可移動(dòng)檢測站建設(shè)指南，南卡羅來納，美國

建筑設(shè)計(jì)：克萊姆森大學(xué)建筑學(xué)院

為了在應(yīng)對大量涌入的新冠肺炎病例的同時(shí)維持醫(yī)療設(shè)施的安全，位于南卡羅來納州查爾斯頓的南卡羅來納州醫(yī)科大學(xué)（MUSC）和克萊姆森大學(xué)建筑與社區(qū)營造課題組展開了一項(xiàng)設(shè)計(jì)研究，將病人分流到專門收集樣本的分支點(diǎn)。為此設(shè)計(jì)了一種可移動(dòng)檢測站（PPOD），以提供更經(jīng)濟(jì)、安全、便捷、直達(dá)式的檢測方法。

起初，項(xiàng)目對南卡羅來納州西阿什利現(xiàn)有的一個(gè)由MUSC 管理的免下車式呼吸樣本采集點(diǎn)（RSCS）進(jìn)行了調(diào)研。這個(gè)采集點(diǎn)具備日采集量約600 個(gè)樣本的能力。病人從抵達(dá)到離開平均耗時(shí)10分鐘。它被分為3 個(gè)區(qū)：

紅區(qū)：高風(fēng)險(xiǎn)。該區(qū)包含了所有的病人登記處、樣本采集口和通道。

橙區(qū)：可能有風(fēng)險(xiǎn)。該區(qū)是紅綠區(qū)之間的過渡，并包含污染區(qū)。

綠區(qū)：無風(fēng)險(xiǎn)。該區(qū)保持無污染狀態(tài)，包括控制臺(tái)、設(shè)備及其他運(yùn)行所需裝置。

在完成對場地的調(diào)研，并對持續(xù)發(fā)展的疫情進(jìn)行觀察之后，我們認(rèn)為需要制定一種更便捷的方案?？偟膩砜?，免下車的方式可能無法惠及服務(wù)不到位和弱勢的人群，比如低收入群體、舊城地區(qū)居民、老年人和少數(shù)族裔。免下車檢測點(diǎn)過高的日常運(yùn)行費(fèi)用，以及更換患者全套個(gè)人防護(hù)裝備（PPE）的需求造成的供給短缺也是問題。

PPOD 方案意在緩解這些問題。這是一種經(jīng)過改造的移動(dòng)式廁所基體，分為標(biāo)準(zhǔn)尺寸和無障礙尺寸，并有為提高視覺性能而用丙烯板改造的病人面板，還有一體化穿過式樣本采集門和手套機(jī)。醫(yī)護(hù)人員在套上最簡式PPE 后從綠區(qū)進(jìn)入PPOD；之后可以坐在艙內(nèi)，用手套接觸坐在外側(cè)（紅區(qū)）的病人并進(jìn)行檢測。

這種PPOD 具有靈活的移動(dòng)性，使用更便捷，可適合各種場地，并具備在未來應(yīng)用的潛力。這種模型因其靈活性而具備不受場地限制的應(yīng)用方式，并能獨(dú)立或組合使用。標(biāo)準(zhǔn)尺寸僅限用于檢測，而無障礙尺寸可獨(dú)立用于登記和檢測。在經(jīng)濟(jì)方面，1.5萬美元可以建一處有6 個(gè)PPOD 的檢測站，另有人員成本。它讓人們基本上不再需要PPE，并提高了安全性，因?yàn)椴∪撕歪t(yī)護(hù)人員是由設(shè)施和一體化手套隔開，分別處在紅綠區(qū)。

其目標(biāo)是讓這種方法和設(shè)計(jì)長期實(shí)施下去，并作為任何醫(yī)療機(jī)構(gòu)設(shè)計(jì)的獨(dú)立補(bǔ)充，形成病人到站登記的第一條防線，以及病毒檢測整體工作的未來環(huán)節(jié)，讓病人安全、有效地接受檢測。（尚晉 譯）

2 調(diào)研階段：南卡羅來納州醫(yī)科大學(xué)免下車式呼吸樣本采集點(diǎn)官方資料（節(jié)選自與南卡羅來納州醫(yī)科大學(xué)合作創(chuàng)建的文件）/Research phase: MUSC RSCS official documentation (excerpts from document created in collaboration with Medical University of South California)

3 獨(dú)立可移動(dòng)檢測站/Self-contained PPOD

To maintain safety in medical facilities while coping with a large influx of patients due to the COVID-19 pandemic, MUSC Health and Clemson University Architecture and Community Build in Charleston, South Carolina are working on a design to divert patients to a secondary location for the sole purpose of specimen collection. A Portable Point of Dispensing (PPOD) has been developed to provide a more affordable, safe, and accessible walkup testing method.

