teaching/Research hospitals are typically set up along the same lines as children hospitals except everything is ward centralised, you almost never need to leave your ward to go do therapy with only stuff like CT scans or MRI's requiring a trip down the hall.

Normally these types of setups are grouped around a common waiting room rather than containing a waiting room in the ward.

And here is my "inpatient pod". Do note that this is turned sideways compared to Mr. Bean's drawing, but I thought this angle showed things to best advantage:


And here's where I explain what I did and didn't use from Mr. Bean:

First of all, we have to remember this is not a hospital in the modern sense. Our proposed bunker will have approximately 1,000 people, possibly with capacity for twice that, and simply cannot support a modern medical system. What we essentially have is a clinic that, depending on whether or not we can get a doctor/surgeon/necessary support staff, might be able to do basic surgery, perhaps handle moderate trauma and disease outbreaks. Given that most of us are young and healthy, and even the old and sickly among us tend to have our chronic conditions under control, I'm assuming that most of them time this is going to be empty or nearly so.

With that in mind, I figure a 10 bed inpatient facility would be adequate. I did make three nurses' desks and LOTS of storage room for things like bed linens, wheelchairs, and all manner of basic supplies. Yes, I know, Mr. Bean, you said medical supplies are not normally stored on the unit, but remember, this isn't a normal hospital. 10 years of stuff needs to be stored somewhere and it makes sense to store some of it near where it is likely to be used.

I also have not quite finished "furnishing" this most recent series of drawings so use your imaginations. One of those big, empty rooms on the right should have things like a blanket warmer in it, and Og knows what else.

Assume there are doors - I know Mr. Beans suggested curtains (which is what we have in the ER) but my experience with hospitals invariably has doors on the rooms. Also, this would allow us to use any of these rooms as an isolation room if necessary (and let's hope that never is). The patient bathrooms are just toilet and sink, patient showers are the two rooms with checkboard tiles between two of the nurses' desks. They're large enough to get a wheelchair and an attendant or two in there if the patient needs assistance with showering.

We aren't going to divy up the medical space into categories like "adult" and "child" - everybody gets served by the same facility, in part because we won't have a large enough population to justify such a thing.

[Broomstick]

A tour of the "medical complex":

An overview of the entire complex/pod:

Clockwise from top left we have the inpatient unit, a very nice waiting room/sitting area that is two levels tall, a unit of offices at bottom right and continuing clockwise we have the staff rest/sleep rooms and break room. Continuing to the left is the ER, slightly reconfigured from the last time we saw it.

I am considering making an access tunnel from the inpatient storage room into the ER storage room just under the theory that it's good to have multiple routes through the place in case Something Bad happens. I'm also thinking that it might be a logical place to provide access to the outer storage areas (remember, we're talking about building this in a salt mine) at that location, and having the "10 years medical supply" parked "outside" in that location




The waiting room/sitting area:

Hardwood floor for sure footing, a water fountain, seating... could probably "furnish" it some more. The translucent "grating" on the right edge is a slanted roof for the outer walkway, glass block that can be back-lit with variable light from twilight levels up to daylight full spectrum lighting which is good for both plants and people.


A more or less floor level view from inside the sitting area. In this photo the water fountain has obviously been turned off, probably for routine maintenance.

[Broomstick]

This is a closer view of the offices/nap rooms/break room. The nap rooms are, obviously, for staff on call and the closet has bed linens and spare clothes (because Stuff Happens in medicine, and some of it is wet, oogy, and leaves stains). It's a little hard to see from this angle, but there is a staff bathroom with shower in between the bunk rooms. While the rooms are four bunks apiece it would be a rare occasion they'd all be used, it's redundancy and maximum capacity, ordinarily you'd have one doc on call at most. There is a "foyer" room to provide a little additional noise insulation from the hallway outside that unit. The breakroom is more generous than previous designs.

The offices are very bare - could be for administrative uses, exams, one could be a pharmacy/take-away supply store...

[Zaune]

Nice. Maybe a bit elaborate for something that's only going to be used by hospital patients, but I guess there's no reason why it couldn't be open to the general public as well.

