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