Design and construction of clean operating room
1 Overview
Than to come with the growth of the economy, people's living level wide forward a few years, with the transition from subsistence to former times the health-based. The more people on the health front, must request to accelerate medical conditions and medical walking method improvements. At the same time with the growth of technology, new ideas and new technologies are received and a large number of operations, which created conditions for a brilliant medical sight and improved hospital medical walking method of creation, but also on the hospital's medical walking method made more high request. Especially the design of the hospital operating room made a new request. From a hundred years ago, the earliest British doctors Listeria infectious agents familiar to the suspension of the operation of hazardous dip, to thirty years of this century, sterile craft widely received, to the moment laminar flow technology operations, which are confirmed after contamination rates with air cleanliness is directly related to the operating room air is clean and efficient processor preparation has been put on the agenda.
2, in former times in former times substantially all domestic hospital surgery unit relatively simple, clean and non-surgical unit foundation, an important basis for disinfectant to sterilize, easy to produce interspersed infection.
In terms of temperature control is used Window fan coil air harmony of transfers. The window air conditioners himself is a source of dust hair bacteria, the number of long-term action causes house dust and bacteria concentration increased. Popular fan coil and drain pan before it was a source of infection, easily fouling bacteria, especially in the summer there is the risk of infection indoor air. At the same fan coil repair and nursed back to health are in the room, not only will affect the operation rate of the operating room, but due to multiple operating easily leak pipe fittings, and maintenance due to the water in the fan coil inside the machine are easy disassembly Ceiling infection secondary infection, so use these two kinds of situations can not be used in a clean, air-conditioned theater. In addition there is a wide range of lower Furthermore air conditioning system, lack of fresh air for these systems, air volume is not enough, there are bound to be difficult to meet the cleanliness requested surgery performed.
At the same time the building structure there are no rationality, it is important to purge the line regardless implied. After surgery dirt and sterile surgical instruments and a doctor from the same corridor and out, so it is easy to produce interspersed infection.
Based on the above picture, in former times within the Department of Surgery domestic rarely composed fair and orderly spread positive pressure air distribution.
3, operating room structure to comply with reasonable success stories of foreign operating room and "Clean hospital surgery unit construction craft standard GB50333-2002" request new surgical area must comply with the principles of the structure of the three districts brutal two-channel (ie surgical area, sponsorship areas, Other space area, clean walkways and quasi clean and walkways) preoperative and postoperative staff and sterile items from a clean walkway through the process, after the dirt from the dirt path through the process, so that the dirt can clean up after surgery, respectively, in real time was at the processor, from the foundation to cut the likelihood of infection interludes, but also the flat structure more reasonable, to the construction plane and air conditioning system organically associated together, so that both the request and the appropriate technology to meet the purification hospital architectural design and RBI request.
4, clean design
4.1 purification moderation policy and points
Purification design approach is through the process of purifying the land ban outdoor design infectious agents invade the room, landing after contamination rate, while active infection usefully eliminate indoor air, to prevent bacteria respectively.
Comply with design guidelines, front following in the hospital operating room design:
A compilation of useful air filters to remove bacteria and dust into the air.
B Airflow usefully rely on dilution of interest dispute except medical staff of dust (bacteria), indoor, especially the moment to achieve a high degree of sterility site.
C control pressure gradient good surgery within the Department to ensure fair air flow and pressure differences between regions spreading, prevent the intrusion of outside infectious agents.
D department again and again the appropriate temperature and humidity, the amount of bacteria and landing of human hair indoor bacteria.
E Useful exhaust gas and harmful gases, protect the indoor air chic and air qualities.
