PERSYARATAN TEKNIS

SUMBER DAYA LISTRIK

di RUMAH SAKIT
 Pemanfaatan Energi Listrik di Rumah Sakit.

SUMBER
DISTRIBUSI BEBAN
LISTRIK
PLN
Generator Kabel/Penghantar Lampu-Lampu
UPS
Peralata-Peralatan

Amper Volt Frekuensi kW kWh Cos phi

meter meter meter meter meter meter

2
 Persyaratan Teknis
• Persyaratan sistem kelistrikan harus memenuhi :
(1) SNI 04-0227-1994 atau edisi terbaru; Tegangan standard.
(2) SNI 04-0225-2011 atau edisi terbaru; Persyaratan Umum
Instalasi Listrik (PUIL edisi terakhir).
(3) SNI 04-7018-2004 atau edisi terbaru; Sistem pasokan daya
listrik darurat dan siaga.
(4) SNI 04-7019-2004 atau edisi terbaru; Sistem pasokan daya
listrik darurat menggunakan energi tersimpan.
(5) Untuk persyaratan lainnya atau yang belum memiliki SNI,
dapat digunakan standar baku atau pedoman teknis yang
diberlakukan oleh instansi yang berwenang
 Daerah Pelayanan di Rumah Sakit

a) Daerah pelayanan pasien.

Setiap bagian dari fasilitas pelayanan kesehatan yang mana pasien
diperiksa dan diobati (Poliklinik).

b) Daerah pelayanan umum.

Kamar tidur pasien, kamar periksa, kamar tindakan, klinik, dan
daerah serupa yang mana pasien akan bersentuhan dengan
peralatan umum seperti sistem panggil perawat, tempat tidur listrik,
lampu periksa, telepon dan alat hiburan. (Ruang rawat inap).

c) Daerah pelayanan kritis.

Unit rawat khusus, unit rawat intensif, unit rawat jantung,
laboratorium angiography, laboratorium kateter jantung, ruang
bersalin, ruang operasi,ruang pemulihan pasca anestesi, unit gawat
darurat, dan daerah serupa yang mana pasien dimaksudkan untuk
dikenai prosedur invasive dan disambungkan ke peralatan medik
listrik yang berhubungan dengan perawatan pasien.

4
Jumlah Stop Kontak untuk Layanan Pasien
 Kotak kontak untuk lokasi tempat tidur pasien di daerah
pelayanan umum.
 Setiap lokasi tempat tidur pasien harus disediakan minimal empat
kotak kontak.

 Kotak kontak untuk lokasi tempat tidur pasien di daerah

pelayanan kritis (ICU).
 Setiap lokasi tempat tidur pasien harus disediakan minimal enam
kotak kontak.

 Kotal kontak untuk kamar mandi atau toilet.

Kotak kontak tidak wajib di kamar mandi atau toilet.

 Kotak kontak untuk daerah khusus.

 Kotak kontak tidak disyaratkan dalam daerah-daerah secara medik
tidak diperbolehkan (seperti psychiatry, pediatry, atau daerah
hydrotherapy).

Kotak Kontak sebaiknya diberi warna; hijau = normal, kuning =

normal+genset; merah; normal, genset, UPS
5
 Sistem Kelistrikan Esensial RS
Panel Utama Listrik

Panel Tenaga (N)

Panel Pencahayaan (N)

Transformator

Panel Tenaga (N/S)

AC
M
Panel Pencahayaan (N/S)

Generator Set
Panel Emergency (N/S/E)

Panel Emergency Tenaga (N/S/E)

M

UPS

Panel Emergency Pencahayaan(N/S/E) 6

 Sumber Daya Listrik
• Sumber daya listrik pada Rumah Sakit
umumnya dibagi menjadi 3, antara lain
sebagai berikut.
• (A) Sumber Daya Listrik Normal
• Sumber daya listrik normal adalah sumber
daya listrik utama gedung yang harus
diusahakan menggunakan tenaga listrik dari
PLN.
 (B) Sumber Daya Listrik Siaga

