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AirConditioning

Design For
Medical
Buildings

AE 173
Refrigeration &
Air Conditioning

Prepared by: Cristobal M.


Tardo

Overview of the
Topics

A. Introduction
B. Importance of air conditioning in hospitals
C. Plant desired capacity
D.Process flow and description
E. Load Calculations and specifications
F. System requirements: material flow, airflow, steam
flow, etc.
G.Air Conditioning system adopted
H.Plant layout and site development proposal
I. Control factors
J. Energy requirements

A. INTRODUCTION
Microbial
transmission
in
healthcare
setting is in inevitably a very potential risk.
The main routes are droplets, contact,
common
vehicle
and
air
borne
transmissions.
Infection
control
for
patients, healthcare providers and visitors
is of paramount importance in the
healthcare process in medical facilities.
Proper air conditioning of medical care
facilities is helpful in prevention and
treatment of diseases.

A. INTRODUCTION
Amedicationormedicineis a drug taken to cure
and/or ameliorate any symptoms of anillnessor
medical condition, or may be used aspreventive
medicinethat has future benefits but does not treat
any existing or pre-existing diseases or symptoms.
Apatientis any recipient ofhealth careservices.
The patient is most oftenillorinjuredand in need
oftreatmentby
a
physiotherapist,physician,physician
assistant,advanced
practice
registered
nurse,psychologist,podiatrist,veterinarian,
or
otherhealth care provider.

A.1 Relevance & Economic


Value

Saving and Improving Lives

New medicines are enabling more people


than ever before to live longer, healthier
lives. In recent years, prescription medicines
have played a key role in achieving dramatic
declines in death rates from diseases such
as cancer heart disease and HIV/AIDS. When
used appropriately, medicines can halt or
slow
disease
progression,
minimize
complications, improve quality of life,
prevent hospitalizations and surgeries, and
avert debilitating diseases.

B. Importance of Air-Conditioning in
Hospitals

Air conditioning(often referred to as


'A/C' or 'AC') is the process of altering
the
properties
ofair(primarilytemperatureandhu
midity)
to
more
comfortable
conditions, typically with the aim of
distributing the conditioned air to an
occupied space such as a building or
a
vehicle
to
improvethermal
comfortandindoor air quality.

B. Importance of Air-Conditioning in
Hospitals

In the most general sense, air


conditioning can refer to any form of
technology that modifies the condition of
air (heating, cooling, (de-)humidification,
cleaning, ventilation, or air movement).
However,
inconstruction,
such
a
complete system of heating,ventilation,
and air conditioning is referred to as
heating, ventilation, and air conditioning
(HVAC-as opposed toAC). (Wikipedia,
the free encyclopedia)

B. Importance of Air-Conditioning in
Hospitals

Air conditioning and ventilation is


rarely more important than in
hospitals and medical facilities.

Patient
comfort
is
paramount
andconditions can
have
a
real
impacton treatment and recovery.
Minimizing the risk of healthcare
associated infections is also vital to
patient care.

B. Importance of Air-Conditioning in
Hospitals
An integrated heating,ventilationand air
conditioning
(HVAC)
system
offers
manageable temperatures and excellent
air quality. As long as its properly
maintained, its also an important ally in
infection control.

Whether you manage a hospital, doctors


surgery or research lab, air conditioning
and ventilation are integral to your facility.

B. Importance of Air-Conditioning in
Hospitals

According to studies it has been


proved that patients show speedy
recovery in controlled environment
than in an uncontrolled environment.
For example, cardiac patients may
not be able to maintain adequate
circulation to facilitate standard heat
loss. This is also a reason that
cardiac wards and rooms are
equipped with air conditioning units.

B. Importance of Air-Conditioning in
Hospitals

Patients within head injuries, those


subjected with brain operations and
those with poisoning may have high
fever in a hot environment due to
trouble in the brains heat regulatory
system. The best thing to ensure
recovery here is to maintain cool and
comfortable environment.

B. Importance of Air-Conditioning in
Hospitals
Air conditioning is extremely important in the
operation theater. This helps in controlling the
temperature, humidity and sterile filtration.
Air conditioning has helped in making the
environment
of
hospitals
livable
and
extremely comfortable.
This
also
facilitates
in
keeping
the
environment of the hospital clean and
hygienic. The patients will feel happy, healthy
and comfortable with an air conditioning
installed in hospitals.

