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    ASHRAE - HVAC-HospitalBook - Room Design PDF

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    alialavi2
    This document discusses best practices for room design in hospitals. It focuses on maintaining proper pressurization in rooms like operating rooms (ORs) that require positive or negative air pressure. Positive pressure rooms like ORs need a differential of at least 0.01 in. of water and an offset of 200-400 cfm between supply and exhaust airflows. Negative pressure isolation rooms require exhaust airflow greater than supply to maintain pressure differences across all surrounding spaces and prevent contamination from escaping. Tight construction and minimizing leakage areas are important to attain the desired pressurization with reasonable airflow offsets.

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    ASHRAE - HVAC-HospitalBook - Room Design PDF

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    alialavi2
    202 views4 pages
    This document discusses best practices for room design in hospitals. It focuses on maintaining proper pressurization in rooms like operating rooms (ORs) that require positive or negative air pressure. Positive pressure rooms like ORs need a differential of at least 0.01 in. of water and an offset of 200-400 cfm between supply and exhaust airflows. Negative pressure isolation rooms require exhaust airflow greater than supply to maintain pressure differences across all surrounding spaces and prevent contamination from escaping. Tight construction and minimizing leakage areas are important to attain the desired pressurization with reasonable airflow offsets.

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    This document discusses best practices for room design in hospitals. It focuses on maintaining proper pressurization in rooms like operating rooms (ORs) that require positive or negative air pressure. Positive pressure rooms like ORs need a differential of at least 0.01 in. of water and an offset of 200-400 cfm between supply and exhaust airflows. Negative pressure isolation rooms require exhaust airflow greater than supply to maintain pressure differences across all surrounding spaces and prevent contamination from escaping. Tight construction and minimizing leakage areas are important to attain the desired pressurization with reasonable airflow offsets.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    202 views4 pages

    ASHRAE - HVAC-HospitalBook - Room Design PDF

    Uploaded by

    alialavi2
    This document discusses best practices for room design in hospitals. It focuses on maintaining proper pressurization in rooms like operating rooms (ORs) that require positive or negative air pressure. Positive pressure rooms like ORs need a differential of at least 0.01 in. of water and an offset of 200-400 cfm between supply and exhaust airflows. Negative pressure isolation rooms require exhaust airflow greater than supply to maintain pressure differences across all surrounding spaces and prevent contamination from escaping. Tight construction and minimizing leakage areas are important to attain the desired pressurization with reasonable airflow offsets.

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    of 4

    CHAPTER 8

    ROOM DESIGN
    Many rooms in hospitals require special design considerations 8.1 INTRODUCTION TO
    because of heightened infection concerns, high internal loads, special ROOM DESIGN
    equipment, unique processes, and unique patients. Air change and
    pressurization requirements for all such rooms are listed in Table 3-3;
    these values reect ANSI/ASHRAE/ASHE Standard 170-2008
    (ASHRAE 2008) with addenda through July 2012. This chapter
    presents best practice suggestions along with details about how to
    achieve these requirements..

    Many spaces in hospitals require maintenance of a differential


    pressure relative to adjacent spaces. For example, ORs, protective
    isolation, and sterile supply require positive pressure, whereas airborne
    infectious isolation, toilet, soiled, bronchoscopy, and decontamination
    rooms require negative pressure.

    Measuring a differential air pressure between a room and the 8.2 ROOM
    corridor may provide evidence that all air movement is in one direction. PRESSURIZATION
    There are a number of factors, however, that may well allow air to
    escape from a room or air to enter a room in spite of a negative or
    positive room-to-corridor pressure relationship. One such factor is
    opening and closing of the room door.

    The truly signicant factor in determining the amount of air migra-


    tion from a room to a corridor is the airow volume differential (Hayden
    et al. 1998). In all cases, some air volume migration occurs through an
    open door when the air pressure difference is essentially zero.

    An anteroom is recommended as a means of reducing airborne


    contaminant concentration by containment and dilution of the migrating

    151
    152 HVAC DESIGN MANUAL FOR HOSPITALS AND CLINICS

    air and to protect the adjacent corridor from excess airow into or out
    of the isolation room. In one study, for a range of room air exhaust
    ows from 50 to 220 cfm [24 to 104 L/s], the migration between a
    room and its anteroom was found to be 35 to 65 cfm [17 to 31 L/s]
    (Hayden et al. 1998). For example, through dilution, a 500 ft3 [14 m3]
    anteroom with a migration of 50 cfm [24 L/s] would (in an hour)
    experience a 90% reduction in the transmission of contaminated air to
    and from the patient room.

    Provide a tight envelope to maintain desired pressurization. Walls


    must extend from oor to structure and openings (such as electrical
    and medical gas outlets) must be sealed. Maintain a specic differential
    airow rate between supply and return/exhaust. Airow from one
    space to another occurs through cracks or gaps in walls, ceilings,
    oors, and around doors. The sum of the areas of all these pathways is
    called the leakage area. The inltration or exltration ow from a
    room is a function of the leakage area and the pressure differential
    across all surfaces of the room. Isolation is maintained only when the
    airow is unidirectional on each surface. Air pressure differential is a
    measurable quantity and should be maintained at 0.01 in. of water
    [2.5 Pa] relative to adjacent spaces.