• Sumber daya listrik siaga adalah berupa diesel

generator (Genset) dan harus disediakan 2
(dua) unit dengan kapasitas minimal 40% dari
jumlah daya terpasang pada masing-masing
unit. Genset dilengkapi dengan sistem AMF
dan ATS.
 Sumber Daya Listrik Darurat
• Sistem instalasi pada rumah sakit harus memiliki sumber daya listrik
darurat yang mampu melayani kelangsungan pelayanan seluruh atau
sebagian beban pada bangunan rumah sakit apabila terjadi gangguan pada
sumber listrik utama. Sumber daya listrik darurat tersebut harus mampu
melayani semua beban penting termasuk untuk perlengkapan pengendali
kebakaran, secara otomatis.
• Sumber listrik darurat yang umum digunakan adalah genset diesel dengan
sistem ATS dan AMF (sama dengan sumber listrik siaga). Adapun
pengelompokkan beban antara beban normal dan beban darurat dirancang
pada panel utama tegangan rendah (LVMDP). Pada saat kebakaran, sistem
ATS dan AMF secara otomatis akan :
(1) memutuskan sumber listrik dari PLN;
(2) memutuskan listrik untuk beban-beban normal; dan
(3) menggantikan sumber listrik dari PLN menjadi Genset.
• Adapun untuk ruangan-ruangan dengan fungsi
tertentu, pasokan daya listrik darurat berasal
dari UPS (Uninterruptable Power Supply).
Ruangan-ruangan yang harus dipasangi UPS
antara lain : ruang operasi, ruang perawatan
intensif (ICU, NICU, PICU), dan ruang
perawatan intensif khusus jantung (ICCU).
• Persyaratan untuk pengadaan UPS antara lain
sebagai berikut.
(1) Harus tersedia ruang UPS minimal 2 x 3 m2
(sesuai kebutuhan), terletak di ruang operasi
rumah sakit, ruang perawatan intensif dan
diberi pendingin ruangan.
(2) Kapasitas UPS minimal 5 (lima) kVA atau
sesuai kebutuhan menurut perhitungan dan
perancangan.
• Instalasi beban darurat seperti pompa kebakaran,
lift kebakaran, peralatan pengendali asap, sistem
deteksi dan alarm kebakaran, sistem komunikasi
darurat, dan beban darurat lainnya harus terpisah
dari instalasi beban normal; dan harus dilindungi
dari resiko terbakar saat terjadi kebakaran. Jenis
perlindungan yang bisa dijadikan alternatif pilihan
adalah dengan menggunakan kabel instalasi tahan
api sesuai dengan ketentuan yang berlaku.
Prasyarat Sumber dayalistrik RS

• Kapasitas
• Kualitas
• Kontinyuitas
Panel Utama Listrik (Main switchgear)

14
 Generators

UPSs and a generator in a network design

15
 A
GANSET
B
GANSET
BACK UP GANSET
C
GANSET
D
GANSET

ATS
Jenis gangguan Listrik
 POWER DISTURBANCES

• CAUSES
• TYPES
• DURATION
• RESULTING PROBLEMS
• COMMENTS
• WHAT THE POWER UTILITY CAN DO
• WHAT THE ORIGINAL EQUIPMENT MANUFACTURER (OEM) CAN DO
• WHAT YOU CAN DO
• PROTECTIVE DEVICES

18
 Disturbance Sources:
Electric Utility
• Accidents • Normal Systems
– Operational Operation
– Vehicles – Load Switching
– Contractors – Fault Clearing
– Explosion & Fire – Load Management
• Natural Causes
– Weather
– Wear and Tear
19
 Power Disturbances

With High-Speed
50/80 Hertz With Noise Spike
Pure Sinewave

With Ringing
Transient With SAG/DIG With Surge/Swell

Interuption in Service With Frequency Change

20
 The Problem Categories

Sags

Surges
en cy
e q u on s
tio nt

r
F iati Ou
ria fro

Var
ns

ta
Va ave

ge
Noise

Spike
W

21
 Where Errors Accumulate
Number 1 Reason for Loss of Power on the Critical
Bus Is Due to
HUMAN ERROR

Battery
13%
Human Error Site
Infrastructure
60%
12%
Distribution
15%

22
 The Effects of Power Disturbances
A typical mains supply is quite polluted.

Electrical Noise
& Transients
62.6/Month
48.79%
Spikes
Transients
50.7/Month
Sags, Surges 39.52%
Mains
& Brownouts
Failures
14.4/Month
0.6/Month 11.22%
0.47%

23
Disturbance Sources: Facility
• Inadequate • Normal Facility
Supply Operation
– Steady State – Load Switching
– Dynamic – Fault Clearing
– Emergencies – Operator Error
• Inadequate
Distribution
– Capacity
– Coordination 24
 CAUSES OF POWER DISTURBANCES

