Electromechanical Systemsin Hospitals

By

Moustafa M. Elsayed

(Consultant)

Mechanical Systems

• HVAC System

• Smoke Control System

• Fire Protection System

• Medical Gases System

• Hot & Cold Water System

Electrical Systems

• Lighting System

• Electrical Power

System

• Grounding System

• Telephone system

• Nurse-call system

• Fire Alarm System

• Security System

• Paging systems

• Clock System

• BMS System

HVAC System

Objectives

• Comfort

• Indoor Air Quality

• Cross contamination

• Smoke control in fire

HVAC System

Comfort

• Temperature & humidity control:

single and multi-zones

• Air distribution: supply & return

terminals

• Air distribution: terminal velocity

• Insufficient oxygen

• Noise

HVAC System

Indoor Air Quality

• Airborne contagious viruses and bacteria

• Removal of contaminants by:– Filtration

– Exhaust and partial or complete replacement

• Outdoor air: recommended rates

• Short circuiting of exhaust air

• Accessibility of HVAC components for cleaning

HVAC System

Cross Contamination

• Airborne contagious viruses and bacteria

• Operation theater: positive pressure

• Incentive care rooms: positive

• Isolation rooms: negative pressure

• Laboratories: positive or negative

HVAC System

Cross Contamination

• Kitchen: negative pressure

• Toilets: negative pressure

• Corridors & patient rooms:

positive and negative pressure

• Hospital building: positive

pressure

HVAC System

Energy Saving

• Design and construction

• Temperature control

• Occupancy sensors

• Excessive & insufficient outdoor

• Energy recovery equipment

• Economizer cycle

Smoke Control System

• Stair case pressurization

• Smoke removal

• Smoke migration

• Make up air

Hot & Cold Water

Uses

• Domestic

• Cleaning

• Process

• Heat removal of equipment

Hot & Cold Water

Legionnaires’ Disease

Occurred after persons

have breathed mists that

come from a water source

contaminated with

Legionella bacteria.

Hot & Cold Water

Sources of Legionella Bacteria

• Cooling towers

• Shower heads

• HVAC humidifiers

• Respiratory-care equipment

• Warm stagnant water

Hot & Cold Water

Symptoms of Legionnaires

• Legionnaires’ Disease – fever, chills, and a

cough. Some patients may have muscle

aches, headache, tiredness, loss of appetite,

and occasionally diarrhea. The kidneys may

not function properly.

• Pontiac Fever – fever and muscle aches. No

pneumonia. Persons recover without treatment

Hot & Cold Water

Heating Sources

• Electrical heaters

• Steam boilers

• Hot water boilers

• Heat pumps

• Chillers Heat rejection

Hot & Cold Water

Growth of Legionella Bacteria

• Temperatures of 32 to 40 degrees C are ideal for growth

• Rust, scale, and other microorganisms can promote the growth of Legionella bacteria.

Medical Gas Systems

Objectives

• Sufficient flow at required

pressures to the medical gas

outlet - or inlet –terminals

• Convenient access by the

medical staff to outlet/inlet

terminals, valves, and

equipment during patient care

or emergencies

Medical Gas Systems

Gas/Service Application

Oxygen Analgesia, patient care, lab use

Nitrogen Surgical turbo-driven equipments, lab

use

Nitrous

Oxide

Analgesia, patient care, lab use

Medical Air Drying, air driven tools, lab use

Medical

Vacuum

Cardiac arrest, suction of waste

materials, tubes drying, lab use

Medical Gas Demand

Medical Gas Systems

Typical Bulk Supply System

Medical Gas Systems

Medical Air System

Medical Gas Systems

Typical Medical Vacuum System

Fire Protection Systems

Objectives

Protection of:

people

properties

Fire Protection Systems

Identification of Application

• Human occupied areas: patient rooms, nursing rooms, corridors, offices, waiting areas, etc.

• Equipment rooms: electric transformers, generators, and electric panel rooms.

• Laboratories area

Fire Protection Systems

Possible Systems

• Automatic sprinkler system

• Automatic gas suppression system

• Automatic mist system

• Manual: standpipe system

• Manual: portable extinguishers

Sprinkler Heads: Pendent & Upright

Fire Protection Systems

Fire Protection SystemsAutomatic Sprinkler System

Fire Protection SystemsAutomatic Sprinkler System

Fire Protection Systems

Gas Suppression System

Fire Protection Systems

Manual fire fighting equipment

ComparisonSprinkler Extinguishers Item

Very HighLowInitial Cost

High Protection NoProtection at

Unoccupied Areas

HighLow Operating Cost &

Maintenance

LowLowNeed for Training

Personal

High Protection Depends on the

occupancy Response Time

Fire Protection Systems

Lighting System

Integrated properly into the

building as a whole.