4.2 reasonable airflow organization
Well known surgery is directly related to the life and safety of patients, surgery depends largely on the growth of contaminated surgical control technology growth. In Europe and other developed countries, which are all-air system operating room. ASHRAE guidelines adopted six early years provision, with a new air system. Each surgery unit ventilators 8-12 times. Room temperature, 25.6 degrees, relative humidity of 55%. Indoor ventilation exhaust manifold to accumulate, to dominate the whole heat exchanger before accepting received exhausted to the outside. With the growth of the craft, to seventy years promised to circulating indoor air operations, increased to 25 times the number of ventilators, fresh air a minimum of 5 times, the individual will be taken back to the wind to the maximum. China in 88 years in October released the industry standard JGJ49-88 "General Hospital architectural design standards", Rong-line publication "Rong-line hospital surgical unit building and clean technology standard" in 95 years. Compliance with these two standards and "a clean surgical hospital unit construction craft standard GB50333-2002" reference related materials from abroad and to improve the design of the purification system suitable conditions. In this system, with a new air handling units independent of the supply of fresh air in each operating room, due to the higher concentration of dust in the air in Shanghai, set up a new independent air unit can often be conveniently cleaned up early effect filters, and replaced with a new fan outlet true one in effect filter, thus preventing efficient operation unit or sub-efficient filter replacement often caused large economic losses. In the surgery unit, high efficiency filters ceiling placed on both sides away from the high altitude does not exceed 500mm placed at the return air, so that justice can organize indoor air, indoor bacterial particles prevent the accumulation of savings and airflow through the justice process to be active discharge to ensure cleanliness chamber. And sent back to the preparation side of the operating table is set so that in the core area of the operating room, the doctors and staff concerned in the second side of the operating table, the air from the upper air sent by the operating table and then back from both sides, so to maximize the guarantee a high degree of sterility of the operating table.
4.3 temperature, humidity and pressure control
Comply with "a clean surgical hospital unit construction craft standard GB50333-2002" requests the operating room temperature and humidity must be restrained within a certain size, based on the design set in the operating room temperature t = 22-25 ℃; relative humidity 35-60 %, following disagreements size room set up equipment to place the response of the air conditioner and humidifier.
Comply with the principle of two-channel three-zone structure, the pressure the Department of Surgery of descending listed as extraordinary operating room, the individual operating room, clean corridors, vertical channel and dirt gallery. Clean purification level corridor of lower than or equal to the individual operating room, so the pressure difference between the two. Dirt gallery is full surgical unit in the operating room on the lowest level so the pressure is greater than the dirt gallery 5Pa. This can guarantee a fair inter-regional differences in air flow and to prevent the intrusion of outside infection.
For the theater is concerned, in order to maintain cleanliness of my room, from the next room of the infection, shall adjoining link relatively high air pressure, the relative adjoining link a positive static pressure difference. Static pressure difference exists played under the doors, windows closed the scene to prevent outside air from entering cracks and clean room. In addition, when the door open, outward airflow should be sufficient activities, the people instantaneously into the air landing infection to a minimum. Comply with "clean air craft preparation of" provisions, to prevent penetration of cracks, individual two adjacent rooms should be kept 5Pa of pressure, but should be linked to outdoor 15Pa pressure difference. Of 100 operating room, according to the "clean room construction inspection standards", which increased pressure to open the door, 0.6 meters away from the door at the request of not less cleanliness must be met is to protect the gas when the door opened transient people into not 0.6 meters deep outside the door of the premises. Air swap design manual stipulates that individual a clean room workspace at 0.8-1.5 meters from the ground. Vertical laminar flow operating flow rate of 0.25-0.3m / s, "hospital clean, surgical unit construction craft standard GB50333-2002" The door height is 2.0 meters or so, then Vo / V = (2.0-0.8) /0.6, V = 0.15 m / s, that is, when the external V is not greater than 0.15m / s will not affect the interior layer flow, compliance with "clean air craft affair" made people into the gas flow rate at the time the door is 0.2m / s, so from a clean chamber pressure of airflow velocity:. V1 = 0.2-V = 0.2-0.15 = 0.05m / s is assumed that the operating room door width 1.5 m, the area of the door: A = 2 * 1.5 = 3.0 平方米 so the air volume Q = A * V = 3.0 * 0.05 = 0.15 cubic meters / second that is 540 m3 / h. When the operating room is a positive pressure air is greater than 540 m3 / h to meet the request of laminar flow.
