Emergency Services

Health Equipment Master Plan
Guide Manual for

the Architectural
Design of the
Emergency
Service
MAYOR MAYOR'S
OFFICE CITY GOVERNMENT
FROM BOGOTÁ DC
POSITIVE
BOGOTA
Mayor of Bogotá, DC (E) Clara Eugenia López Obregón
District Health Secretary

Jorge Bernal Conde
District Undersecretary of Health

Juan Varela Beltran
Director of Health Services Development

Herman Redondo Gomez
Health Services Analysis and Policy Area Coordination

Beatriz Helena Guerrero Africani
General Document Coordination

Belcy Torres Campos
Technical Support Group- PMES

Sandra Carolina González Saboya
Magnolia Muñoz Robayo
Autocad drawings
Jaiver Marin Pineda
Paola Cecilia Cáceres Rodríguez
Editorial Coordination
Health Communications Advisory Office
Johnatan Nieto Blanco
Style correction
Patricia Arévalo Piñeros
Photography
Diego Bautista M.
Design and layout

Campo Elías Franco
Impression
Xxxxxxxx
District Health Secretariat Carrera 32 No. 12-81

Bogotá, DC, 2011 www.saludcapital.gov.co
Content
Content....................................................................................................................................................3
Introduction.............................................................................................................................................7
Goals.......................................................................................................................................................7
Specific objectives..................................................................................................................................7
Legal Framework of Reference..............................................................................................................8
Generalities.............................................................................................................................................9
Emergency Service...............................................................................................................................10
15
"rr...........................................................................................................................................................20
Adult emergencies................................................................................................................................42
Bibliography.........................................................................................................................................48
Guide Manual for the Architectural Design of the Emergency Service
Introduction
Within the framework of strengthening services, the District Health Secretariat works on tools that serve to improve the physical
infrastructure of Health Services Providing Institutions in order to expand their response capacity, their competitiveness in the market
and the accreditation of services. To this end, it has been considered of great importance importance of providing technical
consultation elements to the Public and Private IPS, allowing them to make quick and reliable decisions.
Considering the need to implement spatial and operating conditions to optimize processes services design, the Health Services
Development Directorate - Service Analysis and Policies, presents the Architectural Manuals that address the EMERGENCY
SERVICE, aimed at achieving a correct form. lation, projection and development of hospital projects, by addressing recurring doubts
and shortcomings, oriented to the disciplines and quality evaluations that concern them.
The information is presented by Service Unit and spaces required for it, describing its function. optimal layout, interrelationships,
finishes and area suggestions in square meters (M2) for each one. It should be noted that these Guides for Architectural Design are
tools to improve current quantitative and qualitative standards, incorporating guidelines that allow the adaptation and inclusion of
vulnerable population groups with special needs to improve the quality and comfort of hospital buildings and health care providers.
services through the improvement of each of the required and complementary spaces, which will not be considered as a norm.
To guarantee compliance with the quality parameters, the Ministry of Social Protection delegates to the Sectional, District and
Local Directorates the responsibility of advising establishments or Pres Institutions. Health Services providers in everything related to
organization, adaptation, provision, optimization of resources and/or construction, taking into account compliance with current
regulations.
This Manual is developed as a technical document, which uses simple language to be understood and used by all those people
who work on projects related to hospital architecture (Doctors, adminis trators, engineers and architects). Likewise, it uses general
space schemes, which are presented as a guide, in relation to the design requirements.
Goals
Have a document that serves as support in the design process of the Emergency Service as it relates do with the Architectural
aspect.
Offer the architect an important tool when designing or evaluating the physical infrastructure of an Emergency Service, so that the
Institutions Providing Human Health Services have help or consultation material NOT MANDATORY COMPLIANCE, which allows
them to dimension a service with Quality, that meets the technical specifications for the benefit of the users, in which all the variables
have been foreseen and in this way to be able to provide a service with opportunity in attention, creating better environments for the
users and for the officials of the institutions.
Specific objectives
• Prepare a Manual that is easy to apply in the task of organization, adaptation, and optimization of physical resources in the
construction of the Emergency Service in Health Services Providing Institutions according to their level of complexity.
• With this instrument, facilitate Health Service Providing Institutions with the organization and adaptation of the Emergency Service
through a guide document in the aspect of physical resources.
• Promote the quality of the institutions in the Emergency Service, making known through this Guide Book the necessary
environments (spaces), characteristics and specifications for the best functioning of this service.
7
District Health Secretariat
Legal Framework of Reference
• LAW 09 of 1979 - Health Code

Sanitary conditions that establishments of all kinds must comply with.
• LAW 10 OF 1990
By which the National Health System is established and functions and responsibilities are granted to the National Directorate tional
Directorate of the Health System (Ministry of Health) to the Sectional Directorates of the Health System (established in
departments, mayors and police stations) and to the Local Directorates of the Health System (established in the Municipalities, the
Capital District, the Cultural and Tourist District of Cartagena and the metropolitan areas). Furthermore, Article 12 establishes the
functions for the Local Directorates of the Health System corresponding to Health Surveillance and Control in the institutions that
provide health services.
• LAW 100 OF 1993

Social Health Security Law in Colombia.
• RESOLUTION 4445 OF DECEMBER 2, 1996, OF THE MINISTRY OF SOCIAL PROTECTION

By which rules are dictated for compliance with the content of the Fourth Title of Law 09/79 in relation to the sanitary conditions that
Health Services Providing Institutions must comply with and other technical and administrative provisions are dictated.
• RESOLUTION 05042 - DECEMBER 26, 1996, OF THE MINISTRY OF SOCIAL PROTECTION By which Resolution 4445/96 is
modified and added.
• DECREE 1011 OF 2006 OF THE MINISTRY OF SOCIAL PROTECTION

By which the Mandatory Health Care Quality Guarantee System of the General Social Security Health System is established.
• RESOLUTION 0686 OF 1998 OF THE DISTRICT SECRETARY OF HEALTH

By which the procedure for the execution and presentation of design and construction projects is regulated; and maintenance of the
physical facilities of the public institutions of the District order that provide health services.
• LAW 400 of 1997 and NSR OF 1998 - DECREE 33 OF 1998

By which standards on earthquake-resistant constructions are adopted and everything related to earthquake-resistant structures is
regulated, with mandatory compliance for all constructions.
• RESOLUTION 1043 OF 2006

Which establishes the conditions that Health Service Providers must meet to enable their services, and implement the audit
component to improve the quality of care, with its Technical Annexes 1 and 2.

