HEALTHCARE FACILITIES CODES

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HEALTHCARE FACILITIES CODES STANDARDSFORDESIGN
AND CONSTRUCTION
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HEALTCARE FACILITIESPresented by

• Jon Cechvala, Architect, AHJ Emeritus
• Eppstein Uhen Architects, Milwaukee/Madison
• Dave Soens, P.E,- R. A. AHJ/Consultant
• Provider Regulation Quality Assurance Section-
  BQA State of Wisconsin
• Wade Rudolph, CBET
• Wisconsin Health Care Engineer Codes Standards
  Committee Chairman

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Health Care Facilities

• Hyperbaric Chambers
• Design and Installations

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Classifications of Chambers

• Class A- Human, Multiple Occupancy
• Class B- Human, Single Occupancy
• Class C- Animal, no Human Occupancy
• Note If animal, but, access for personal care,
  then classified as Class A

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Hyperbaric Oxygenation

• Defined as The application of pure oxygen or an
  oxygen enriched gaseous mixture to a subject at
  elevated pressure
• Used to treat variety of nonhealing conditions
  such as diabetic ulcers, failing skin flaps, and
  osteoradionecrosis of the mandible

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Hyperbaric

• Definition
• Pressures above the Atmospheric Pressure

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Noncombustible (hyperbaric)

• Defined as a Substance that will Not Burn In 95
  5 Oxygen Concentration
• at Pressures up to 3 ATA (44.1 psia).

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Oxygen Toxicity (Hyperbaric)

• Physical impairment resulting from Breathing
  Gaseous Mixtures containing Oxygen Enriched
  Atmospheres at Elevated Partial Pressures for
  extended periods of time.
• Two types
• Pulmonary
• Central Nervous System
• Easily controlled with well established safety
  practices

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Electrical Hazards

• Electrical Hazard Potential
• Ignition sources includes
• Broken Light Bulb Elements
• Switches
• Overheated Motors
• Electrical Thermostats
• Static Sparks
• Childrens sparking type Toys

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Fire Hazards

• Due to Increase of Oxygen Levels
• -Flammability and Combustibility Increase
• Products normally not a Risk will become One
• Human Tissue becomes Combustible
• 20 seconds or less to Burn Clothes
• Oil based Cosmetics become Extremely Flammable

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Other Hazards

• Explosive Hazards
• Fires create Heat and Additional Pressures that
  Exceed the Structural Limits of the Vessel
• Implosive Hazards
• Collapse of Light Bulbs
• Overloading Fan Motor
• Health Hazards Oxygen Toxicity

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Construction Requirements

• Class A Chambers inside of a Building
• Required 2 -hour Fire Rated Construction Fire
  Barrier
• Fire Doors 1 ½ hour Fire Rating
• Wet pipe Sprinkler System per NFPA 13
• Chamber Room Heads shall be Fusible, as low
  temperature rating as possible, consistent with
  protection against false operation
• Flooring shall be Noncombustible and Antistatic
• Finishes and Furnishings shall be Flame Resistant

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Construction Requirements

• Class A and B Chambers
• Room or Rooms shall be Exclusive for this use.
• Supporting Foundation shall support Chamber which
  includes an on Site Hydrostatic Test.
• Illumination
• Provided from Outside the Pressure Vessel unless
  specially designed i.e. explosion proof.
• Emergency Lighting shall be provided

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Construction Requirements

• Chamber ventilation Class A and Class B
• If used for operations, vessel shall meet minimum
  requirements for Anesthetizing locations
• Recommend Humidity Controls of 50 70 for Static
  Control
• Minimum shall be 3cfm actual per Occupant
• If Anesthetic Agents used, must provide Closed
  Anesthetic System with Gas Scavenging
• No Flammable Anesthetics allowed
• Individual Breathing Apparatus required for Each
  Occupant in and Key Staff Outside of Chamber
• Special Issues regarding Air used in the Chamber
• Compressors shall produce Medical Air and be
  monitored
• Dual Compressors served from 2 Electrical Branches

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Construction Requirements

• Fire Protection in Class A
• Independently supplied Handline and Deluge System
  shall be installed, which, upon activation shall
  activate Visual and Audible Indicators at
  Operators Console
• And Disconnects Ungrounded Leads in Chamber. But
  not the Communication systems. Emergency Lighting
  and Communications shall be activated.
• Fire alarm Signaling Device(s) shall be at the
  Operators Station
• Booster pumps, Control Circuit for Fire
  Suppression shall be connected to the Critical
  Electrical Branch

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Deluge System RequirementsClass A

• Manual Activation and Deactivation Controls
  inside Chamber and at Control Console
• Water shall be delivered in less than 3 Seconds
  at a minimum of 2 gal/ sq. ft for at least one
  minute
• Shall have stored Pressure to Operate for 15
  Seconds without Electrical Branch Power
• Deluge System shall be Tested Annually.

