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Hvac in Hospitals (Ot)
Hvac in Hospitals (Ot)
The greatest amount of Bacteria found in Operating rooms comes from the Surgical team and is the result of
their activity during Surgery.
THEREFORE,
✓ Heating, Ventilating and Air-Conditioning (HVAC) installations in hospital ORs play a determinant role on the
indoor environmental quality (IEQ).
✓ The priority is to control the indoor air quality (i.e. protects from airborne hazards or chemical agents like
anaesthetic gases ) and maintain indoor comfort conditions (i.e. temperature, humidity, ventilation and airflow).
✓ The air in an OR must be aseptic, at a reasonably constant temperature and humidity and have low velocity in
order to avoid drafts and swirls that promote the recirculation of microbes.
✓ The total heat production caused by the staff, operation room lighting and equipment may be about 2 KW or
1750 kcal per hour.
✓ That’s why we need good HVAC setup in OT rooms to tackle the heat and providing comfortable environment.
✓ The HVAC system comprises of the following components –
1. Compressor 2. Condenser 3. Evaporator 4. Pumps & Cooling Towers 5. AHU 6. Air Distribution systems
SPACE LAYOUT
✓ Usually the No. of OT’s are 2.5% of the Total beds in that Hospital.
✓ The sizes of OT varies from 25 m2 to 75 m2 depending upon the use of medical equipments.
AIR CONDITIONING IN OT
✓ For fulfilling the air conditioning requirements for Operation Theatre the following guidelines have been finalized.
✓ For this purpose OT’s have been divided into 2 groups-
o Super specialty OT: Super specialty OT means operation theatres for Neurosciences, Orthopaedics (Joint
Replacement), Cardiothoracic and Transplant Surgery (Renal, Liver etc).
o General OT: This includes operation theatres for Ophthalmology, District hospital OTs, FRU OT and all other
basic surgical disciplines.
✓ The following basic assumptions have been kept in view:
o Occupancy: Standard occupancy of 5-8 persons at
any given point of time inside the OT is considered.
o Equipment Load: Standard equipment load of 5-7
kW considered per OT
o Ambient temperature & humidity at each location
to be considered while designing the system.
REQUIREMENTS -:
1. Air Changes Per Hour:
✓ Minimum total air changes should be 25 based on
international guidelines although the same will vary
with biological load and the location.
✓ The fresh air component of the air change is required
to be minimum 4 air changes (i.e. 16%) out of total
minimum 25 air changes. 20 for general OT .
✓ If HCO chooses to have 100% fresh air system than
appropriate energy saving devices like heat recovery
wheel, run around pipes etc should be installed.
-In this equation:
Q is the volume flow rate of air being calculated, and ACH is the
number of air changes per hour .
✓ For a average room size of 50 m2 / 5400 cubic
ft., the volume flow rate of air will be-
FACT -
o Just one air-change with fresh air can remove 63% of
suspended particles from the room air.
Q = (25) X (5400) = 2250 cu. Ft / min. o If a ventilation system can perform 10 air changes per hour
60 (ACH), it takes 14 minutes to remove 90% of airborne
contaminants in a room and 28 minutes to remove 99%.
2. Air Velocity:
✓ The vertical down flow of air coming out of the
diffusers should be able to carry bacteria carrying
particle load away from the operating table.
✓ The airflow needs to be unidirectional and downwards
on the OT table.
✓ The air velocity recommended as per the international
and national guidelines is 90120 FPM at the Grille/
Diffuser level.
3. Positive Pressure:
✓ There is a requirement to maintain
positive pressure differential
between OT and adjoining areas to
prevent outside air entry into OT.
✓ The minimum positive pressure
recommended is 15 Pascal (0.05
inches of water) as per ISO 14644
Clean Room Standard.
4. Air handling in the OT including air Quality:
✓ Air is supplied through Terminal HEPA filters in the ceiling.
✓ The minimum size of the filtration area should be 8’ x 6’ to cover the entire OT table and surgical team.
✓ The minimum supply air volume to the OT (in CFM) should be compliant with the desired minimum air change.
✓ Air quality at the supply i.e. at grille level should be Class 100/ ISO Class 5 (at rest condition).
Note: Class 100 means a cubic foot of air should not have more than 100 particles measuring more than 0.5 microns
or larger.
✓ http://arogyakeralam.gov.in/docs/quality
/NABH_Air_Conditioning_OT_07022014.
pdf
✓ https://www.slideshare.net/heenakousar
102/air-condition-requirement-in-
hospitals
✓ HVAC design for healthcare facilities
www.CEDengineering.com
✓ Environmental Control Including
Ventilation In Hospitals (Vipin Kaushal,
P.S. Saini, A.K. Gupta).
✓ Research Paper :
Master Planning of HVAC Installations in
Hospital Operating Rooms.
✓ Google Images .