Partially modifies Resolution 1043 of 2006, with its Technical Annexes 1 and 2.

They partially modify Resolutions 1043 and 1448 of 2006 and Resolution 2680 of 2007, Technical Annex.

Defines the Qualification Conditions for institutions that provide health services under the Telemedicine modality.

Drug addiction and drug dependence.

It regulates health brigades or days, with its Annexes 1 and 2.
• CIRCULAR 0076 OF 2007

Modify and adopt the registration forms and news (Version 4.0)
8
By which the Pharmaceutical Service Management Model is determined, the Esen Conditions Manual is adopted cials and
Procedures and other provisions are issued.
• AGREEMENT 20 OF 1995 OF THE COUNCIL OF SANTA FE OF BOGOTÁ

Capital District Construction Code.
• RETIE
Technical standard for electrical installations.
• STANDARD 2050
Colombian Technical Standard 2050 – National Electrical Code
Generalities
• The first requirement for the formulation of an investment project in Health must be the preparation of a feasibility study, based on
clear and precise statistics that provide an accurate diagnosis to calculate the demand, analyze the supply, the resources available.
and make the most convenient and profitable decisions, both social and economic, that guarantee the viability and sustainability of
the Project.
• To carry out the design of an Emergency Service, you must have a group that has knowledge on the subject, an Architect with
extensive experience in Planning and Design of Hospitals and the team of Engineers (Structural tural, electrical, special gases,
voice and data network, hydraulic and sanitary network, mechanical ventilation) with knowledge and understanding in the
application of the standards that govern each topic.
• The areas of care for children and adults must be differentiated, taking into account that the pathologies are different.
9
Emergency Service
1. Service description
It is the Service intended for the care of patients who, due to their condition, require immediate medical attention; It must have
direct access from the outside and has the function of receiving, assessing, examining and treating patients who require care as a
result of an accident or sudden illness. The speed of response given to the emergency is important to save a life, the situation of the
patient who enters the emergency room must be resolved in a time of no more than 24 hours. The Emergency Service must have
support and diagnostic services such as Clinical Laboratory, imaging and pharmacy.
This service must meet at least the following conditions:

• Have an exclusive area with restricted circulation.
• Have a registration area for patients entering the service.
• Provide 24-hour diagnostic and therapeutic support services.
2. Description of the Service environments
2.1 Access
Patient access to the emergency service is external and must have independent, fast, broad and easy-to-identify access; In the
same way, access for patients by ambulance and patients who move by their own means must be differentiated, which must be
independent. The following environments are found in this service:
2.2 Reception and control
Environment intended for people who inform and control access to the service, requires a customer service furniture,
intercommunication system and telephone.
2.3 Police station

Environment for the police officer who remains in the emergency service, in order to be informed of cases resulting from attacks
by third parties and/or traffic accidents, for which he requires a customer service furniture.
2.4 Radio and communication

Environment intended for the radio-communication operator in charge of communicating with ambulances and the health network.
11
2.5 Billing and cash office
Public service environment where the provision of the service is invoiced and the respective payment is made. It is important that
this area has a bathroom because the personnel in charge cannot be absent and neglect the workplace.
It must have an intercom system and telephone.
1
2
2.6 Coordination Office
Office for managing medical and nursing coordination; It must have a bathroom and areas for secretarial and re unions.
2.7 User service or social work
Area intended for officials who must analyze and provide solutions to the situations of users who have financial difficulty in
canceling the service provided and for situations that arise with users. This work is normally carried out by the Entity's Social Worker.
Its furnishing is office type.
13
2.8 Waiting room and public bathroom battery
1
4
2.80 It is the area intended for the public and

family patients, must be visually controlled by
the reception area, that is, provided with a
communication system (public telephones),
ease of consultation provision of refreshments,
television point, background music and public
bathrooms. wars for both sexes and for people
with disabilities These should be located next
1.60
to the waiting room.
2.9 Stretcher and wheelchair

parking
Place intended for the permanence of

stretchers and wheelchairs available for the
use of patients, its design solution can be a
bay over the internal circulation located
immediately at the access to the emergency
care area and that does not interrupt the
circulation and normal functioning of the
Service .
15
2.10 Triage Office

5.00
15-1* 17.15
Office intended for the initial assessment of the patient, it is a system of classification and pre-assessment of the patient, where
the necessary data is obtained for the identification of the user and it is determined whether he or she is referred to the emergency
assessment clinics. It must have direct communication to the service office area.
2.11 Typical valuation office