• STORM ACTIVITY – LIGHTNING, WIND

• OBJECTS COMING IN CONTACT WITH POWER LINE AND TRIPPING
BREAKER – TREE BRANCHES, ANIMALS, OTHER
• UTILITY FAULT CLEARING
• CONSTRUCTION ACTIVITY
• ACCIDENTS – MOTOR VEHICLE, OTHER
• EQUIPMENT FAILURE
• OVERLOADING
• LOAD SWITCHING
• NON-LINEAR LOADS
• POOR GROUNDING

25
 TYPES OF POWER DISTURBANCES
• INTERRUPTION
• SAG, UNDER VOLTAGE
• SURGE, OVER VOLTAGE
• VOLTAGE FLUCTUATION
• FREQUENCY VARIATION
• SPIKES / TRANSIENTS
 IMPULSIVE
 OSCILLATORY
• WAVEFORM DISTORTION
 DC OFFSET
 HARMONICS
 NOTCHING
 NOISE
• VOLTAGE IMBALANCE

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 DURATION OF POWER DISTURBANCES

• INSTANTANEOUS - ½ CYCLE (8 1/3 ms) OR LESS

• MOMENTARY - ½ CYCLE TO 3 SEC
• TEMPORARY - 3 SEC TO 1 MIN
• SUSTAINED - GREATER THAN 1 MINUTE

27
 CLASSIFICATION OF PROBLEMS RESULTING FROM
POWER DISTURBANCES

• DISRUPTIVE
 EQUIPMENT DOES NOT OPERATE AS INTENDED

• DISSIPATIVE
 EQUIPMENT EXPERIENCES REPEATED STRESSES THAT LEAD TO FAILURE LATER FOR NO
APPARENT REASON

• DESTRUCTIVE
 EQUIPMENT FAILS AT THE INSTANT THE DISTURBANCE OCCURS

28
WHAT THE POWER UTILITY CAN DO TO MINIMIZE THE EFFECT
OF POWER DISTURBANCES

• INSTALL STORM RESISTANT WIRING

• USE INFRA RED SCANNING TO DETECT WEAK SPOTS IN POWER LINES
• INSTALL REMOTE CONTROLLED RADIO SWITCHES TO RESTORE POWER
QUICKLY
• CLEAR TREE LIMBS AWAY FROM POWER LINES

29
 WHAT YOU CAN DO TO MINIMIZE THE EFFECT OF POWER
DISTURBANCES

• BUY EQUIPMENT THAT HAS INTERNAL PROTECTIVE DEVICES

 FOR EXAMPLE, BATTERY BACK UP FOR ANY APPLIANCE THAT CONTAINS A CLOCK

• USE ONE OR MORE EXTERNAL PROTECTIVE DEVICES

 SURGE PROTECTORS
 LINE FILTERS
 ISOLATION TRANSFORMER
 VOLTAGE REGULATING LINE CONDITIONER
 UPS

30
 PROTECTIVE DEVICES OTHER THAN UPS

• SURGE PROTECTIVE DEVICES – SPD’S

PROTECTS AGAINST SPIKES OF LIMITED ENERGY
 METAL OXIDE VARISTORS – MOV
 DIODES
 GAS TUBES
 LCR FILTERS
 HYBRIDS

• LINE FILTERS
FILTERS OUT HARMONICS, TRANSIENTS AND NOISE

• ISOLATION TRANSFORMER
ELIMINATES DC OFFSET AND NOISE

• VOLTAGE REGULATING LINE CONDITIONER

AUTOMATICALLY ADJUSTS FOR UNDER AND OVER VOLTAGES
 CONSTANT VOLTAGE TRANSFORMER - CVT
 MOTORIZED VARIAC

31
 Power Solutions
Power Standby Power TVSS Automatic UPS
Problem Power Conditioner Voltage (online) Dual
System CVT Stabiliser Conversion
Generator (AVS)

Mains Failures
    
Sags /
Brownouts     
Surges
    
Spikes /
Transients     
High Frequency Noise
    
Frequency Variation
    
 WHY USE A UPS?