Anyway. It came up briefly in the last thread, but what do the forum's medical professionals think of having a small dispensary attached to each residential block with a small medical staff -two RNs and a pharmacy tech maybe- assigned to carry out home visits? The bunker is likely to be small enough that people who'd be considered low-priority inpatient treatment cases could simply be sent home to their own bed. If they lived on that particular block they could also double as the designated emergency medical responders for that block. And I do mean for emergencies, I hasten to add; anyone hitting the panic button for a broken toe or something stupid like that would be on refuse duty for a month.

[Broomstick]

This is a revised view of the developing habitat, rearranged since last time.

At the top is the big exercise/hydroponics unit. To the right we have the medical pods. I thought locating them next to the exercise center might be a good idea as I expect in the normal course of events that's where accidents/injuries are most likely to happen. Also, it allows the exercise facilities to be utilized as a rehab facilities for recovering people. Closer but still on the right is the mess hall/industrial kitchens. On the left are three library/town square pods, which should provide ample area for learning, "shopping", socializing, and so forth (this view is only the first level - exercise/hydroponics and learning both have second levels.

In the big "courtyard" area I am planning a park. This is will be 3-4 levels tall, and definitely the highest room in the place. It will have cycling lighting from "full moon night" to "daylight noon", full spectrum, and living plants. While there will be some "just pretty" stuff there I think some of it should also be "edible landscaping".

The "dorms" can either be placed in the foreground of the current view OR they could be level two either around the exercise/hydroponics area, or over the medical pod/mess hall (in which case, while a second level, would actually be at "level 3" height due to the higher ceilings in some parts of the medical pod and mess hall), or level two over workshops/armory in the foreground of the courtyard (which, again, might be at a third level height).

Which reminds me - we still need a few things. Like that armony/gun range. I think having a pod with a gun range (how big should that be?) for ranged weapons (guns, bows, etc.), a weapons workshop (ammo reload, cleaning, repair, etc.), and a storage/armory would be good but I have no idea how large such a range should be.

In addition, we need some "heavy" workshops for carpentry, metal work, and the like. This would include a chemical/pharmaceutical production area. We could also locate the commercial laundry area there as well.

After that, we just have to sort out the "outer" storage areas, in the raw tunnels.

Oh, and assume fire doors are on the exterior entrances of most pods. Fire would be a HUGE disaster in such a habitat, fire controls are an absolute must.

[Broomstick]

Finally, if you were wondering what these drawings look like "in process"....



This is my current draft of the park. The first row of arches is 1 level high, so consider that in relation to the more interior parts. I was going for arches for a sort of soaring cathedral effect.

Just as a note: some of the second row of control buttons on the top of the screen are an add-on for converting the drawing to files understandable by our computer-controlled router/cutter... which means in theory I could make an actual 3D model of this... if I had the time to make everything a hell of a lot more detailed, de-bug files, and had the money to spend on materials.

[krakonfour]

Whoah, good job on the effort.
Have you thought of adding a maximum of vegetation for stress relief? Maybe also more elaborate lighting along the corridors?

[Raw Shark]

@Broomstick: Great design, IMHO. It wouldn't be ideal, but I could see myself not going "Eat other humans" crazy there.

[Broomstick]

Whoah, good job on the effort.
Have you thought of adding a maximum of vegetation for stress relief? Maybe also more elaborate lighting along the corridors?

The exercise area is surrounded by vegetation, and the park will be loaded with it.

We've discussed full spectrum light in the hallways giving a sort of "daylight" effect

@Broomstick: Great design, IMHO. It wouldn't be ideal, but I could see myself not going "Eat other humans" crazy there.

Thanks, but I have had some help from other thread contributors.

[Eternal_Freedom]

Whilst I'm far from an expert, I would say a shooting range that has targets at 10-100 yards should be sufficient. Said range would require considerable sound-proofing and it would probably be ideal to have a separate archery range. I would think it unlikely you would have more than twelve or so people shooting at any given time so that gives you the number of lanes you need.

[Forgothrax]

Nice. Maybe a bit elaborate for something that's only going to be used by hospital patients, but I guess there's no reason why it couldn't be open to the general public as well.