• Recognized the psychological

and physiological impact of

lighting upon humans

• Verify the requirements of the

medical and nursing staff

• Verify quantity and quality

Design Considerations

Lighting System

Quality factors in lighting

• Free from glare

• Properly distributed

• Adequate illumination levels

• Good color rendition

• Quiet and controllable

Lighting System

Type of lighting system

• Normal Lighting

Feeding through non-essential supply

• Critical lighting

Feeding through essential power supply

• Safety lighting

Feeding through essential power supply but including separate battery system

Lighting System

Hospital lighting applications (Examples)

• Patient and treatment rooms typically require relatively shadowless high intensity light at the center

• Operating rooms which use surgical lights should be lit to an ambient level high enough to produce sufficient visual comfort

• Patient rooms bed head unit is used for direct and indirect lighting, addition of incandescent luminaires at patient rooms as well as helps to achieve the home-like atmosphere.

• Corridor lighting Indirect systems or linear systems along the sides of the corridor

Lighting System

Operating rooms lighting

Indirect corridor lighting

Lighting System

Lighting Fixture used in

clean room

Bed Head Unit in

patient room

Linear along Sides corridor lighting

Lighting Fixture used in

intensive care unit

Lighting System

• Using compact fluorescent fixtures instead of incandescent fixtures.

• Control of lighting using proximity switches in equipment rooms, bathrooms, offices…etc

• Using infrared or ultrasonic occupancy sensors in selected spaces

• Effective use of daylighting in conjunction with switching.

• Using reflectors in fluorescent luminaires

Energy Saving

Electrical power system

Objectives of Power systems

Power systems for health care facilities require a high degree of:

• Safety

• Maintainability

• Expandability

• Flexibility

• Reliability

Electrical power system

Special design considerations

Most areas of health care facilities will require

additional considerations as dictated by:

• The numerous governing codes and standards.

• The use of complex and electrically sensitive

medical equipment.

• The patients and medical personnel must be

guarded against electrical hazards.

Electrical power system

• Normal power source

is furnished by the electric utility

• Alternate power source

by an on-site power source such as

a generator set, uninterruptible

power supply (UPS), or

battery/inverter system.

Power sources

Electrical power system

• Non-essential

electrical system.

• Essential electrical

system.

– Emergency System

– Equipment System

Distribution circuits

Electrical power system

Life Safety Branch

• Illumination of Means of Egress

• Exit Signs

• Alarm and Alerting Systems

Emergency System

Electrical power system

Network service

Electrical power systemEmergency System

Critical Branch

• Critical care areas

• The isolated power systems in special environments

• Patient care areas

• Nurse call systems

• Blood, bone, and tissue banks

• Telephone equipment rooms and closets

Electrical power system

Equipment System

Equipment for Delayed Automatic Connection

• Central suction systems

• Compressed air systems

• Smoke control and stair pressurization systems

• Supply, return, and exhaust ventilating systems

• Sump pumps and other equipment required to operate for the safety

Electrical power system

Equipment System

Equipment for Delayed Automatic or Manual Connection

• Heating equipment

• An elevator(s) selected to provide service to patient

• Automatically operated doors.

• Minimal electrically heated autoclaving equipment

• Hypobaric facilities.

Grounding System

• Equipment grounding

– Reduce electrical shock

hazards

– Provide freedom from fire

hazards

– Minimize damage to equipment

from component overheating

caused by over-currents, arcs,

or bolted faults

Grounding System

• System grounding

– To limit the potential differences between all

non-insulated conducting objects in a local

area

– To provide for isolation of faulty equipment

and circuits where a fault occurs.

– To limit over voltages appearing on the

system under various fault conditions.

Grounding System

Telephone systems

• Efficient and gracious handling of incoming calls

• Providing easy-to-use patient telephone service

• Providing access for visitors to the public network

• Providing an efficient communication base for administrative and operations staff

• Providing access to the public network for personal use by staff.

Design criteria for telephone systems

Telephone systems

• Private Automatic Branch Exchange (PABX)

• Main distribution frame (MDF)

• Back up battery and battery charger

• Telephone distribution network

• Telephone sets

Telephone System Components

Telephone systems

• Speed dialing

• Intercom

• Direct inward dialing (DID)

• Voice mail

• Automatic route selection

System features

Telephone systems

• ISDN compatibility

• Station message detail recording (SMDR) and station message detail accounting (SMDA)

• Tandem switching

• Remote diagnostics

System features

Nurse-call system

Objectives

• Provides a means for a patient to signal the nursing staff that he or she requires assistance.

• Patient-nurse communication

• Signaling other departments that a nurse or other staff member needs additional assistance.