• PROTECTS AGAINST MULTIPLE TYPES OF POWER DISTURBANCES

• ONLY DEVICE THAT PROTECTS AGAINST AN OUTAGE
• OFFERS PROTECTION AGAINST
 EQUIPMENT NOT OPERATING PROPERLY
 COMPUTER AND EQUIPMENT DAMAGE
 DATA LOSS
 TIME AND EXPENSE TO RECOVER BACK TO WHERE YOU WERE, IF
EVEN POSSIBLE

33
 UPS Technologies
On-Line
Power Problem Off-Line Line Interactive
Double Conversion
Mains Failures
  
Sags / Brownouts
  
Surges
  
Spikes / Transients
  
High Frequency Noise
  
Harmonic Distortion
  
Frequency Variation
  
No Break Change-over
  
 POWER DISTURBANCES
AND
PROTECTIVE DEVICES
POWER DISTURBANCE PROTECTIVE DEVICE OFFER PROTECTION?
SURGE LINE FILTER ISOLATION VOLTAGE ON-LINE UPS
PROTECTOR TRANSFORMER REGULATING
LINE
CONDITIONER
INTERRUPTION YES
SAG, UNDER VOLTAGE YES YES
SURGE, OVER VOLTAGE YES YES
VOLTAGE FLUCTUATION YES YES
FREQUENCY VARIATION YES
IMPULSIVE YES YES YES
SPIKES / TRANSIENTS
OSCILLATORY YES YES YES
DC OFFSET YES YES
HARMONICS YES YES
WAVEFORM DISTORTION INTERHARMONICS YES
NOTCHING YES YES
NOISE YES YES YES
VOLTAGE IMBALANCE YES

35
 UPS (Uninterruptible Power Supply)
• Protects against sags, brownouts, and blackouts.
• What devices should be supported by UPS?
– Factors to consider: cost, importance of service,
quality of ac line power.
– Every network file server should have power backup.
– Any critical devices (hubs, bridges, switches, routers)
should be backed up.
• UPS is for outages of short duration (on average, < 15 min).
– For extended periods of time, a generator is needed.

36
 UPS Components
• Batteries - storage of electrical energy (DC).
– Larger batteries (greater storage capacity) mean
UPS can supply backup power longer.
• Battery Charger - keeps batteries fully charged
when ac line power is available.
• Power Inverter - converts DC voltage from
batteries into AC line voltage.

37
 UPS Operation
• Basic UPS (also called line-interactive UPS or switched UPS):
– Monitors power line.
– When line power is interrupted, UPS switches to inverter powered
by batteries.
– Transfer time - time UPS takes to switch over to inverter power -
typically a few milli-secs.
• More expensive on-line UPS:
– Operates continuously on-line, supplying AC power from inverter.
– Batteries are charged from AC line voltage.
– Transfer time is zero.

38
 Basic UPS Block Diagram
• S1 & S2 normally closed, S3 & S4 normally
open. When AC voltage is lost, the inverter
switches on, S1 & S2 open, and S3 & S4 close.

39
 Uninterruptible power supply
• An uninterruptible power supply (UPS)-is a device
that contains surge protection circuits and one or
more batteries that can provide power during a
temporary or permanent loss of power
– A UPS connects between your computer and a power
source
– UPS software can shut down computers cleanly if power is
out for a pre-specified number of minutes

40
 On-line UPS Block Diagram
• Operates continuously on-line.
• Transfer time is zero.

41
 Two types of UPS
• Two types of UPS devices are standby and online
– Standby UPS-sometimes called an offline UPS, switches to
battery power when a problem occurs in the power line.
The amount of time a standby UPS allows a user to
continue working depends on the electrical requirements
of the computer and the size of the batteries in the UPS
• UPS for a PC should be 10 to 30 minutes
• Time to save current work and shut down the computer properly
– Online UPS-always runs off the battery, which provides
continuous protection
• More expensive than a standby UPS

42
 Uninterruptible Power Supply
• UPS: device with a built-in battery, power conditioning,
and surge protection
– A standby UPS normally supplies power to plugged-in
devices by passing the AC power directly from the wall
outlet to the device receptacle
– An online UPS supplies power continuously to plugged-in
devices through the UPS battery, which is recharged by the
wall outlet power
– Power conditioning cleans the power, removing noise
caused by other devices on the same circuit
– Surge protection keeps the computer from being affected
by sags or spikes in power flow

43
 UPSs (Uninterruptible Power Supplies)
• Battery-operated power source directly attached
to one or more devices and to power supply
– Prevents undesired features of outlet’s A/C power
from harming device or interrupting services
– Standby UPS: provides continuous voltage to device
• Switch to battery when power loss detected
– Online UPS: uses power from wall outlet to
continuously charge battery, while providing power
to network device through battery