Anyway. It came up briefly in the last thread, but what do the forum's medical professionals think of having a small dispensary attached to each residential block with a small medical staff -two RNs and a pharmacy tech maybe- assigned to carry out home visits? The bunker is likely to be small enough that people who'd be considered low-priority inpatient treatment cases could simply be sent home to their own bed. If they lived on that particular block they could also double as the designated emergency medical responders for that block. And I do mean for emergencies, I hasten to add; anyone hitting the panic button for a broken toe or something stupid like that would be on refuse duty for a month.

*pokes head in* Someone called?

At any rate, the plausibility of this idea really depends on the size of the residential block and on our population. Home visits are primarily useful for people who have chronic conditions or are recovering from a serious acute condition or surgery and need continuous monitoring, management, and support. They also make sense when people are unable to access the medical system on a regular basis due to difficulties with transportation on their end. Our population is likely to have relatively low prevalence of conditions that require constant monitoring, and those that we know about prior to entering the bunker can be situated close to the medical pods. The relatively small size of the bunker also allows home visit personnel to base themselves out of the medical pod or nearby and simply travel from residential block to residential block. In addition, we are not going to have a very large number of RNs to spread around if we also want to be able to staff the medical pod on a regular basis. The statistics I last saw on RN population put us at around 1:120 compared to the general population, so I would be very surprised if there were more than 8-9 RNs in the entire population of SDN. Even stretched somewhat, we're going to have difficulty staffing the medical pod on a regular basis. Assuming 12 hour shifts, a 1:10 patient ratio so one RN can run the entire medical pod when it's full, and a 4-day work week, we're going to need 4 RNs just to keep the medical pod running consistently, not counting the fact that we'll probably need to have extra personnel for high-volume periods or emergencies.

Having medical staff available to perform home visits, and encouraging people to call us before coming to the medical pod if it's not urgent, is a good idea. I just don't see us having the personnel nor the need to staff each residential block with high-level practitioners. I would suggest that we get multiple people per residential block pushed through EMT-Basic programs prior to the disaster so we can have them act as emergency medical personnel, and run even more of them through training programs that our in-house people set up once the bunker is sealed. That gives us emergency responders and low-level personnel who can deal with emergencies while the medical professionals make transit. Combine that with a visiting nurse/doctor program and access to the medical pods on an as-needed basis and we should be fine.

My $0.02, but I'm sure Painrack or Knife, who both have a lot more experience than I do, can go into more or better detail.

[Broomstick]

So... it might be a good idea to park a second-level "dorm" over the medical pod to house both medical staff and people needing nursing care?

But other than that... if someone in the regular dorm needs a "home visit" it's close enough the med staff can simply walk there or vice versa. Anyone sicker than that should be in the med unit (or perhaps in the dorm above it).

[CaptainChewbacca]

I think each dorm might have a 'nurse's office' for first aid and minor injuries/meds with an RN or PA on duty.

Has there been any consideration to a security or 'jail' room? Sooner or later someone is going to need to be locked up.

[Broomstick]

I think each dorm might have a 'nurse's office' for first aid and minor injuries/meds with an RN or PA on duty.

I'm not sure we really have the personnel for that, or the need. How about a well-stocked first aid kit in each dorm?

Has there been any consideration to a security or 'jail' room? Sooner or later someone is going to need to be locked up.

We've discussed it briefly. I have some one-person rooms that might work for confinement (I'm assuming NOT a complete isolation - such person would have some ability to communicate with others, access to books/entertainment although probably limited, and so forth). If someone became exceedingly dangerous our options would be limited, though. We can no more staff a prison than we can a comprehensive hospital.

[Broomstick]

Probably spent more time thinking about this today than I should have, but here are some thoughts about the medical services on our 1,000 person (give or take a few) ark:

* Assuming we institute some preventive care as basic as an annual check up for everyone, that works out to three such exams per day. Now, also remember that the overall complex I've shown up thread is not for the entire 1,000 people. Depending on how we divvy things up, it could be for 500 (half) or maybe for 1/3 or even 1/4 of our total planned capacity. That means this facility may average one annual check up per year per day. Assuming the ER isn't being used much such exams could be done there. Needless to say, if an emergency did occur any routine exams for that day would be rescheduled. Most likely, the annuals for the week would all be piled into one, maybe two days per week.

