Air condition requirement in hospitals Presentation Transcript

1. Air conditioningAir conditioning requirements in hospitalsrequirements in

hospitals Presented by Heena kousar
2. Introduction Microbiological transmission in healthcare setting is inevitably a
very potential risk. The main routes are droplets, contact, common vehicle and air
borne transmissions. Infection control for patients, healthcare providers and visitors is
of paramount importance in the healthcare process in medical facilities. Proper air
conditioning of medical care facilities is helpful in prevention and treatment of
diseases.
3. Continual advances in medicine and technology have led to the development in
medical care processes as many new complex diagnostic and therapeutic procedures
have been added to the armamentarium of medical care. There is a need for
constant evaluation of air conditioning needs of the hospitals and medical facilities for
better patient care.
4. What is air conditioning? Air conditioning (often referred to as aircon, AC or
A/C) is the process of altering the properties of air (primarily temperature and
humidity) to more favorable conditions. More generally, air conditioning can refer
to any form of technological cooling, heating, ventilation, or disinfection that
modifies the condition of air.
5. DefinitionDefinition Air conditioning is defined as a processAir conditioning is
defined as a process which cools(or heats), cleans, freshenswhich cools(or heats),
cleans, freshens air and controls its moisture contentair and controls its moisture
content simultaneously.simultaneously.
6. Types of air conditioning in hospital HVAC designer will recommend different
types of air conditioning systems for different applications. most commonly using are:
1)Window air conditioner: is the most commonly used air conditioner for single
rooms. In this air conditioner all the components, namely the compressor, condenser,
expansion valve or coil, evaporator and cooling coil are enclosed in a single box. This
unit is fitted in a opening made in the wall of the room, or more commonly a window
sill.
7. 2) Split Air Conditioner: The split air conditioner comprises of two parts: the
outdoor unit and the indoor unit. The outdoor unit, fitted outside the room, houses
components like the compressor, condenser and expansion valve. The indoor unit
comprises the evaporator or cooling coil and the cooling fan. For this unit you dont
have to make any slot in the wall of the room. Further, present day split units have
aesthetic appeal and do not take up as much space as a window unit. A split air
conditioner can be used to cool one or two rooms.
8. 3) Packaged Air Conditioner An HVAC designer will suggest this type of air
conditioner which is used to cool more than two rooms or a larger space at home or
office. There are two possible arrangements with the package unit. In the first one,
all the components, namely the compressor, condenser (which can be air cooled or
water cooled), expansion valve and evaporator are housed in a single box. The
cooled air is thrown by the high capacity blower, and it flows through the ducts laid
through various rooms. In the second arrangement, the compressor and condenser are
housed in one casing. The compressed gas passes through individual units, comprised
of the expansion valve and cooling coil, located in various rooms.
9. 4) Central Air Conditioning System Central air conditioning is used for cooling
big buildings, houses, offices, entire hotels, gyms, movie theaters, factories etc. If
the whole building is to be air conditioned, HVAC engineers find that putting
individual units in each of the rooms is very expensive making this a better option.
A central air conditioning system is comprised of a huge compressor that has the
capacity to produce hundreds of tons of air conditioning. Cooling big halls, malls,
huge spaces, galleries etc is usually only feasible with central conditioning units.
10. Chilled Water Applied Systems A chilled-water applied system uses chilled
water to transport heat energy between the airside, chillers and the outdoors. These
systems are more commonly found in large HVAC installations, given their efficiency
advantages. The components of the chiller (evaporator, compressor, an air- or
water-cooled condenser, and expansion device) are often manufactured, assembled,
and tested as a complete package within the factory.
11. HEPA FILTERS High-efficiency particulate air or HEPA is a type of air filter.
The filter must satisfy certain standards of efficiency such as those set by the
United States Department of Energy (DOE). To qualify as HEPA by US
government standards, an air filter must remove (from the air that passes through)
99.97% of particles that have a size of 0.3 micro metres or larger.