In normal operation, you can set the ventilation system to eliminate excess gas in the system, so that the value of the operating room is always a positive pressure in a fair value basis.
It should also set up one or several front theater interior pressure can lead to negative operating room to prevent popular procedure in patients with the bacteria through contaminated air conditioning systems to others.
4.4 high efficiency filter settings
In the decontamination, the filter always plays a big dip, directly connected to the level of purification and filtration efficiency filter operation unit, for the purification operation unit level only popular request individual settings device placed sub-efficient filter. The response to the extraordinary operating room efficiency filter is placed at the end of setting up the device. End DOP efficiency air filter is not less than 99.97%. In order to move forward at the end of the operating life of the filter clean air conditioning units should be used three filters loop situation.
4.5 saving preparation
In order to advance energy dominate the rate, front section in the system design arts master operation, since only part of the picture theater operation in the presence of full surgical unit, so the independent set of new fans and ventilation machine interlocking control, namely new fan ( Frequency) With the operating room operand policy initiative to increase growth until the full load. Also in response to the open exhaust fan, (exhaust fan is also used variable frequency drive) so you can observe differences in wind speed and the use of the differences, so as to achieve energy-saving policy.
If the full theater system surgery unit fighting strength, operating low peak in the evening when there are several isolated operation can bring independent source of hot and cold operating room, so the refrigeration system is not fully open, but open only with independent source of hot and cold operating room, in order to achieve energy-saving policy.
In the heat accepting receive respect, acceptance can receive the sensible heat of the exhaust system in the preparation of the recipient receive the waste energy to preheat fresh air pre-cooling, thereby reducing energy consumption broken new fan, to achieve energy saving policy. There is also the total heat accepting Kasaba received demolition of the new exhaust air processor, which received demolition set energy received and disinfection in one, through the process of spraying a chemical solution to achieve energy conversion and disinfection dip. In order to achieve pre-cooling and preheating of fresh air approach.
4.6 Automatic Control System
Because of the extraordinary nature of the operating room design, automatic control decision in an important position in the operating room, and the operating room temperature and humidity is of crucial importance, which requires compliance with indoor air return parameters of cold (hot) water supply quantity, delivery return air ratio and steam humidification amount of the swap. In addition, to comply with the request of the operating room interior pressure, adjust the ratio of new exhaust, connecting the interior pressure, to achieve a positive pressure request.
Set fault alarm lights mark the filter infarction alarm.
5. Design Example
In Shanghai a tertiary level hospital operating room design, comply with design elements designed for purification. The hospital surgical unit has four floors, each about 1,000 square meters, five for the operating room preparatory layer, 6, seven for individual operating room, eight extraordinary request to the operating room, according to the structure of each layer of dirt Gallery accepting receive type set up a dual-channel, before and after surgery doctors and staff from the core a clean walkway through the process, the dirt from the outside of the post-operative gallery quickly shipped out of the dirt. Surgical instrument sterilization chamber through the process by five. Private elevator directly to the sterilization chamber hidden layers of sterile room. Doctors disinfected after five to eight from five dedicated stairs or the elevator into the layers. Exhaust dedicated vertical set of stairs at the top. The vertical staircase connecting corridor to a relative vacuum cleaner. Private elevator room set pressure delivery outlet, the front room for a clean corridor also links a certain pressure.
6, clean operating room seven of the compliance area size differences respectively, purifying selection disagreement air volume air conditioning units, air conditioning units with secondary filter, and set the sub-high efficiency filter in the operating room, the return air from the second side of the back, fresh air through three After filtering and sub-high efficiency filter is blown. Each operating room is set in an isolated air vents at the verge of gas hanging tower, and adjacent to the exhaust manifold exhausted to the outside. Eight by the end of the filter efficient filter kitchen on behalf of the sub-efficient filter, the remaining design with 6, seven.
In short, we want to be taken seriously in the design scene flashed differences and to differentiate, to make the design more reasonable and more appropriate national standards, but also to better meet the request of the owners.