Thread necro but I figured this might be fun to stick some pics in.
Broomstick wrote: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:
* 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.

With the use of chemicals, sterilization requires less than one hour of time.
However, if we're using steam autoclaves and the like, this means 1-2 hours worth of steam time. And dedicated personnel...... This used to be done by nursing staff but I see no reason why clinic assistants can't do that.
Essentially, you need to clean your syringes and stuff first, then you fill it up with hot water, boil it using electricity(modern autoclaves do it much faster than the antiques shown here) and then immerse your equipment for an hour.
Ooh.
And for funsies, somebody is going to have to resharpen the needles. WITHOUT getting poked by it:D
It takes a few minutes per needle for experienced staff but yeah.
Sterilisation used to be done by night nurses, ditto for needle sharpening, although clinics used to have a clinic assistant whose sole job was to autoclave and then resharpen, repackage equipment. Remember, sterilization isn't enough, you need to PACK it so as to ensure it stays sterile.
And in an era where you don't have disposable paper(hmm......... anyone knows whether recycled paper might work?), that means cloth. And steam. Modern machines require up to 90 min of errr......... I think its 80 degree Celsius to properly sterilize some bug resistant material, otherwise, normal temp is I think 60. Anyone knows this for certain?
Anyway. All this adds up to fuel and power consumption for 1 thousand people.
* 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.
If you have milk bottles, a fridge, adequately typed blood groups and a database, you can transfuse whole blood.
And with coconuts, you get an adequate source of short term saline, alternatively, you can simply prep your own saline industry inside a bunker.
But this will require space inside said salt mine and more drain on fuel.
The only real limitations is more of drugs and the lack of surgeons.
However.... palliative care.......
First, we need to define the population group. We're not going to get that many cancer cases that decline dramatically, but palliative cases from the apocalypse is another story. Radiation poisoning? Or simply dying from infection?
We have some existing posters with health problems..........so that means ESRF care and either heart failure or COPD.
That means a couple of things.
Oxygen. You can do that using oxygen concentrators nowadays.
Drugs. And that's the big problem.
You need a wide supply of drugs to provide palliative care. There's the basic painkillers, so, you need large doses of paracetemol, NSAIDs, stuff to protect you from painkillers side effects, and lastly, morphine. A huge array of opoids.
In real life, more than 5 million people go without adequate pain relief because of their inability to access adequate drugs, including actual drug shortages. Some of them are grossly perverse, such as shortages of morphine in countries neighboring the Golden Triangle.......
To give an example of just how profilic such drug use is, we keep more than 100 tabs of paracetemol in my ward of 25 patients. We can use it all up within 2-4 days. Recommended dosing for pain patients is 8 tabs a day. And you need this drug for everything.......
Opoids is however still the biggie. You can simplify the logistics by only stocking certain drug types and optimizing it, but that increases consumption of short term opoids. And for heart failure, COPD, cancer, even Parkinson use painkillers.
And this ignores the other drugs for other symptoms, be it from drying up secretions to sedation drugs.
To put it simply, without a logistic base, you can't really provide effective palliative care for a lot of people. We might be able to stockpile and do it if we don't have a large patient load, but that really depends on what the disaster inflicts on us and whether said injuries/care is a long term or short term issue.
Granted, this is probably me bringing in real life biases into a thread but the logistic issues for palliative care is one of the main obstacles in real life, that along with trained personnel.