* Assuming we give a damn about basic dental care (and let's get real, preventing root canals and major work under our proposed Apocalypse Event is a good idea) with two cleanings per year that's six routine dental cleanings per day across the entire collection of bunkers. We'll need both a couple dentists and a small cadre of dental hygienists/techs (we should retain the capacity to make bridges, dentures, and fillings).

* We're not going to have a lot of doctors or other formally trained medical personnel. It's a good idea to cross-train people as assistants for the official medics, up to an including teaching "civilians" how to do things like suture and assist during surgery, EMT training, and the like so they can pitch in during any emergencies. Most of the "assisting", though, will be boring/yucky patient care, maintenance of facilities, and sterilization of equipment.

* Yes, we're going to be sterilizing stuff because we can't resupply. So we'll get autoclaves and equipment that can be re-used where possible. We'll probably still have some disposable stuff, but it will be the exception and not the rule.

* There are some things we just are not going to be doing. Organ transplants, major heart surgery, and modern cancer treatment are examples - we won't have the personnel or the base civilization required. We can provide palliative care for most conditions. For early skin cancer we can cut it out. But realistically we can not maintain what is required for advanced early 21st Century medical care. Our capacity to deal with trauma will likewise be limited. Broken bones, yes, many times of lacerations, some types of gunshots, etc. but major trauma care as currently defined will probably be beyond this facility.

* On the upside, it is possible we might be able to refine insulin on our own - there were people doing this during WWII under war time conditions using small scale facilities. It will require the use of livestock, the keeping of which may be problematic, but it's possible. We might be able to provide kidney dialysis. We can provide some types of neo-natal care for premature babies. The question is whether or not we want to build that into the system or not. Which brings me to the pharmacy requirements for this bunker: it's the pharmacists who are going to be making insulin, purifying/making saline for IV's, managing the medication stocks, and possibly formulating new ones from raw ingredients. Cross training pharmacists will be as important as cross-training for doctors, nurses, and paramedics.

* Anyone who loses a limb can get a primitive prosthesis but not one of the fancy modern ones, we just don't have the tech for it. If you enter the bunker with one take care of it, as aside from large-scale mechanical repairs we won't be able to fix or replace it. Likewise, if you enter with a cochlear implant fantastic but we can't repair or install them. If you walk in as the recipient of a prior organ transplant we can try to keep you alive but you won't get another if it fails and managing the required medication schedule and dealing with side effects is likely to be problematic.

In sum - we can do a lot, but we do stand a chance of people dying of things that are currently treatable as things are now in the real world. I suggest we plan for some mental health professionals, and ask them to be prepared to deal with issues arising from this.

[Forgothrax]

So... it might be a good idea to park a second-level "dorm" over the medical pod to house both medical staff and people needing nursing care?

But other than that... if someone in the regular dorm needs a "home visit" it's close enough the med staff can simply walk there or vice versa. Anyone sicker than that should be in the med unit (or perhaps in the dorm above it).

Pretty much this. The dorm might be useful if we know ahead of time that we have people requiring long-term chronic care, but I'd keep it fairly small. Just a few beds.

I think each dorm might have a 'nurse's office' for first aid and minor injuries/meds with an RN or PA on duty.

I'm not sure we really have the personnel for that, or the need. How about a well-stocked first aid kit in each dorm?

One of the things we should do with our five-year warning and funds is abuse them to get some of our people back into school. IIRC, at least here in MI, you can run people through a EMT-B course in a semester and for $3-4k. We can fairly easily have a bunch of people with skills not applicable to living in a bunker go through a career change and pick up useful training in the years prior to the event. That way, we can have some EMTs in each bunker with their schedule shuffled to provide coverage.