15 5.00
•• **.15
Yo---------------------------------------4.05----------------------------------------------------------------- Yo-----1.00 -------------•,25 i-
1
6
Separate offices for adults and children should be considered as much as possible. Patients access these offices once they have
been directed to the triage, their minimum area as a rule is 10 M2, they must have a consultation area and an examination and/or
assessment area, sink for each office, with a gas outlet. medicinal, preferably separate patient waiting room for adults and children
with natural lighting and ventilation and sufficient electrical lighting.
At the same time, it is possible to consider locating a health unit in the offices.
2.12 Resuscitation Room
Environment intended for the initial care of the patient who is in a state of arrest and who requires stability. lized. It must have a
minimum area of 15 M2 that allows comfortable movement around the patient to facilitate their care, it must have all the special gas
networks, sufficient electrical outlets to connect the required equipment; The walls, floors and ceiling must be made of durable
material that is easy to clean, corners and corners of the walls are rounded, broom guards and the connection of the ceiling with half-
round walls, finishing for walls and ceiling in epoxy paint or similar; The door to the resuscitation room must be swinging and be at
least 1.50 meters wide and 2.10 meters high, with their respective bump protectors for stretchers and wheelchairs and with a glass
viewer at a height of 1.30 meters.
The lighting must be adequate and sufficient, if possible having an operating room type ceiling lamp, with natural lighting and
ventilation and/or mechanical ventilation. Its location must be very close or close to the emergency service access door.
17
2.13 Patient washing and/or stretcher shower
Environment intended for washing the patient who arrives into

poisoning fallen or in a high degree of dirt, requires an area around dor
of the stretcher to wash the patient with shower, telephone and privacy
with curtain. This space must be located fallen right after the access to
the emergency care area; The walls, floors and ceiling must be made of
durable material that is easy to clean, corners and vertices of walls
rounded, broom guards and connection of ceiling with half-round walls,
walls preferably veneered.
2.14 Septic Procedures Room

TO------------------------------------------- 5.80------------------------------------------------------------------------- TO
.15 -11---------------------------------------------------------------------5.50---------------------------------------------------------------------*1.15
2.80
IO
Space intended for the care of contaminated patients, which must have a minimum area of 12 M2 as a rule, a pre-wash, a support
area in which the report of the procedure carried out is presented, availability of
1
8
special gas network outlets, electrical outlets necessary to connect the required equipment, with walls, floors and ceiling finishes
in durable, easy-to-clean material, preferably epoxy paint; rounded corners, broom storage and ceiling joints with the half-round wall,
the living room door must have minimum 1.50 meters wide and 2.10 meters high with their respective protectors for stretcher and
wheelchair impacts and with a glass visor at a height of 1.30 meters, with ventilation and natural lighting and/or mechanical ventilation.
2.15 Aseptic procedure room
Space intended for the care of uncontaminated patients, must have a minimum area of 12 M2, a pre washing and a support area
in which the report of the procedure carried out is presented, availability of special gas network outlets, electrical outlets necessary to
connect the required equipment. The finishes of walls, floors and ceilings should be made of durable material that is easy to clean,
using epoxy paint if possible; rounded corners, broom storage and ceiling joints with the wall, in a half-round shape. The door to the
room must have a minimum or 1.50 meters wide and 2.10 meters high with their respective protectors for stretcher and wheelchair
impacts and with a glass visor at a height of 1.30 meters, it must have ventilation and natural lighting and/or mechanical ventilation.
19
2.16 plaster room
15
"rr
5.80
Environment for patient care that must have a minimum area of 12 M2, a pre-wash, a plaster chamber, a materials warehouse, a
support area where the report of the procedure carried out is carried out, electrical outlets necessary to connect the required
equipment for this work. The finishes of walls, floors and ceilings must be made of durable, easy-to-clean material, which can be an
epoxy paint for walls and ceilings, rounded corners, broom guards and ceiling joints with the half-round wall. The door to the room
must be swinging at least 1.50 meters wide and 2.10 meters high with its respective protectors against impacts from stretchers and
wheelchairs and with a glass viewer at a height of 1.30 meters. and must have ventilation and natural lighting and/or ventilation
mechanical connection.
2
0
2.17 Respiratory Therapy Room
Environment intended for the care of patients with respiratory problems, its area depends on the number of users to be
served taking into account the study of supply and demand of the service; It must have stretchers or chairs to carry out the
necessary procedure for users, with a medical gas network, a pre-wash, storage of materials and an administrative area where
the report of the procedure carried out is carried out. The finishes of walls, floors and ceilings They should be made of durable
material that is easy to clean, preferably with epoxy paint; rounded corners, broom storage and ceiling joints with the half-
round wall. The door to the room must be a minimum of 1.50 meters. wide and 2.10 meters. high with their respective
protectors for stretcher and wheelchair impacts and with a glass visor at a height of 1.30 meters; In turn, it must have
ventilation and natural lighting and/or mechanical ventilation.
21
2.18 Observation Room

A. Observation cubicle.
B. Deposit.
C. Cleaning room.
D. Dirty clothes.
E. Dirty work.
F. Clean work.
G. Medicines.
H. Clean clothes.
Environment for patient care that remains under monitoring for a

period of no more than 24 hours, the size of the room is determined
by the study of supply and demand according to the number of
patients to be treated. Observation rooms should be considered if
necessary. independent sible for men men, women and children.
The observation room for adults (men and women) and the
observation room The pediatric ward must have a minimum area per
stretcher of 6 M2 (Resolution 4445 of 1996), medical gas outlets.
nals (Oxygen, air and vacuum), electrical outlets and electrical
lighting per stretcher or cubicle both in the ceiling and at the patient's
head and furniture to place the patient's belongings. The privacy of
the pa cient must be given by ele easy-to-move items such as
curtains that also allow They limit patient mobility and the
cleanliness and asepsis required in the service; a station in nursing
with its support environments which must have preferences ably a
direct line of sight to the patient in order to ensure easy monitoring
and complete patient baths.
2
2
A. Observation cubicle.
B. Deposit.
C. Cleaning room.
D. Dirty clothes.
E. Dirty work.
F. Clean work.
G. Baby tub.
H. Clean clothes.
I. Medicines.
Wall finishes, pi Floors and

ceilings must be made of durable,
easy-to-clean material. za, which
can be epoxy paint for walls and
ceilings, rounded corners, broom
guards and ceiling joints with the
half-round wall.
The door to the room must