B.1 Types of Air- Conditioning in


Hospitals

1. Window Air Conditioner


Is the most commonly used air
conditioner for single rooms. In this air
conditioner all the components, namely
the compressor, condenser, expansion
valve or coil, evaporator and cooling coil
are enclosed in a single box. This unit is
fitted in a opening made in the wall of
the room, or more commonly a window
sill.

B.1 Types of Air- Conditioning in


Hospitals

1. Window Air Conditioner

B.1 Types of Air- Conditioning in


Hospitals
2. Spilt Air Conditioner
It comprises of two parts: the outdoor unit and
the indoor unit. The outdoor unit, fitted
outside the room, houses components like the
compressor, condenser and expansion valve.
The indoor unit comprises the evaporator or
cooling coil and the cooling fan. For this unit
you dont have to make any slot in the wall of
the room. Further, present day split units have
aesthetic appeal and do not take up as much
space as a window unit. A split air conditioner
can be used to cool one or two rooms.

B.1 Types of Air- Conditioning in


Hospitals

2. Spilt Air Conditioner

B.1 Types of Air- Conditioning in


Hospitals
3. Packed Air Conditioner
It comprises of two parts: the outdoor unit and
the indoor unit. The outdoor unit, fitted
outside the room, houses components like the
compressor, condenser and expansion valve.
The indoor unit comprises the evaporator or
cooling coil and the cooling fan. For this unit
you dont have to make any slot in the wall of
the room. Further, present day split units have
aesthetic appeal and do not take up as much
space as a window unit. A split air conditioner
can be used to cool one or two rooms.

B.1 Types of Air- Conditioning in


Hospitals

3. Packed Air Conditioner

B.1 Types of Air- Conditioning in


Hospitals
4. Centralized Air Conditioning System
Central air conditioning is used for cooling big
buildings, houses, hospitals, entire hotels,
gyms, movie theaters, factories, etc. If the
whole building is to be air conditioned,
engineers find that putting individual units in
each of the rooms is very expensive making
this a better option. A central air conditioning
system is comprised of a huge compressor that
has the capacity to produce hundreds of tons of
air conditioning. Cooling big halls, malls, huge
spaces, galleries, etc. is usually only feasible
with central conditioning units.

B.1 Types of Air- Conditioning in


Hospitals

4. Centralized
System

Air

Conditioning

B.2 Typical Temperature for


Hospitals

D. Process flow &


Description

D. Process flow &


Description
1. SURGERY AND CRITICAL AREAS
Operating Room
The primary task of the ventilation system in an operating
room is to provide an acceptable indoor climate for
personnel and patients, to remove odor, released
anesthetic gases and to reduce the risk of infection in the
operating area. The greatest amount of bacteria found in
operating rooms comes from the surgical team and is a
result of their activity during surgery.
Labor & Delivery
The procedures for normal child birth are considered noninvasive and the room are controlled.

D. Process flow &


Description
2. NURSING

Patient Room
Air conditioning of bed rooms in our warm humid
climate desirable not only for medical reason but
also to keep out noise, pollution from mainly cars
& buses, trucks. It is more important in dry areas
where dust storm common in the summer
months. When central air-conditioning system
used for pt rooms avoid ducted air supply and
return to the rooms in order to eliminate chance
of cross infection and to odors through the
common ducts for the same reason, packaged air
conditioner feeding a group of rooms through a
ducted supply must also be avoided.

D. Process flow &


Description

3. Ancillary

Autopsy Room

Comfort conditions are maintained with


a 100% fresh air system with full
exhaust. Due to heavy bacterial
contamination and odor, autopsy room
require special attention for exhausting
all air above the roof of the hospital. To
prevent spread of contamination to
adjoining areas, the autopsy room must
be maintained at average pressure.