Nurse-call system

• Type of nurse call system

– visual system

– audiovisual system

• Which rooms or areas need to communicate with each other

Design criteria

Nurse-call system

• Provides audible signaling and

visual annunciation of patient calls

• Normal calls and emergency calls from toilet emergency stations

• Utilized on small nursing units

• Used primarily in hospital ancillary areas such as physical therapy, radiology, hydrotherapy, and emergency departments or other treatment areas

Visual system

Nurse-call system

• Patient bed station

• Toilet emergency station

• Duty station

• Dome Light (corridor or bed)

• Master station annunciator

visual system components

Nurse-call system

• Provides audible signaling, visual annunciation,

• Patient-to staff communication,

• Staff-to-staff communication, and

• Intercommunication between master station annunciators

• Fully programmable input and output call levels

• Microprocessor-controlled systems

• Provide interface to, record system activity, and facilitate day/night transfer of calls between nurses stations.

Audiovisual system

Nurse-call system

• Patient bed station

• Patient station cord set (built-in bed controls)

• Toilet emergency station

• Duty station

• Master station annunciator -Microprocessor-controlled system

• Dome light (corridor or bed)

Patient station cord set

Dome light

Audiovisual system Components

Fire Alarm System

• Provide life safety which is a high priority in hospitals

• Protect property and heritage (structure, contents, and so forth)

• Limit the environmental impact of fire

Objective

Fire Alarm System

Conventional system

• A zoned system is where protected premises are divided into specific areas (zones)

• A number of devices sited appropriately.

• When a device is activated, the alarm panel indicates the zone where the fire has been sensed.

Type of Fire alarm systems

Fire Alarm System

Conventional system schematic diagram

Fire Alarm System

Addressable System

• Signals from each device and

is individually identified on the

fire alarm panel.

• The wiring configuration is

normally a loop for the devices

with separate sounder circuits.

Type of Fire alarm system

Fire Alarm System

Addressable system schematic diagram

Fire Alarm System

• Integrate with the overall fire protection plan.

• Compartmentalization, Fireproofing, Sprinklering

• A high percentage of patients in acute care

hospitals are not ambulatory.

• Ambulatory patients may be sedated and may

not be able to evacuate

• The high incidence of plastics, volatile liquids,

and other combustibles in a hospital

Design criteria

Fire Alarm System

• Fire alarm control panel

• Fire detectors (Smoke, Heat and Beam)

• Duct smoke detectors

• Manual pull station

• Bells and Horns

• Standby battery

• Emergency communication systems (fireman telephone)

System Components

Manual pull station

Smoke Detector

Electronic horn

Fire Alarm System

System Features

• Early detection

• Accurate location of the alarm origin

• Automatic control of HVAC system, elevators

and other system

• Fire department notification

• Automatically recall elevator to the ground level

at fire

Fire Alarm System

Schematic Block Diagram

Security Systems

Objectives

• Passive physical and staff monitoring provisions.

• Protect from staff leaving through unmonitored exits

Security Systems

• Metal-detection system

• Intrusion-detection system

• Closed-circuit television system

Security System Types

Security Systems

• To prevent unplanned or planned loss of valuable hardware, instrumentation, movable equipment,…etc

• Used at all loading (discharge) platforms to screen all carts or material-handling equipment leaving the facility.

Metal-detection system

Security Systems

Include:

• Door switches

• Motion detectors

• Capacitance detectors

• Photoelectric beams

• Pressure mats

Intrusion-detection system

Motion Sensor

Break Glass Sensor

Security Systems

Used for:

• Pharmacy dispensing

areas

• Drug storage

• Radiology

• Silver recovery

Intrusion-detection system

• Bulk storage rooms

• Gas storage rooms

• Cashiers

• Emergency exits

• Medical records.

Security Systems

CCTV System Including:

• Digital cameras

• Matrix switchers

• Multiplexer

• Digital video recorder (DVR)

• Monitors

• Controller

Closed-circuit television system (CCTV)

Security Systems

Television cameras are located in:

• Main lobbies

• Waiting areas

• Cashiers and counters

• Loading docks

• Parking areas.

Closed-circuit television system (CCTV)

Security Systems

• Verify saving and assurance

• Warn the security staff in case of intrusion

• Trigger an alarm if door opening time period longer than the preset time

• Recording and viewing live capture on multi-screen view

• Display and stored all alarm cases

• Surveillance from outside through Internet

• Automatic operation by Stored Program

System Features

Security Systems

Card Reader BiometricsDoor Alarm

Live Camera

Feeds

Card Reader

DatabaseDoor Alarm

DatabaseBiometrics

Database

SmartCatch

Vision

Central Matrix Switch

ALERTS

RULES

Card Reader

signal

Master Antenna and Television

System (MATV)

• Transmit visual and, when desired, audio data over cable circuits

• Obtain commercial entertainment programming or both

System Objectives

Master Antenna and Television

System (MATV)