swing at least 1.50 meters. wide
and 2.10 meters. high with their
respective protectors for stretcher
and wheelchair impacts and with a
glass visor at a height of 1.30
meters. and must have ventilation
and lighting natural nation and/or
mechanical ventilation.
23
in
2.19 Nursing station
A. Deposit.
B. Clean clothes.
C. Clean work.
D. Dirty work.
E. Dirty clothes.
F. Toilet room.
g. Medicines.
H. Attention.
I. Wash ducks.
Space intended for nursing support work delimited by a piece

of furniture that allows staff to carry out their support work with a
direct and visual relationship with patients and medical staff. The
station is proportional in size to the number of activities that are
going to be carried out there and must provide comfort to the
medical and paramedical personnel who are going to work there. It
must also have the environments required by standard and
function. ment with spaces for computer terminals and printers,
story cart, drawers, booths and other elements ments necessary
for the surveillance activity of medical and paramedical personnel.
Its use and location is exclusive to the service, with immediate
access for personnel who require it.
1
-----------2.55------------+——1 .20 —1.20 —
115 \l5 \15 \l5
2
4
2.20 Duck washing

Environment for washing ducks that are used in the observation rooms,
this space must have an area for the dishwashing basin, drying and storage of
these; and with a flushometer toilet, which allows the disposal of liquids.
Takes it out Furniture surfaces, walls, floors and ceilings must be easy to clean.
The joints between walls, floor - walls and ceiling - walls must be half-round.
Have lighting nation and ventilation.
Space intended for the cleaning of the elements used in the care of the
patient. cient, it must be an independent environment with a piece of furniture
with a lid, basin and splash made of resistant material, which allows washing
and disinfection. Low cabinet in ma dera lined with Formica or similar. Takes it
out Floors of this environment must be easy to clean both in walls, floors
and ceiling, with joints between walls, floor - walls and ceiling - half-round walls.
It must have ventilation and lighting.
2.21 Dirty work
25
2.22 Clean work Space intended for the preparation of

medications that are going to be supplied to
patients, must be an environment in which clerk
with furniture for high school ration of medicines
with a lid, container and dashboard made of
resistant material, which allows washing and
disinfection; and low wooden furniture covered in
Formica or simi lar. The finishes in this
environment must be easy to clean on walls,
floors and ceilings, with joints between walls, floor
- walls and ceiling - half-round walls. It must have
ventilation and lighting.
2.70
2.23 Nurses dressing room bathroom

Space for the staff's dressing room, which
allows the change of street clothes for work
clothes, must have a bathroom, locker and
storage area. tion of used clothing; The finishes
must be easy to clean, the joints between walls,
floor - walls and ceiling - walls must be half-round
and with natural or mechanical ventilation.
2
6
2.24 Medicine deposit

Space intended for the storage of medications required for patients of the
Service. It can be a room or a ble that allows the medications to be kept
under lock and key and its finishes must be easy to clean. za, like wood covered
in Formica or similar. It must have temperature and humidity control in order to
preserve the conditions. optimal tions of medications that require it.
27
2.25 Clean clothes deposit
Space intended for the storage of clean clothes

necessary for the service, it must have a resistant
2.26 Dirty clothes deposit piece
of
furniture that is easy to clean. piece that allows
clothes to be locked and organized, the furniture can
be made of wood, covered in Formica or similar and
must have good ventilation.
2
8
Space intended for the temporary storage of

dirty clothes that leave the Unit, you have ta that is
led to the laundry service, with easy-to-clean
finishes and a door; does not require furniture since
the clothes are sewn crazy in the comseros where it
is taken out of service. It must have good ventilation.
2.80
29
2.27 Equipment deposit

Area for storing equipment that is not in permanent use but that is
exclusive to the service, the space must have a location that allows the
equipment to be disposed of quickly. ask. This space must be provided with
electrical outlets that allow the batteries of the service equipment to be kept
recharged to provide an optimal and timely response to the needs
presented. It must have ventilation and lighting natural mination.
2.50
3
0
2.28 Medical Staff Star
3.80
Environment intended for the rest of the staff on duty, it must have a living room, furniture with a coffee maker installation, intercommunication system,
telephone and call for nurses.
31
2.29 Rest nurses on duty
1.20 *1.52*1.20
Environment for the rest of nurses on duty with an area for beds and a bathroom with a shower, it must be provided with a telephone and intercom system.
It must have ventilation and natural lighting and be located outside the aseptic area. It can be individual or collective according to service requirements.
3
2
2.30 Medical rest on duty
1.20•1.52*1.20
Environment for the doctor on duty to rest with an area for beds and a bathroom with a shower, it must be provided with a telephone and intercom system. It
must have natural ventilation and lighting and be located outside the aseptic area. It can be individual or collective according to service requirements.
33
2.31 Custody room
Space intended for the storage of elements that are part of the evidence and/or evidence in judicial proceedings carried out related to patients who enter the
emergency service. It must be a room that allows items to be kept locked and its finishes must be easy to clean, have natural and/or mechanical lighting and
ventilation.
3
4
2.32 Personal bathroom for men and women
009
The Service must have bathrooms for men and women of medical and paramedical personnel, which will be located located at a
point equidistant from all service environments.
35
2.33 Red wine room

IT
Space intended for the comfort of the personnel

who work in the service, must have a kitchen-type
furniture with a sink and backsplash made of resistant
material, which allows washing and disinfection, a
stove to heat red wines and furniture. Low wooden
base covered in Formica or similar. The finishes of
this environment must be easy to clean on walls,
floors and ceilings and must have ventilation and
lighting.
2.34 Bathroom
Space dedicated to storing cleaning items and

implements (rags, buckets, detergent). people,
among others) that are used only in the Emergency
1.10
Service; It must have a rag-washing basin. Pi

finishes floors and walls must be made of waterproof
material ble, resistant and easy to clean.
3
6
It is enough space to temporarily store the waste generated in the Emergency Service, which is identified in colored bags. Its
location must allow easy evacuation to the final or general hospital waste collection site, avoiding As far as possible, the crossing with
2.35 Temporary waste deposit
aseptic circulations, the finishes of floors and walls of
must be made of waterproof, resistant and easy-to-clean
material, you must have supplies tro of water for washing
the site and siphon. For sizing, the volume of waste
generated in the service must be taken into account.
1.10
37
3. Service Sizing
This must be based on the analysis of supply and demand of care that the population requires, percentage of occupancy. pation,
need for human resources to provide a timely response to this demand and support services at the service level, including the
availability or need for technology thereof, and the current standards that regulate the service must be taken into account. Based on
the analysis carried out, the Architectural Medical Program is projected that measures the need for physical installation in square
meters (M2).
3.1 Parameters for calculating stretchers for the Emergency Service