D. Process flow &


Description
4. Administration
Main Lobby &
Administrative Desk
This includes the medical
records, business offices &
nurses station.
Waiting Areas

D. Process flow &


Description
5. Sterilizing and Supply
Cleaning Area, Sterilizing Area & Storage
If in common room keeping air flowing from clean to
contaminated temperature as in comfort areas.
Important Guidelines:
Insulate sterilizers to reduce heat load.
Apply ventilation on sterilizing equipment to remove excess
heat.
If Ethylene Oxide (ETO) gas sterilizers are used, use separate
exhaust system with terminal fan. Proper velocity at ventilation
hood at sources of ETO. Install an exhaust at sterilizer doors
and above sterilizers drain. Exhaust aerator and service rooms
as well. Install ETO sensors, exhaust fan flow sensor with
alarms. ETO sterilizers should be located in dedicated
unoccupied rooms and have highly negative pressure to
adjacent rooms.
All sterile supplies to be strored at 50% RH or lower.

D. Process flow &


Description
6. SERVICE
Dietary Facilities
Includes the main kitchen, bakery if any, dish
washing room. Enclosed, high ventilation with hood
exhaust may be divided in clean and contaminated
area, then flow air from clean to contaminated /
dining space, comfort AC with ASHRAE ventilation
rates or local codes, overflow fresh air to kitchen
using a 80% filter. If cafeteria type is used, employ
hood above serving and steamed areas. Provide
special care to these areas characterized by high
heat, high moisture production and cooking odors.

D. Process flow &


Description
6. SERVICE
Mechanical Facilities
Lots of fresh air to boiler room. Design to keep max
90F at workstations. If outdoor air is above 97F precool the air to protect the motors. Evaporative
cooling may be employed

Maintenance Shops
Carpentry, machine, electrical, and plumbing
workshops have no unusual requirements. Welding
areas, require excellent ventilation. If we have paint
workshop or storage exhaust to ventilate well and
reduce fire hazard.

D. Process flow &


Description
7. Diagnostic & Treatment
MRI & CT Scan Rooms
Normal comforts air conditioned and ventilation
is required. However the special needs of the
equipment manufacturer must be checked out
and at times a precision AC may be called for to
handle the high heat release of computer
equipment and cryogens used to cool the
magnet.

Treatment Rooms
Individual temperature and humid control at
patient room level

D. Process flow &


Description
4. Diagnostic & Treatment
Inhalation Therapy
Pulmonary and other respiratory diseases; very
clean air requirements and positive pressure.

Physical Therapy Department


The normal AC cooling load of the electrotherapy section is affected by the short wave
diathermy, infrared and ultraviolet equipment
used in this area. The exercise section requires
no special treatment and temperature and
humidity should be within the comfort zone.

E. Load Calculations
Click Here

E. Load Calculations
A. Tansmission Load
Material

To(ambient) = 32 C
R, Thermal
resistance,
m2-C/W

a. Wall conduction:
1. Outside airfilm
2. Mineral fiber, 75 mm

4. Gypsum plaster, 16 mm

0.1

B. Ceiling conduction

3. Gypsum plaster, 16 mm
4. Inside airfilm

56

A2=(3 * 4)

To= 34 C,

0.029

0.0925

Ti= 24C

1.94
0.1
0.12
2.189

Sub total

Ti= 24C

0.12
2.4210

2. Mineral fiber, 75 mm

To= 32 C,

Qa, kJ/s

1.94
0.232

1. Outside airfilm

A1= [(3*2*4)+(4*2*4)]
0.029

3. Light Concrete, 120 mm

5. Inside airfilm

Area, m2

Ti (wall) = 24
C
Tf-Ti, C

12

10

0.0548

Q1 =

0.1407

F. System
Requirements

G. Air-Conditioning System
Adopted

Centralized Air-Conditioning System

Centralized systems are defined as those in


which the cooling (chilled water) is generated in
a chiller at one base location and distributed to
air-handling units or fan-coil units located
throughout the building spaces. The air is cooled
with secondary media (chilled water) and is
transferred through air distribution ducts. A
typical chilled water central system is depicted
in Figure below. The system is broken down into
three major subsystems: the chilled water plant,
the condenser water system (or heat rejection
system) and the air-delivery system.