Applications of television system

• Entertainment and education programming

• Interdepartmental communication

• Security monitoring

• Patient monitoring

• Pathology consultation

• Medical staff education

Master Antenna and Television System (MATV)

• Head end unit equipment (modulator, receiver modules, combiners, amplifiers, system rack…etc)

• Antenna and satellite receivers

• Television sets and recorders

• Computer-directed programming

• Master antenna and TV network ( Cables, Tap off, amplifiers, splitters …etc)

• CCTV Camera

System Components

Master Antenna and Television System (MATV)

Schematic Diagram

Data processing systems

• Patient information management

• Accounting and inventory purposes

• Laboratory information system

• Electronic filing technology

• Will be installed in most every area of the hospital

Objectives

Data processing systems

Data processing facilities shall be provided to

• All central control stations

• Nursing stations

• Patient rooms

• Laboratories

• Administrative areas

• Departmental offices

Data processing systems

A data system may consist of:

• Terminal equipment (workstations, personal computers…etc)

• Local distribution cable (a shielded twisted pair cable, coaxial cable, fiber optics cable)

• Transmission equipment (Switchers, hubs, …etc)

• Data center equipment (data processing centers, computer centers)

• Long-distance transmission facilities

• Rack with modular cable terminations

System Components

Data processing systems

• High reliability networks

• Easy for Extension

• High rate of data transmission

• Sharing devices like hard disk, scanner and printers available

• Security features to protect data

• Internet facility to all computers

System Features

Paging Systems

• Voice paging system (public address system)

• Radio paging system

• Flashing annunciator paging

Type of Paging System

Paging Systems

Voice paging system

Objectives

• Used to make general audio announcements

• Produce local audio signals over large floor areas

• Transmit background music

• Transmit recorded fire alarm system announcements

• interconnected with the building telephone, intercom

• For issuing instructions in response to emergency conditions

Paging Systems

Voice paging system

System performance is measured by:

• Reliability

• Control of signal sources

• Correct distribution and syllabic articulation of voice

Paging Systems

Voice paging system

Design criteria

• Priority (paging and other sources)

• Zoning (local volume and paging control)

• Distribution

• Muting (the priority signal mute the nonpriority)

• Volume control

• Sources (microphone, pr-ecorded message, background music)

Wall Mounted

Speaker

Microphone

Paging Systems

System includes:

• Preamplifiers

• Power Amplifiers

• Audio Mixer

• Zone paging consul

• Cassette player.

• Compact disc player.

• AM/FM radio tuner with relevant antennas

• Monitor panel.

• Loudspeakers

• Volume control

• Central equipment rack

Voice paging system

Paging Consul

Ceiling Speaker

Paging Systems

Schematic Diagram

Tuner

Central rackSpeakers

zonesCassette

player

CD player

Paging Systems

Radio paging systems

• Can be used for messages, or one-way or two-way voice transmission can be provided

• Effective in many areas where visual or voice paging is not practical

• Rest rooms, utility spaces, and nearby outdoor areas

• Radio paging can be tied into the telephone system

Objectives

Paging Systems

Radio paging systems

• Number of active radio pager users

• Average system call rate

• Desired grade of service

• Average input waiting time

• Maximum message storage time

Design criteria

Paging Systems

Radio paging systems

• System input or encoder

• On-site pagers

• Pager batteries and chargers

• Transmitter

• Base station

• Antenna systems

System components

Clock system

• Provide accurate and reliable time indication

• Efficient and safe operation of health care facilities

• Provide accurate and reliable synchronized time indication

Objectives

Clock system

• Nurses stations

• Recovery rooms

• Scrub sinks

• Birthing rooms

• Emergency treatment rooms

• Intensive care rooms

• Coronary care rooms

• Operating rooms

• Nurseries

• Lobbies

• Waiting rooms

• Cafeterias

• Staff lounges

• Offices

• Central control centers

System locations

Clock system

• Individual clocks

• Elapsed-time clocks

• Central clock system

System Types

Clock system

System Components:

• Master clock unit

• Slave clocks

• Networking (cables)

Central Clock System

Clock system

System Schematic Diagram

BMS System

• Control of mechanical and

electrical systems

• Saving time and effort

• Reduced maintenance

costs

• A PC with graphics

interfaces will also be used

Objectives

Electrical

SystemMechanical

System

Ventilation

systemDomestic water

system

Sanitary drainage

system

Water Treatment

system

Mechanical

Systems

Air conditioning

system

Lighting

system

Fire alarm

system

Security

System

Data processing

network system

Electrical

Systems

Closed Circuit TV

(CCTV)

Voice paging

system

Nurse call

system

Telephone

System

BMS System

• Energy-savings increases because energy is used only when needed

• Cost saving because operation depend on occupancy percent

• Good surveillance verifying more safety to the patient and staff

• Decreasing the maintenance cost and saving time

Features