    As discussed in Chapter 6, differential measure may be achieved


    by controlling supply and exhaust via a pressure monitor; or it can
    be accomplished with a xed offset between supply and exhaust
    airow. A minimum differential airow rate for a very tight room is
    200 cfm [94 L/s]. The engineer must encourage the architect to seal
    the room to allow a 0.01 in. of water [2.5 Pa] pressure difference with
    a xed air volume difference. ASHRAE HandbookFundamentals
    (ASHRAE 2009) provides a method to estimate the allowable leakage
    area as follows:

    AL = C5Qr (U'pr )1/2CD 'pr

    AL =air leakage area, in.2 [cm2]


    C5 =units conversion, 0.186 [10 000]
    Qr =air leakage volume, cfm [m3/s]
    U =air density, 0.0724 lbm/ft3 [1.158 kg/m3] at
    normal room temperature
    CD = discharge coefcient, often set to either 1.0 or 0.6
    'pr = reference pressure difference, in. of water [Pa]

    The coefcient CD depends upon the gaps through which the air
    ows. An estimate of this parameter, 0.186, has been made and
    empirically tested. The designer should estimate the leakage area AL
    using the method from the ASHRAE HandbookFundamentals
    chapter on inltration.

    A rooms static-pressurization value is wholly dependent upon the


    differential airow and the rooms leakage rate. Figure 8-1 shows, for
    ROOM DESIGN 153

    a room with 1.0 ft2 [0.09 m2] of leakage area, that a differential pressure
    pr of just under 0.01 in. of water [2.5 Pa] occurs when the difference
    between the rooms supply air and the total room exhaust is 250 cfm
    [118 L/s]. This relationship exists regardless of the rooms ventilation
    rate (air changes per hour). Therefore, to maintain a specic room
    pressurization value, supply and exhaust airow must be controlled
    and maintained at the appropriate value.

    Most modest-sized patient rooms will have a total room leakage


    area of at least 0.5 to 1.0 ft2 [0.05 to 0.09 m2], even with relatively tight
    construction. To attain a tighter room, extensive sealing and meticulous
    attention to wall, ceiling, and oor penetrations (where conduit, piping,
    ductwork, and other items pass through) are required. Leaky rooms
    require a larger airow offset, thereby wasting energy. An offset of 100
    to 200 cfm [47 to 94 L/s] is desirable.

    If the leakage area for a negative-air-pressure room cannot be 8.2.1 Negative Air Pressure
    reduced to that needed for an airow differential of 100 cfm [47 L/s],
    recalculate with the known air leakage area and solve for Qr . In most
    cases, Qr will need to be larger; and can even equal the total cooling
    supply air volume. To reduce the value of Qr , the ventilation designer
    should inuence the envelope tightness as a means of decreasing the
    leakage area. Per Figure 8-1, leakage areas of 60 in.2 [38,700 mm2]
    require a Qr of 100 cfm [47 L/s] at 0.01 in. of water [2.5 Pa]. Maintaining

    Figure 8-1 Room Differential Airow versus Differential Pressure for Various Room Leakage Areas
    154 HVAC DESIGN MANUAL FOR HOSPITALS AND CLINICS

    a negative air pressure difference between a room and the corridor


    may not be enough to provide isolation. Because there are up to six
    possible shared bounding surfaces for any room, and because there
    may be adverse pressure relationships across any of these surfaces,
    each surface must be considered. Pressures in adjoining rooms may
    be lower than in the room under consideration and air may ow out.
    To prevent such ows, the Qr may need to be increased beyond that
    required to maintain appropriate ow to the corridor only. The value of
    Qr must be set to ensure that the negative-air-pressure room will pull
    air from all of the surrounding spaces.

    8.2.2 Positive Air Pressure Maintaining positive air pressure, preferably with anterooms and
    continuous alarms, requires continuous monitoring of pressurization. To
    reduce airow to or from corridors, anterooms are highly recommended.

    8.3 OPERATING ROOMS The purposes of the HVAC system in an operating room (OR) are
    to minimize infection, maintain staff comfort, and maintain patient
    comfort. As indicated in Table 8-1, the recommended air change per
    hour (ACH) value has been 15 to 25 for 40 years. The current recom-
    mendation in the FGI Guidelines (AGI 2010) and ANSI/ASHRAE/
    ASHE Standard 170-2008 (per Table 3-3) is 20 ach supply air including
    4 ach of outdoor air (20% outdoor air). Note that 100% outdoor air
    systems have not been recommended since the early 1980s; although
    until very recently the U.S. Veterans Administration has required 100%
    outdoor air systems. Operating rooms must be designed for a positive
    pressure differential of 0.01 in. of water [2.5 Pa]. As discussed above,
    this will require a 200400 cfm [94189 L/s] offset. Although ANSI/
    ASHRAE/ASHE Standard 170-2008 does not require continuous
    monitoring, various authorities having jurisdiction (AHJs) frequently
    request or require monitoring of temperature, relative humidity (RH),
    and dew point in ORs.

    The surgical suite contains operating rooms as well as substerile


    rooms, clean supply, sterile corridor, preoperative preparation, and
    postoperative recovery care (postanesthesia care unit [PACU]).
    Common usage of the term OR is often intended to include both
    the surgical room and these support areas. In some hospitals, other
    spaces, such as locker rooms, doctors lounges, control desks,
    anesthesia workrooms, and even surgical waiting areas, may be
    included in the general term. The OR special environment, however,
    embraces only the restricted area of the surgical suite. Surgeries may
    be classied as shown in Table 8-2.

    As indicated in Table 8-3, most standard operating rooms require


    MERV 14 ltration. In the past, some standards recommended MERV
    17 in orthopedic and organ transplant surgery operating rooms.
    Although this is no longer the case in ANSI/ASHRAE/ASHE Standard
    170-2008, many deem it good practice. Assuming that the nal lter
    assembly is tight, only one nal lter is necessary. Placing two nal
    lters in series, such as one in the AHU and one outside the OR, is

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