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Handline System RequirementsClass A

• Shall be at least ½ inch internal diameter with
  rated working pressure greater than the supply
  pressure of the system
• Activated by quick opening ¼ turn valve located
  within the chamber
• Shall have override valves outside chamber
• Shall have supply pressure 50 psi over chamber
  maximum pressure
• Shall provide minimum of 5 gpm for two lines at
  maximum chamber pressure
• Tested annually

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Automatic Detection SystemClass A

• Are optional, but if provided must meet the
  following
• Shall respond within 1 second of flame
  origination
• Number of detectors depends on configuration and
  sensitivity of detector
• Shall have automatic battery back up power or be
  supplied by critical branch of emergency
  electrical system
• Can be used to active deluge system
• Shall include self monitoring functions for fault
  alarms

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Fire Protection for Class B and C

• No requirements for fire protection
• Has not been proven to be effective in these
  applications
• Chamber must be vented to the outside of the
  building

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Electrical System RequirementsClass A

• All controls shall be outside of and in the
  vicinity of the chamber.
• All components (line fuses, circuit breakers,
  controllers, relays, transformers, ballasts,
  lighting panels, power panels) shall be located
  outside of pressure chamber.
• If sprinkler is activated the electrical
  equipment shall be protected so to safely
  decompress the chamber.
• Two sources of power are required
• If unit not in hospital, then NFPA 70 article 700
  applies

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Electrical System RequirementsClass A

• Equipment for Life Support shall be connected to
  Critical Branch circuits of Emergency Power
  System (restored in less than 10 seconds)
• Compressors, motors, and equipment located
  outside of chamber shall be connected to the
  Equipment system or the Emergency system
• Designed such to Prevent Hazardous condition
  during outage or Restoration of Power

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Electrical System RequirementsClass A

• Conductors inside the Chamber must be Insulated
  with Flame Resistant Materials
• Fixed Wiring shall be in threaded RMC or IMC
  conduit using Waterproof Materials and Methods
• Means to Drain Conduits shall be Provided
• Receptacles and Switches shall be Waterproof and
  Prohibit Sparks in the Chamber
• In Healthcare Facilities power require isolated
  Power
• All Permanent Furniture shall be Grounded

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Electrical System RequirementsClass B

• Electrical Equipment inside Chamber limited to
  Communication and Physiological Monitoring only.

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Communications and Monitoring

• Intercommunications
• Combustible gas detection
• Oxygen monitoring
• Carbon Dioxide monitoring
• Chamber gas supply monitoring

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AIA Guidelines for Construction and Design of
Health Care Facilities

• Hyperbaric Suite Recommendations
• Included in Appendix Section

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AIA-General Requirements

• Chambers constructed according to ASME PVHO-1
  Safety Standard for Pressure Vessels for Human
  Occupancy and carry a U stamp
• Shall meet NFPA 99 chapter 20
• Shall meet NFPA 101 chapter 12

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AIA- Suggested Service Areas

• Reception/Control Desk
• Patient Waiting area
• Holding Area (room or alcove outside of normal
  traffic flow)
• Patient Records storage area
• Patient Restroom
• Patient Dressing Room
• Staff Toilet Room
• Consultation/Treatment Room
• Storage Space
• Soiled Holding Area
• Staff Hand Washing Station
• Housekeeping Room
• Gas Cylinder Room
• Compressor Room

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AIA-Multiplace (Class A) Chambers

• Facility should be Designed to allow Rapid
  Evacuation
• The Rapid Removal of One Chamber Occupant shall
  not restrict the Simultaneous Removal of Patients
  from all other Chambers/Compartments

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AIA-Multiplace (Class A) Chambers

• Minimum Clearances
• Chamber entry should accommodate Gurney Access
  10 feet
• If Access Ramps provided it shall be Flush with
  Chamber Entry Door
• Chambers be designed to allow Immediate Removal
  of Patients upon Depressurization
• Chamber Man Lock Entries shall have 4 feet clear
• Access between the Chamber and Control Console
  shall be 4 feet wide

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AIA-Monoplace (Class B) Chambers

• The Rapid Removal of One Chambers Occupants
  shall not Restrict the Simultaneous Removal of
  Patients from all other Chambers or Chamber
  Compartments
• A Minimum of 2 Exits shall be provided from
  Chamber Room unless a Direct Exit is Provided to
  an Exit Access Corridor
• Exit door shall be 46 inches minimum opening
• Space shall comply with NFPA 99 Chapter 20

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AIA-Monoplace (Class B) Chambers

• Minimum Clearances
• Chamber and Sidewall 18 inches
• Chamber and Sidewall -if Controls present on Wall
  Side 36 inches
• Between 2 Chambers 4 feet
• Between Backside of 2 Chambers 2 feet
• At Foot of Chamber 14 inches
• At Head of Chamber 8 feet 6 inches
• Any Electrical Receptacle within 10 feet of
  Chamber shall be located no less than 36 inches
  AFF