12. HEPA filters are critical in the prevention of the spread of airborne bacterial
and viral organisms and, therefore, infection. Typically, medical-use HEPA
filtration systems also incorporate high-energy ultra-violet light units to kill off the
live bacteria and viruses trapped by the filter media. Some of the best-rated HEPA
units have an efficiency rating of 99.95%, which assures a very high level of
protection against airborne disease transmission.
13. Why do hospitals really require air conditioning? Installing these units in
hospitals provides a comfortable environment to patients. Doctors and staff will also
be able to work more comfortably and concentrate on their duty in a better manner.
These days most modern hospitals are equipped with this air conditioning. The
technology is also utilized to provide various therapies to patients. According to
studies it has been proved that patients show speedy recovery in controlled
environment than in an uncontrolled environment. For example, cardiac patients may
not be able to maintain adequate circulation to facilitate standard heat loss. This is
also a reason that cardiac wards and rooms are equipped with air conditioning units.
14. Patients within head injuries, those subjected with brain operations and those
with poisoning may have high fever in a hot environment due to trouble in the brains
heat regulatory system. The best thing to ensure recovery here is to maintain cool and
comfortable environment. Burn patients also require a warm environment with high
relative humidity. The room for severe burn patients must possess temperature
controls that can keep the level of temperature should be 32 degree Celsius. The
relative humidity should go up to 95 per cent, this is where air conditioning is used as
a clean room application.
15. Air conditioning is extremely important in the operation theater. This helps in
controlling the temperature, humidity and sterile filtration. These units are also
considered as a necessity for other departments of hospitals such as delivery room,
radiology, recovery room, intensive care unit, CT, & MRI. Air conditioning has
helped in making the environment of hospitals livable and extremely comfortable.
This also facilitates in keeping the environment of the hospital clean and hygienic.
The patients will feel happy, healthy and comfortable with an air conditioning
installed in hospitals.
16. Need for air conditioning of hospital facilities Proper air conditioning is helpful
in the prevention and treatment of diseases. The factors determining the need for air
conditioning in hospital facilities are: (a) The need to restrict air movement within and
between various departments. (b) The specific requirements for ventilation and
filtration to dilute and remove contaminants in the form of airborne microorganisms,
viruses, odour, hazardous chemicals and radioactive substances. (c) Different types of
temperature and humidity requirements for various areas. (d) Permit accurate control
of environmental conditions. (e) Control of air quality and air movement
17. Infection Sources and Control Measures Bacterial Infection. Infectious bacteria
are transported by air. Droplet or infectious agents of 5 mm or less in size can remain
airborne indefinitely. It has been shown that 90 to 95 per cent effective filters remove
99.9 per cent of all bacteria present in hospitals.
18. Viral Infection Epidemiological evidence and other studies indicate that many
of the air borne viruses that transmit infections are sub- micron in size, thus there is
no known method to effectively eliminate 100 per cent of the viable particles. HEPA
filters and/or Ultra-Low Penetration (ULPA) filters provide the greatest efficiency
currently available. Therefore, the isolation rooms with appropriate ventilation
pressure relationships are the primary means used to prevent the spread of airborne
viruses in the hospital environment.
19. Outdoor air in comparison to room air is virtually free of bacteria and viruses.
Infection control problems frequently involve a bacterial or viral source within the
hospital. Ventilation air dilutes the viral and bacterial contamination within the
hospital. Properly designed, constructed and maintained ventilation systems
preserve the correct pressure relationship between functional areas; they remove
airborne infectious agents from hospital environment.
20. Indoor Air Quality in Hospitals Indoor air quality in hospital is a complex
multi- faceted issue. Contaminants come with dust, air and visitors as well as
originate inside the hospital complex and threaten the quality of environment. Most
common contaminants are microbes and organic compounds. Ventilation and
filtration provides a means of fighting contaminants by diluting their concentration.
21. Acceptable indoor air quality can be achieved by following the fundamental
principles: (a) Contaminant source control. (b) Proper ventilation. (c) Humidity
management. (d) Adequate filtration. The temperature and humidity conditions in
hospital environment can inhibit or promote the growth of bacteria and activate or
deactivate viruses. Ventilation systems are used to provide air virtually free of dust,
dirt, odour, chemicals and radioactive pollutants.