The number of stretchers in the observation rooms, as well as the number of assessment offices, is determined by the supply and
demand study of the Emergency Service. In adult observation, stretchers must be distributed separately by sex, with individual
bathrooms and showers.
3.2 Architectural Medical Program

It is the pre-sizing in areas, which corresponds to the necessary spaces or physical environments that must be taken into account
in the construction projects of a health institution, in accordance with the study of supply and quality. mandates and the current
regulations of the Health Sector.
In this Program, the physical spaces are related to the areas that require, the procedures that are necessary. They are located to
comply with the final activities, in accordance with the requirements of the current regulations of the Health Sector; and in its
preparation, at least a team made up of one or more health professionals must intervene according to the services that are going to be
intervened (Example: dentist, gynecologist, nurse, among others) and an architect with experience and knowledge of architecture.
hospital, in order to obtain a comprehensive approach.
To prepare this Program, the environments that make up the service, the mobi, must be taken into account. required number and
the number of users and patients who will occupy these spaces.
Considering physical aspects that facilitate the architectural schematization of the structure in its physical plant, the establishment
is divided into: Services, units and environments that are defined for the purposes of this study:
a) Environment: space in which a specific activity or several compatible activities are carried out. Example: reception, waiting
room, general medicine office, among others.
b) Unit: set of environments that fulfill different functions but with a coordinated and defined final objective. nest. Example:
external consultation.
c) Service: grouping of several units that carry out complementary final activities, capable of meeting (without mixing) due to
functional, administrative relationship needs or operational support. Example: am services bulatory.
For investment projects of remodeling, expansion, new construction, relocation and rearrangement works hospital physical
development, the architectural medical program must be attached, which must respond to the requirements given by the supply and
demand studies, the existing infrastructure and current regulations, as follows:
3.3 . Medical Architectural Programs Guides
Two Medical Architectural Programs are related, as guides for the pre-sizing of the Emergency services of low and high
complexity Hospitals.
3
8
Architectural medical program guide low complexity hospital
Qty. Area Partial area

No. Environments
A. M2 M2
1 Reception, control and police (Three jobs and archive) 1 11 11
2 Radio (Two jobs) 1 6 6
4 Billing and cashier office (Two workstations, bathroom and file) 1 8 8
5 Coordination Office (Includes meeting room and bathroom) 1 17 17
6 Customer service or social work office 1 15 15
7 Waiting room (40 people - 1 M2 per person) 40 1 40
Battery of public bathrooms for men and women (Four sanitary units, including for the
8 1 14 14
disabled)
9 Parking for stretchers and wheelchairs. (A stretcher and a chair) 1 4 4

10 Triage Office 1 12 12
11 Pediatric assessment office with bathroom 1 17 17
12 Adult assessment office with bathroom 1 17 17
13 Obstetrics and Gynecology assessment office with bathroom 1 17 17
14 resuscitation room 1 14 14
15 Shower stretcher 1 5 5
16 Procedure room (Two stretchers) 2 10 20
17 Aseptic procedure room (One stretcher) 1 12 12
18 Plaster Room 1 12 12
Respiratory therapy room for three children (Includes stretcher, material washing, bathroom
19 1 17 17
and storage room)
20 Children's observation room 4 6 24
21 Women observation room 4 6 24
22 Men's observation room 4 6 24
23 Bathroom for children, women and men (Three rooms) 3 3 9

24 Nurse station:
a) Attention 1 10 10
b) Duck washing 1 5 5
c) Dirty work 1 5 5
d) Clean work 1 5 5
e) Bathroom-dressing room for nurses 1 5 5
f) Medicine deposit 1 5 5
25 Clean clothes deposit 1 6 6
26 Dirty clothes deposit 1 6 6
27 Equipment warehouse 1 6 6
28 Being a medical staff 1 13 13
29 Rest for nurses on duty, with dressing room and full bathroom 1 15 15
30 Rest for the doctor on duty, with dressing room and full bathroom 1 15 15
31 Custody room 1 6 6
32 Personal bathroom for men and women 1 13 13
33 Red wine room 1 3 3
34 Cleaning room 1 2 2
35 Temporary waste deposit 1 2 2
SUBTOTAL EMERGENCY SERVICE 461
WALLS AND CIRCULATIONS 35% 161
TOTAL EMERGENCY SERVICE 622
39
Highly complex hospital guide architectural medical program

No. Atmosphere
A. M2 M2
ADULT EMERGENCIES
1 Reception, control and police (Four jobs and archive) 1 14 14
2 Radio (Two jobs) 1 6 6

3 Box (Three workstations, bathroom and file) 1 9 9
4 Billing Office (Four jobs and file) 1 14 14
5 Coordination Office (Includes meeting room and bathroom) 1 17 17
6 Customer service or social work office 1 15 15
7 Waiting room (60 people - 1 M2 per person) 60 1 60

Battery of public bathrooms for men and women (Six sanitary units includes disabled
8 1 21 21
people)
9 Parking for stretchers and wheelchairs. (Two stretchers and two chairs) 1 8 8
11 Surgery office with bathroom 1 17 17
12 Internal Medicine Office 3 17 51
13 Obstetrics and Gynecology assessment office with bathroom. 1 17 17
16 Procedure room (Two stretchers). 2 10 20