Initially, documentation was completed on an existing drive-through Respiratory Specimen Collection Site (RSCS) managed by MUSC in West Ashley, SC. This site had the capability to collect up to approximately 600 samples per day. On average, approximately 10 minutes was spent from the time the patient arrived to the time they departed. The site was structured into three zones:

Red Zone: High hazard. This zone encompassed all patient registration, sample collection, and traffic lanes.

Orange Zone: Possible hazard. This zone was the intermediate between green and red zones and included the decontamination area.

Green Zone: No hazard. This zone was kept contamination free and included control-ops, equipment, and other operational needs.

Upon completing a study of this site and observing the ongoing pandemic it became clear that a more accessible option was needed. In general, drive-through methods can fail to reach underserved and vulnerable populations, such as low-income communities, urban areas, seniors and minorities. Excessive overhead costs to operate the drive-thru testing sites and the need to replace full PPE between patients resulting in dwindling supplies was also an issue.

The proposed PPOD works to mediate these issues. A repurposed portable restroom shell, of either standard or handicap accessible size has it's patient-facing panel modified with an acrylic panel for visibility, with an integrated specimen sample pass-through door and glove ports. Medical personnel enter from the Green Zone into the PPOD after donning minimal PPE, and can sit within the structure and utilise the gloves to reach through and test the patient sitting on the exterior (Red Zone).

The PPOD is flexible in mobility for increased access, in application for various sites, and potential future applications. This model has a site-less approach due to this flexibility, with the ability to be stand-alone or in multiples. The standard size functioning strictly for testing and the accessible size acting as a self-contained option for both registration and testing. Economically, a site of six PPODs can start up for around 15,000 USD with additional costs of "X" for staff. It nearly eliminates the need for PPE and increases safety as patients and personnel are separated between the Red and Green Zones by the structure and integrated gloves themselves.

The goal is to develop this method and design to be implemented permanently as a stand-alone supplement to any healthcare facility design and plan as a first line defense for patient registration upon arriving on-site, as well as becoming the future for virus testing as a whole so that patients can be safely and efficiently tested.

4 可移動(dòng)檢測站現(xiàn)場測試/PPOD testing in field

5 可移動(dòng)檢測站概念平面/PPOD concept plan

6 可移動(dòng)檢測站組裝照片/PPOD assembly photos

7 可移動(dòng)檢測站大型場地布局及剖面/PPOD large site layout and section

8 可移動(dòng)檢測站立面/PPOD elevation

項(xiàng)目信息/Credits and Data

地點(diǎn)/Location：美國南卡羅來納州查爾斯頓/Charleston, South Carolina, USA

客戶/Client: Medical University of South Carolina (MUSC)

設(shè)計(jì)團(tuán)隊(duì)/Design Team:

David Pastre/Clemson University School of Architecture Justin Acevedo, Ryan Bing, Jeremy Eaton, Mohamed Fakhry, Luke Gibson, Audrey Hesson, DJ Holmes, Steve Kurtz, Henry Lee III, Andrew Matthews, Claire Mcmanus, William Poynor, Courtney Wolff/Clemson University Architecture + Community Build Students

合作/Collaborators:

Erik Modrzynski, Kimberlyn Whitaker, Mary P. Mauldin/MUSC

Simeon A. Warren/National Centre for Preservation Technology and Training

Paul Mosher/Cluck Design Collaborative

Will Bullock/Will Bullock Creative

施工/Construction:Meadors, Inc. Millwork

顧問/Consultant: Jeff Polutta, Trash Gurl LLC.

材料/Material: 全新/再利用/移動(dòng)廁所/New/Repurposed Porta-Potty

建筑面積/Floor Area: 標(biāo)志型–約1.347m2/Standard – Approx. 14.5 ft2, 無障礙型–約2.415 m2/Accessible – Approx. 26 ft2

造價(jià)/Cost: Approx. 2500 USD/PPOD with additional costs of "X" for staff on-site

設(shè)計(jì)周期/Design Period: 2020.01-2020.05（調(diào)研記錄/Research and Documentation）, 2020.05-2020.06（設(shè)計(jì)組裝/Design and Assembly）

建造時(shí)間/Construction Period: 2020年夏季/Summer 2020完成時(shí)間/Completion Time: 首期6個(gè)月且仍在實(shí)施中/6 month initial phase; On-going for continued production

繪圖/Drawings: Clemson University Architecture + Community Build Students

攝影/Photos: Clemson University Architecture + Community Build Students and Professor