22. Contamination can be dispersed into the air of the hospital environment by one
of the many routine activities of normal patient care. Because of the dispersal of
bacteria resulting from such necessary activities, air-handling system should provide
air movement patterns to minimize the spread of contamination. The sense of
thermal comfort results from an interaction between temperature, relative humidity,
air movement, clothing, activity levels and individual physiology. The temperature
and relative humidity measurements are indicators of thermal comfort. The medical
care needs of patients require thermal comfort provided by air conditioning system.
23. Operating Room Air Conditioning Requirements The primary task of the
ventilation system in an operating room is to provide an acceptable indoor climate for
personnel and patients, to remove odor, released anesthetic gases and to reduce the
risk of infection in the operating area. The greatest amount of bacteria found in
operating rooms comes from the surgical team and is a result of their activity during
surgery.
24. During an operation most members of the surgical team are in the vicinity of the
operating table, creating the undesirable situation of concentrating contaminants in
this highly sensitive area. Studies of operating room air distribution systems and
various air delivery systems indicate that these are the most effective methods for air
movement pattern in operation theatres for limiting the concentration of contaminants
to an acceptable level.
25. The total heat production per hour caused by the staff, operation room lighting and
equipment may be about 2 KW or 1750 Kcal/h.
26. Operating Room Ventilation To maintain oxygenation for 10 persons in the
operating room, a volume of about 28 m3 of air will be required per hour. How much
outside air is required for the dilution of odour will depend on the nature and intensity
of odor producing sources. It is indicated by some studies that air supplied at 0.24
m3 per minute per person is the critical level of odour suppression. A ventilation
rate of 10 air changes per hour reduces the level of any contamination present in the
air by about 99 per cent.
27. 15 to 20 air changes per hour should be sufficient for comfort, to ensure
pressurization in the operation room and to maintain considerable control of airborne
micro organisms in an operation room of the size of about 40 sq meter, if an average
surgical team is involved. Another study shows that bacteriological contamination
of the air is markedly reduced by the use of ultra clean air filters. Airborne
contamination in operating room is mainly derived from the personnel in the
operation theatre and their activities.
28. The number of individuals present, ventilation and airflow implements the
bacterial count in operation theatre. Proper design and ventilation of operation
theatre is the most important means of controlling airborne infection in operation
theatre.
29. Empty Operation Theatre The empty operation theatre should have: a) Less
than 35 colony-forming units (CFU) of bacteria/m3 of air. b) Less than one CFU of
Clostridium perfingens or Staphylococcus aureus in 30 m3. c) During operation less
than 180 CFU/ m3 of air using ultra clean laminar flow in the theatre. d) Less than 20
CFU/ m 3 at the periphery of the enclosure and less than 10 CFU/ m3 at the centre.
30. Direction of Air Flow Direction of airflow should be from clean to less clean
areas. Airflow rate of 0.28 -0.47 m /sec is desirable across an open door to prevent
back flow into cleaner area. In Ultra clean air enclosure, the airflow should not be
less than 0.2 m/sec .
31. Humidity Control One of the aspects of humidity is that bacteriological
microorganisms ride on dust particles whose attract ability to one another is favored
by low relative humidity resulting in increased static energy. Low relative humidity
is reported to be suitable for Klebsiella pneumoniae activity. High humidity in the
hospital enhances the danger of growth of Pseudomonas aeruginosa.
32. Humidity in operation room is believed to contribute to the prevention of
dehydration of exposed tissue. To minimize the explosion risk , the relative
humidity required is 40-65 per cent.
33. Air conditioning other zones 1) Patient rooms: air conditioning of bed rooms in
our warm humid climate desirable not only for medical reason but also to keep out
noise , pollution from mainly cars & buses, trucks. It is more important in dry areas
where dust storm common in the summer months. When central air-conditioning
system used for pt rooms avoid ducted air supply and return to the rooms in order to
eliminate chance of cross infection. and to odours through the common ducts for the
same reason, packaged air conditioner feeding a group of rooms through a ducted
supply must also be avoided.
34. Use of individual fan coil units in each room connected to a central chilled water
plant and room thermo stats for indipendent temp control is ideal solution .