G. Air-Conditioning System
Adopted

Centralized Air-Conditioning System

Table 1. Typical Applications of Central Systems


Centralized systems are mostly used in mid to
high rise buildings, which are structures with 57+ floors. Commercial buildings commonly
choose several types of systems based on the
space conditioning needs of different systems.
A constant-volume (CV) system might cool the
interior, which has relatively uniform cooling
requirements while a VAV system conditions
perimeter
areas,
which
have
variable
requirements. Table below shows some typical
applications for various types of systems.
Building Type
Office Buildings (low rise)
VAV; or CV in the core, and hydronic at
perimeter
Office Buildings (high-rise)
Central CV system for core and VAV or hydronic
at perimeter
Department Stores
Multiple CV or VAV air handlers
Universities
CV, VAV or combined air-water systems at each
building
Schools
CV or VAV air handlers serving individual
common areas, and hydronic or combined airwater systems in classrooms

Type of System

Hospitals

Separate CV systems for critical areas; CV or VAV for


common areas; hydronic and combined air-water in
patient rooms

Hotels

VAV for common areas like lobbies, restaurants,


ball rooms & banquets; fan-coil units in guest
rooms for individual temperature and humidity
control
Multiple VAV air handlers
Multiple CV air handlers, with precise humidity
and temperature

Assembly, Theatres
Libraries, Museums

H. Plant Layout & Site


Development

H. Plant Layout & Site


Development

I. Control Factors
1. Bacterial Infection
Infectious bacteria are transported by air. Droplet or
infectious agents of 5 mm or less in size can remain
airborne indefinitely. It has been shown that 90-95%
effective filters remove 99.9 percent of all bacteria
present in hospitals.
Examples that can be transported around by the AC
duct system by air or air + water mixtures are:

Mycobacterium Tuberculosis
Legionella Pneumophila
(In
these
cases
our
FILTRATION
recommendation is 95% HEPA Filter at 1 micro
meter particles)

I. Control Factors
1. Bacterial Infection
What is HEPA Filter?
HEPA is a type of air filter which means
High-efficiency Particulate Air. The filter
remove (from the air passes through)
99.97% of particles that have a size of 0.3
micro meters or larger.
HEPA filters are critical in the prevention of
the spread of airborne bacterial and viral
organisms and, therefore, infection.

I. Control Factors
2. Viral Infection
Epidemiological evidence and other studies
indicate that many of the air borne viruses that
transmit infections are sub-micron in size, thus
there is no known method to effectively
eliminate 100% of the viable particles. HEPA
filters and/or Ultra-Low Penetration (ULPA)
filters provide the greatest efficiency currently
available. Therefore, the isolation rooms with
appropriate ventilation pressure relationships
are the primary means used to prevent the
spread of airborne viruses in the hospital
environment.

I. Control Factors
3. Molds
Some molds such as Aspergillis can be fatal to advanced
Leukemia, Bone Marrow transplant and other imuno
compromised patients.

4. Outdoor Air Ventilation


When Outdoor Air Intakes are properly located in areas
properly maintained around them, outdoor air in
comparison with room air is virtually free of viruses and
bacteria. Infection control problems arenormally sourced
inside the Hospital. Properly Designed, Constructed and
Maintained Ventilation Air Systems dilute the viral and
bacterial contamination within the hospital, preserving
the correct pressure relations between the different
functional areas and remove airborne infectious agents
from the Hospital.

I. Control Factors
5. Temperature & Humidity
One of the aspects of humidity is that
bacteriological microorganisms ride on dust
particles whose attract ability to one another is
favored by low relative humidity resulting in
increased static energy. Low relative humidity is
reported to be suitable for Klebsiella pneumonia
activity while high humidity in the hospital enhances
the danger of growth of Pseudomonas aeruginosa.
Humidity in operation room is believed to contribute
to the prevention of dehydration of exposed tissue.
To minimize the explosion risk, the relative humidity
requirement in hospital is 40-65 percent.

J. Energy
Requirement

Low energy requirement


Use different systems for different departments.
Zoning:

Compensate for exposures due to orientation or other


building conditions. Define Air intake zones and Air
Exhaust zones & Separate them according to prevailing
winds.
Minimize or make it zero recirculation between
departments. So we dont move bacteria and viruses
around by AC ducting.
Simplify provisions for operations on Emergency
Generator Power. Pre-Select what really needs to be on
and off, including pressurization of areas
Conserve Energy. Use the required Btu/hour with the
least KWh. This is a 24 Hour/day operation 365 days a
year type of work.

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