44
 Uninterruptible Power Supplies (UPSs)
• A standby or offline UPS is an offline battery backup that
detects the interruption of power to the power equipment
• A ferroresonant standby UPS is still an offline UPS
– the ferroresonant transformer reduces power problems
• The line-interactive UPS is always connected to the output, so
has a much faster response time and incorporates power
conditioning and line filtering
• The true online UPS works in the opposite fashion to a
standby UPS since the primary power source is the battery,
with the power feed from the utility constantly recharging
the batteries
– this model allows constant feed to the system, while completely
eliminating power quality problems

45
UPS - Line interactive (Off Line)

MAINS Voltage
INPUT Stabiliser
OUTPUT
LOAD
Battery
Charger Inverter

UPS

46
 UPS - Line interactive (Off Line)

MAINS INPUT Voltage

Stabiliser
OUTPUT
LOAD
Battery
Charger Inverter

Normal Operation

47
UPS - Line interactive (Off Line) 2-20mSecs
break in supply (£)

MAINS Voltage
INPUT Stabiliser
OUTPUT
LOAD
Battery
Charger Inverter

Mains Failure

£ = Square wave ££ = Stepped or £££ = Sinewave

Quasi sinewave

48
 On-Line Dual Conversion (VFI)
VFI = Voltage and Frequency Independent

MAINS INPUT
Converter Inverter

Battery
OUTPUT
LOAD

Static/Maintenance Bypass

On line UPS

49
On-Line Dual Conversion (VFI)
VFI = Voltage and Frequency Independent

Vac Vdc Vac

MAINS
INPUT Converter Inverter

V +/- 20%
45-65Hz Battery OUTPUT
LOAD
V +/- 1%
+
/-1%Hz
Static/Maintenance Bypass
NORMAL OPERATION

50
 On-Line Dual Conversion (VFI)
VFI = Voltage and Frequency Independent

MAINS
Vdc Vac
INPUT Converter Inverter

Battery OUTPUT
LOAD
V +/- 1%
+
/-0.05%Hz
Static/Maintenance Bypass
MAINS FAIL

51
On-Line Dual Conversion (VFI)
VFI = Voltage and Frequency Independent

MAINS
INPUT Converter Inverter

Battery OUTPUT
LOAD

Vac
Static/Maintenance Bypass
OVERLOAD/FAULT

52
 Standards
BS EN 62040: UPS Industry standard
• BS EN 62040-1-1:2003 Uninterruptible power systems (UPS). General and safety
requirements for UPS used in operator access areas

• BS EN 62040-1-2:2003 Uninterruptible power systems (UPS). General and safety

requirements for UPS used in restricted access locations

• BS EN 62040-3:2001 Uninterruptible power systems (UPS). Method of specifying the

performance and test requirements

53
Off-Line UPS

Good
Off-Line Uninterruptible Power Supply:
Elements
Source

TVSS
& Load
Filters
Control

Charger Off - Line

Inverter *

Battery * Intermittent - Duty Rated

Line-Interactive UPS

Better
 Line - Interactive UPS:
Elements

TVSS
Source

Voltage
&
Boost Load
Filters

Bi - Directional
Inverter
&
Control

Battery
On-Line UPS
Best
 On - Line UPS:
Elements

PFC Rectifier Inverter

TVSS
Input

& Bypass Load

Filters

DC - To - DC
Charger Converter

Battery
Kamar Bedah yang membutuhkan Elektrikal Esensial
Ruang ICU/ICCU
Kamar Operasi
Ruang NICU
Sistem Pembumian IT (Isolated Neutral)
ISOLATING TRANSFORMER DI KAMAR BEDAH (SEDERHANA)

ES710 = Isolating Transformer

107TD47 = A-Isometer, Insulation,

load and temperature monitor device.

MK2007 = Remote Alarm Indicator

and Test Combination
ISOLATING TRANSFORMER DI RUANG ICU

PGH474 = Test Device

EDS461 = Insulation Fault Location

System.
ISOLATING TRANSFORMAR DI KAMAR BEDAH

SUE487 = Change Over Switch

PRC 487 = Test Device

107TD47 = A-Isometer, Insulation, Load,

and Temperature Monitoring Device

MK2430 = Remote Alarm Indicator and

Test Combination
SUMBER DAYA DAN ISOLATING TRANSFORMER
Kubikal dan Travo Tegangan Menengah
Transformator dan Panel TM

Travo berpendingin minyak

Pemeriksaan Panel Tegangan Menengah

TERIMA KASIH