35. 2) ICU :These units serves seriously ill pts from post operative to coronary pts.
There needs of clean filtered air without the possibility of contamination from
adjoining areas and variable range of temp capability from 24 to 27 c are important .
36. 3) LABOUR & DELIVERY : The procedures for normal child birth are
considered non invasive and rooms are controlled similar to pts rooms . Invasive
procedures such as a caesarian section are performed in an OT .
37. 4)MRI &CT SCAN ROOMS : Normal comforts AC and ventilation is required.
How ever the special needs of the equipment manufacturer must be checked out and
at times a precision AC may be called for to handle the high heat release of computer
equipment and cryogens used to cool the magnet .
38. 5) AUTOPSY ROOM : comforts conditions are maintained with a 100% fresh air
system with full exhaust . Due to heavy bacterial contamination and odor, autopsy
room require special attention for exhausting all air above the roof of the hospital . To
prevent spread of contamination to adjoining areas ,the autopsy room must be
maintained at ve pressure.
39. 6)PHYSICAL THERAPHY DEPT : The normal AC cooling load of the electro
therapy section is affected by the short wave diathermy , infrared and ultraviolet
equipment used in this area . The exercise section requires no special treatment and
temp and humidity should be within the comfort zone.
40. 7)CSSD : comfort Ac is optional but ventilation and exhaust air system are
essential . Used and contaminated utensils, instruments and equipment are brought to
this unit for cleaning and sterilization prior to reuse. the dept usually consists of
cleaning area ,a sterilizing area and a storage area where supplies are kept until
requested. the storage area should preferably be air conditioned on 24 hour basis in
case the remaining CSSD dept in merely ventilated.
41. 8) KITCHEN: This is generally ventilated, meaning that fresh filtered air is
distributed to the entire area and stale air exhausted through the hoods kept over the
cooking area where the heat is concentrated. cooler and freezer rooms are located
close to the kitchen area and the refrigeration equipment and for these should
preferably be water cooled for the best cooling efficiency. the dietitians office is
often located within or adjoining the kitchen . It is usually completely enclosed to
ensure privacy and noise reduction and air conditioned for comfort.
42. 9) LAUNDRY: this is another area which is generally ventilated with fresh
filtered air and exhausted through hoods placed over the heat generating laundry
equipment such as washers ,flat work ironers and tumblers . special advice must be
taken from the equipment manufacturers and all exhaust should terminate above the
roof or where itll not be are nuisance to neighbors
43. 10) PHARMACIES AND DRUG STORAGE AREAS: Are another unit within
hospitals and other healthcare organizations than require air conditioning in order to
carry 'temperature dependent' drugs. Inadequate temperature control here either means
that medication would not function as required or the hospital would simply not be
able to stock some emergency treatments.
44. Disadvantages of air conditioners Air conditioners use a lot of electricity.
financial disadvantage. spending too much time in an air-conditioned environment
can contribute to health problems such as asthma, tightness in the chest and other
respiratory ailments. Low temperatures will lead to a sharp contraction of blood
vessels, poor blood flow and joint pain. the temperature difference between indoor
and outdoor, people often will feel hot and cold, this will result in the body
conditioning system disorders.
45. Conclusion The benefit to the clientele, prompt recovery, restoration of quality
of life, disability limitation, prevention of hospital acquired infection, enhancing the
productivity of the equipment and staff cannot be quantified in to the exact financial
terms. A single case of hospital acquired infection requires at least double the duration
of stay in hospital, which leads the antibiotic cost to manifold, leads to increase in the
cost due to management of antecedent complications and loss of productive man-
hours, justifies the case for air conditioning. The hospitals/medical institution deals
with life of the clientele, the lives saved by providing appropriate therapeutic,
diagnostic and treatment facilities justify that the investment for air conditioning is a
small cost for better quality care to the patients.
46. REFERANCE http://www.brilliantstore.com/portable_air_conditioners.h tml
http://www.brilliantstore.com/window_air_conditione rs. html
http://www.brilliantstore.com/mini_split_air_conditi oners... www.wikipidia.com.
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