* Assuming we institute some preventive care as basic as an annual check up for everyone, that works out to three such exams per day. Now, also remember that the overall complex I've shown up thread is not for the entire 1,000 people. Depending on how we divvy things up, it could be for 500 (half) or maybe for 1/3 or even 1/4 of our total planned capacity. That means this facility may average one annual check up per year per day. Assuming the ER isn't being used much such exams could be done there. Needless to say, if an emergency did occur any routine exams for that day would be rescheduled. Most likely, the annuals for the week would all be piled into one, maybe two days per week.

The ratio in the US of hospital beds to population is 30:1000, IIRC. A pair of facilities like the one you designed would probably cover our population just fine. We could certainly skate by with one, as we won't have all the dangers of modern living, and our population will probably have much lower prevalence of the conditions that lead to hospitalizations in general. As for doing exams, since we'll want to have one of our MDs or NP/PAs on duty in the medical facilities at all times if we have the personnel, I don't really see much of a problem with simply doing checkups at a rate of 3/day. A good exam, including ob/gyn as needed, shouldn't take more than an hour, and most days our medical providers will have the time on their hands to spare 3 hours between 7AM and 9PM, say. This would also prevent us from getting backed up by an emergency case coming in during the middle of the exam day.

* Assuming we give a damn about basic dental care (and let's get real, preventing root canals and major work under our proposed Apocalypse Event is a good idea) with two cleanings per year that's six routine dental cleanings per day across the entire collection of bunkers. We'll need both a couple dentists and a small cadre of dental hygienists/techs (we should retain the capacity to make bridges, dentures, and fillings).

A multipurpose OR/trauma/dental room is going to be needed. It won't need to be very large, but a room with quick access to all the trauma gear makes it a lot easier. Doing dentals in the same room will let us save space (or we simply set up one of the patient rooms as our dental room and fill that room only if we've used all the others).

* We're not going to have a lot of doctors or other formally trained medical personnel. It's a good idea to cross-train people as assistants for the official medics, up to an including teaching "civilians" how to do things like suture and assist during surgery, EMT training, and the like so they can pitch in during any emergencies. Most of the "assisting", though, will be boring/yucky patient care, maintenance of facilities, and sterilization of equipment.

Again, we can abuse our forewarning by sending most of the current RNs back to school to become NPs or PAs. Those are two-year programs at the moment. While the personnel we'll get back will be fairly inexperienced, they will be trained personnel with a year or two of experience, which is better than nothing. If we have at least 1-2 MDs on the board to ride herd on them, we'll be set for high-level personnel. If we can find a community college in the middle of bumfuck nowhere with a nursing program that is amendable to "donations", we can probably get some new RNs and definitely hygienists and such prepared by the 5-year mark.

Bare minimum, we need one facility with one MD and one NP/PA, one dentist and a hygienist, and 2 RNs plus a pair of EMTs or paramedics. That gives us bare minimum coverage with personnel working 12/7. An ideal situation would be two facilities, 1-2 MDs and 2-3 NPs/PAs, for a total of 4 providers, a dentist and hygienist, and 8 RNs and a matching number of EMTs/paramedics. That would ensure that we always have one provider on duty 24/7 (even if they have to move between facilities) and one RN/paramedic team 24/7 in each facility, with our personnel working approximately 84 hours every 2 weeks. Shaking loose some additional personnel for covering sick days or high-census periods would be nice, but not necessary. I would be very surprised if we had more than 4-6 people in the medical unit every day.

[Crossroads Inc.]

Hey Broomie, Was curious did you ever find an image server to rehost the pics from the FIRST Bunker thread? I know theres a lot of work you put into that, and most of those images are broken now.

[Broomstick]

I think I can re-edit those - they're all still on my photobucket account, just reorganized, and the reorg is what broke the links.

[Crossroads Inc.]

You should just use Imgur, I find it SOOO Much simpler than photobucket these days for image hosting

[Imperial528]

Say, just a thought.

Throughout these threads, was a door ever designed?

Living in a bunker in a salt mine is all well and good, but we need something to keep out the radiation, bio-weapons, zombies, and door-to-door salesmen, after all. And we should do so in style! If no one minds I think I will try to whip up something in CAD.