Respiratory therapy room for four adults (Includes stretcher, material washing,
19 1 18 18
bathroom and storage room)
20 Women's observation room (Viente stretchers) 20 6 120
21 Men's observation room (Twenty stretchers) 20 6 120
22 Bathroom for children, women and men patients (Two rooms) 2 3 6
23 Isolated (Two cubicles) 2 12 24
24 Nurse station: 0
c) Dirty work 1 5 5
d) Clean work 1 5 5
SUBTOTAL 685
TOTAL 925
4
0

No. Atmosphere
A. M2 M2
PEDIATRICS EMERGENCIES
1 Waiting room (Thirty people - 1 M2 per person) 30 1 30

2 Battery of public bathrooms (Three sanitary units includes disabled people) 1 10 10
3 Parking for stretchers and wheelchairs. (A stretcher and a chair) 1 4 4
5 Assessment office with bathroom 3 17 51
8 Procedure room (Two stretchers) 2 10 20
Respiratory therapy room for six children (Includes stretcher, material washing, bathroom
11 1 20 20
and storage room)
12 Children's observation room (Six stretchers) 6 6 36

13 Isolated (A cubicle) 1 12 12
14 Bathroom patients children 2 3 6
15 Nurse station:
c) Dirty work 1 5 5
d) Clean work 1 5 5
SUBTOTAL 303
TOTAL 409
EMERGENCY SUPPORT ENVIRONMENTS
1 Clean clothes deposit 1 6 6
2 Dirty clothes deposit 1 6 6
3 Equipment warehouse 1 6 6
4 Being a medical staff 1 13 13
5 Rest for nurses on duty with dressing room and full bathroom 1 15 15
6 Rest for the doctor on duty with dressing room and full bathroom 1 15 15
7 Custody room 1 6 6
8 Personal bathroom for men and women 1 13 13
9 Red wine room 1 3 3
10 Cleaning room 1 2 2
11 Temporary waste deposit 1 2 2

SUBTOTAL 87
TOTAL 117
TOTAL 1.451
41
4. Service Design
In accordance with the architectural medical program of the Emergency Service, resulting from the study of supply and demand
and the scope of the service provision, the design is prepared, taking into account, among others, the following aspects:
4.1 Location:
It must correspond to the characteristics of the terrain, such as shape, topography, access roads and orientation, to have direct
access from the street, both pedestrian and vehicular through squares and access bays for private cars and ambulances, to avoid
barriers. architectural and achieve good ventilation and natural lighting.
4.2 Interfunctional relationships:

The zoning of services must be taken into account within the Unit, so that the interfunctional relationships that are required with
the Surgery Services, Intensive Care Unit, Gynecology and Obstetrics and with the Support and Diagnostic services (Imaging,
Patient Waiting
access room TRIAG Observation
E
Laboratory Clinical, Pathology Laboratory) which can be horizontal or vertical (By elevator).
General services
4
2
4.3 Zoning:
In this, the following must be taken into account at least:
a) The independent functioning of the access areas and the care area with their respective environments, such as:
ACCESS AREA CARE AREA
• Waiting room. • Assessment Clinics.

• Police and Radio Control. • Procedures Room.
• Billing and Cash. • Resuscitation room.
• Triage. • Observation Room.
• User Support. • Other service environments.
b) In accesses and circulations, patients, public, administrative staff and general services must be differentiated; and they must
function as an independent integral unit, but at the same time, functionally interrelated with the other services of the hospital.
c) The zoning scheme must respond to the operation of the service, the patient must have privacy and their movement must be quick
and without obstacles through circulations independent of those used by the public and administrative staff.
d) Independent environments must be considered for use, related to each other, according to the operation and the requirements of
the standard.
Wait and
Adult emergencies
bathroo
ms
public Nursing and Observation
TRIAGE Offices support areas and areas of
support
Stretcher shower ERA

Revival and procedures
Control, roo
Access information, m
offices Stretcher shower ERA
Revival and procedures roo
m
Observation
Nursing and and areas of
TRIAGE Offices support areas support
Wait and
bathrooms
public
Pediatric emergencies
4.4 . Design overview and specifications:

a) Access and circulations: circulations must be wide and with walls protected with stretcher guards of 15 to .20 cm. wide installed at
a height of .90 cm. of the floor, the floor must be non-slip, made of resistant material, easy to clean and has a broom holder in the
middle, there must be good lighting so that transportation patient care is fast, comfortable and safe. The width of the corridors is
1.40 m. At a minimum, the ceiling must be installed at a height of 2.60 or more meters from the finished floor to allow air circulation
to ventilate the environment.
43
To transport the patient vertically, you must have a stretcher lift that meets the dimensions minimum sions for this purpose and
preferably that it be used exclusively for the movement of patients and medical personnel.
The doors must have a height of 2.10 meters and with appropriate specifications for each environment, taking into account the
minimum specifications of smooth and easy-to-clean finishes. The access door to the Emergency Service through the public area
must have a minimum width of 1.50 meters, with a viewer, stretcher guard and lock. Internal doors that have a functional
relationship with other services that are only for patient management must be swinging and have a minimum width of 1.50 meters
with a viewer and stretcher guard. This same specification applies to the doors of the procedure rooms and observation rooms. .
The doors of deposits, clean clothes, dirty clothes and bathrooms must have blinds at the bottom that allow ventilation of these
environments. Clean work, dirty work and staff doors should preferably have a viewer or glass at the top of the door.
b) Communications systems and computerized registration: the Emergency Service must have a communications system that
facilitates the call of auditory and visual personnel between the nursing center, patient modules, isolation rooms, conference
rooms, staff lounges. , visiting rooms, pharmacy and laboratory clinical thorium.
At the hospital level, there must be an internal and external communications system for emergency cases, when failures occur in
the normal system.
The computerized registration system consists of patient management, with network consultations and diagnoses, which allow
observing the results of the diagnostic services examinations, information data management, entry and exit orders, etc. Integrating
all activities and thus making the personnel involved in patient care aware of the decisions made in the treatment.
c) Finishes: in public waiting and circulation areas, the materials for walls and floors must be resistant and easy to clean; The walls
must be protected with stretcher guards of 15 to 20 centimeters, made of resistant material at a height of 90 centimeters from the
finished floor to the axis of the stretcher guard. The floor finish must be heavy traffic and easy to clean; The ceiling must be
smooth, made of a non-combustible, non-stick material and must be at a minimum height from the floor of 2.50 meters to allow for
airy environments.
Floor finishes in clinics, offices and warehouses must be resistant, non-slip, that do not generate noise and are easy to clean.
Finishes for walls, floors and ceilings in resuscitation rooms; septic and aseptic procedures and observation rooms must be made
of durable, easy-to-clean material, which can be epoxy paint or similar for walls and ceilings, with rounded corners, broom guards
and ceiling joints with the wall, in a half-round.
The door to the resuscitation room must be swinging and be at least 1.50 meters wide and 2.10 meters wide. high, with their
respective bump protectors for stretchers and wheelchairs and with a glass visor at a height of 1.30 meters.
Lighting for all environments must be adequate and sufficient, with natural lighting and ventilation and/or mechanical ventilation.
d) Door and furniture details:
4
4
• DOORS:
45
5. Generalities of the design of the Service regarding the seismic vulnerability of buildings hospital conditions
a) Generalities: it is important that the entities and people involved in the planning, projection and construction of a hospital or health
service provider entity take into account the seismic vulnerability of the construction. tion from the conception of the design. In Law
400 of 1998, the requirement to prepare a seismic vulnerability study of the building is contemplated for existing constructions
whose use is classified as Essential and Community Care Buildings, taking into account that the Institutions Providing Health
Services , must work in earthquake-resistant buildings.
In the particular case of Hospitals, it is of great importance to consider earthquake-resistant structural studies and strict
compliance with the current standard, the application of the new NSR/10 earthquake resistance code, in the same way it must be
left clearly established from the design evacuation routes and signal alternatives lization, for the following reasons:
• The facilities must be kept intact, as much as possible, in the event of an earthquake, due to their importance for disaster relief
in the city. This concerns both structural and non-structural elements.
• At the time of an earthquake, hospitals house a large number of patients who are unfit for EVA. Therefore, for this reason, non-
structural elements must remain fully operational, without generating a risk to them.
• Hospitals have a complex network of facilities and expensive equipment, essential for operation and emergency care, which
must remain intact to avoid a functional collapse of the institution.
• The Hospital must have a 40% free area corresponding to isolation, green areas and parking spaces; in such a way that they
can be considered as contingency areas in an eventual arrival of pro-patients. pipeline of natural disasters or accidents
involving a large number of people and that is outside the normal scope of the Emergency Service, this in order to serve as an
area for pre-hospital care, classification of injured or triage, or at a given moment of care to the patients. Due to the above, part
of the free areas must be immediate to the emergency service with easy connection to the water, electricity, air, oxygen and
vacuum services, so that it can be implemented at a certain time of emergency. tent, or war. Having free areas provided with
service points, special for staying outdoors, expands medical care with mobile hospitals.
• Diagnostic and treatment support services must be close to the Emergency Department and at a certain time provide support
for expansion in the event of an emergency.
• The Physiotherapy rooms offer very positive conditions as areas of expansion of the emergency service in emergency
conditions due to large-scale disasters, as they are internally related to the emergency service and with the possibility of direct
access from the street, avoiding congestion to the arrival of patients, a situation to be taken into account from the design.
Regarding the aseptic conditions and the size of the areas, they are also very appropriate as an expansion area.
b) Non-structural seismic vulnerability: refers to non-structural construction elements such as masonry, floors, ceilings, finishes,
water supply networks, sewage, electrical, voice and data networks, mechanical ventilation, special gas networks, gas home,
among others, as well as the equipment and accessories contained in a hospital construction. For this reason, in the design of the
structure, it must be considered Provide the necessary supports so that the movements caused by the earthquake do not present
ruptures that paralyze the normal provision of the service.
There are non-structural components that can have a significant effect on the good structural response of a building during an
earthquake, even if the building has an earthquake-resistant design. These are:
• Heavy equipment: such as air conditioning, medical scanners, among others, can significantly change the dynamic response of a
building to an earthquake or earthquake. Such exceptional loads may generate additional stresses on roofs and floors that may
cause failure.
These additional weights may produce eccentric forces that subject the building to rotation modes during an earthquake. For this
reason, regarding heavy equipment, it is worth emphasizing or taking into account that they must be anchored to a structural
element to prevent it from sliding or overturns causing structural damage and loss of life.
Hospital equipment must be properly secured so that it is not hit by earthquakes, endangering the safety of patients and staff. The
47
fixing elements to walls or ceilings must be adequately anchored so that they do not become detached and are thrown into the void
in the event of an earthquake.
• Architectural elements: unreinforced masonry is not considered a structural part, although it does give rigidity. dez to the building.
Therefore, it is of vital importance to consider them in the earthquake-resistant structural design.
In the same way, façade coverings can fall during a telluric movement; it is advisable to take them into account in structural
calculations since these could cause total or partial collapse.
In hospital buildings that have platforms, the impact of telluric movements on facades must be considered, which can weaken their
finishes on the upper floors and fall causing great damage.
• Mechanical installations: care must be taken that these respect the construction joints and shear walls provided for in the
earthquake-resistant structural design, that is, that the freedom of movement due to the expansion between constructions is not lost
due to the rigidity of the mechanical installations.
• Water and electricity supply installations: in relation to these, they are vulnerable points in the event of an earthquake and in most
cases they are located in the hallways through the false ceiling; Special care must be taken in the construction aspects using
special supports anchored to the plates to prevent these installations from falling to the floor in an earthquake, becoming a risk
element by obstructing passage through the hallways or affecting people who are in the area. at the time of the disaster are located
or transit through these sectors.
As for the vertical ducts, they must have sufficient space and be located in such a way that they absorb seismic movements. It is
important to provide inspection doors in these ducts that allow access to change affected parts.
Hydraulic installations must consider the use of materials such as flexible hoses, connections nes with rotary movements and
automatic interruption valves.
For electrical installations, flexible conductors, cables and rigid closure connectors must be considered.
• Furniture: in a hospital, these must be secured so that they are not hit by telu movements. rich, endangering the integrity of patients
and staff. The fixing elements to walls or ceilings must be adequately anchored so that they do not become detached and are
thrown into the void in the event of an earthquake.
• Signage: it is one of the most important tools in a hospital, not only for the orientation of users when going to services, but also in
the process of evacuating the building at the time of disasters. Its location must be strategic and indicate evacuation routes to
emergency stairs, alternative exits designed especially for these cases. In addition, the location of fire extinguishers, hose racks
and fire equipment must be clearly identified; fire doors and walls in the event that these exist, emergency telephone numbers,
among others. Good evacuation of the building largely depends on good signage. The signage must not only cover the interior of
the building, but must also include the exterior, the surrounding urban fabric, in such a way that the location of the hospital is known
and identified by citizens from anywhere in the city.
c) Application of the hospital safety index: it is important to apply the tool developed by PAHO-WHO to existing designs or
construction, whose purpose is to have a guidance document for the calculation of the hospital safety index, which allows
establishing the capacity of the establishment. to continue providing services after an adverse event of natural origin has occurred
and guide the necessary intervention actions to increase their safety in the face of disasters.
The objectives of the Guide are:

• Guide professionals to apply the safe hospitals checklist, in order to preliminarily determine the probability that the health facility
can continue to operate in the post-disaster stage or cannot do so, through its safety level , in an objective and standardized
manner.
• Guide actions and make recommendations to entities, based on the data obtained on the measures necessary measures to
increase hospital safety.
• Facilitate the registration, classification and systematization of information on the capacity of the health facility, individually and
as part of a health services network.
• Support the formation, development and growth of interdisciplinary groups of experts committed to risk reduction and disaster
assistance.
4
8
Bibliography
• Design for Obstetric and facilities a guide to architectural planning of hospital facilities for care of mothers, babies, and children.
Written by Bruce M. Thogmartin [and] Michael D. Tyne; edited by James E. Jeffries [and] Robert A. Dell.
• Ross Laboratories Columbus Ohio.
• ISAZA, Pablo and Arq. SANTRA, Carlos. Hospital Design Guides for Latin America, Pan American Health Organization, World
Health Organization, 1991.
• MINISTRY OF SOCIAL PROTECTION. Resolution 4445 of 1996.
• MINISTRY OF SOCIAL PROTECTION Resolution 1083 of 2006.
• Pan American Health Organization, Regional Office of the World Organization. Disaster Mitigation in Health Facilities, Architectural
Aspects. Volume 3, 1993.
• National Seminar on Hospital Architecture and Engineering. Villa de Leiva. Nov. 26-29 of 1997.
• American Society Intensive Care Unit Seminar, New York, January 1999.
49
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Health Equipment Master Plan

Guide Manual for

District Health Secretary

District Undersecretary of Health

Director of Health Services Development

Health Services Analysis and Policy Area Coordination

General Document Coordination

Technical Support Group- PMES

Design and layout

District Health Secretariat Carrera 32 No. 12-81

Legal Framework of Reference

• LAW 09 of 1979 - Health Code

• LAW 100 OF 1993

• RESOLUTION 4445 OF DECEMBER 2, 1996, OF THE MINISTRY OF SOCIAL PROTECTION

• DECREE 1011 OF 2006 OF THE MINISTRY OF SOCIAL PROTECTION

• RESOLUTION 0686 OF 1998 OF THE DISTRICT SECRETARY OF HEALTH

• LAW 400 of 1997 and NSR OF 1998 - DECREE 33 OF 1998

• RESOLUTION 1043 OF 2006

• RESOLUTION 2680 OF 2007

• RESOLUTION 3763 OF 2007

• RESOLUTION 1448 OF 2006

• RESOLUTION 1315 OF 2006

• RESOLUTION 4796 OF 2008

• CIRCULAR 0076 OF 2007

• RESOLUTION 1403 OF 2007

• AGREEMENT 20 OF 1995 OF THE COUNCIL OF SANTA FE OF BOGOTÁ

This service must meet at least the following conditions:

2. Description of the Service environments

2.2 Reception and control

2.3 Police station

2.4 Radio and communication

2.5 Billing and cash office

It must have an intercom system and telephone.

2.6 Coordination Office

2.7 User service or social work

2.8 Waiting room and public bathroom battery

2.80 It is the area intended for the public and

to the waiting room.

2.9 Stretcher and wheelchair

Place intended for the permanence of

2.10 Triage Office

2.11 Typical valuation office

Yo---------------------------------------4.05----------------------------------------------------------------- Yo-----1.00 -------------•,25 i-

2.12 Resuscitation Room

2.13 Patient washing and/or stretcher shower

Environment intended for washing the patient who arrives into

2.14 Septic Procedures Room

2.15 Aseptic procedure room

2.16 plaster room

2.17 Respiratory Therapy Room

2.18 Observation Room

Environment for patient care that remains under monitoring for a

Wall finishes, pi Floors and

The door to the room must

2.19 Nursing station

Space intended for nursing support work delimited by a piece

2.20 Duck washing

2.21 Dirty work

2.22 Clean work Space intended for the preparation of

2.23 Nurses dressing room bathroom

2.24 Medicine deposit

2.25 Clean clothes deposit

Space intended for the storage of clean clothes