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HVAC IN OPERATION THEATER.

CIRCULATION ON
OPERATION THEATER.
Heating, Ventilation and Air-conditioning (HVAC) system of
ICU
Suitable and safe air quality must be maintained at all times.
Air movement should always be from clean to dirty areas.
It is recommended to have a minimum of six total air changes
per room per hour, with two air changes per hour composed of
outside air.
Where air-conditioning is not universal, cubicles should have
fifteen air changes per hour and other patient areas at least
three per hour.
The dirty utility, sluice and laboratory need five changes per
hour, but two per hour are sufficient for other staff areas.
Central air-conditioning systems and re-circulated air must pass
through appropriate filters.
For critical care units having enclosed patient modules, the
temperature should be adjustable within each module to allow a
choice of temperatures from 16 to 25 degrees Celsius.
A few cubicles may have a choice of positive or negative
operating pressures (relative to the open area).
Power back up in ICU is a serious issue. The ICU should have its
own power back,
which should start automatically in the event of a power failure.
This power should be sufficient to maintain temperature and
run the ICU equipment
Voltage stabilisation is also mandatory.
An Uninterrupted Power Supply (UPS) system is preferred for
the ICU
WHY HVAC IN OT?
Infection control in the operating room environment is the most
challenging as the nature of surgery provides significant infection
risk. The other aspect of surgery is that infections will be internal and
difficult to treat.

Hence, the operating room is a unique area, even within a hospital in


terms of the risk factors for a patient. Sources of infection are
multiple, including:
The patient, self-infection into the body from the patients skin
flakes and other particles on the body;
The operating room staff, from skin flakes, expired air, hair, etc.;
The surgical instruments, wadding, etc. used in the procedure;
Clothing worn by operating room staff;
The room and equipment used in the room;
Air supplied to the room;
Infiltration air.
Importance of a hospital hvac system
Hospital air conditioning and hospital ventilation systems are
required to meet higher standards of performance and serve a
greater function than those in standard buildings. A hospital HVAC
system is probably the most vital application of HVAC technology in
terms of human health, comfort and safety.
Hospital HVAC system design presents unique challenges due to the
level of demands placed on the it, the heating and cooling loads and
the requirements for dependability and hygiene.
A hospital air conditioning system also has the added challenge of
integrating with a number of other complex systems not present in
conventional buildings.
The function of the HVAC system is to create a comfortable
environment for occupants.
Hospital air conditioning and hospital ventilation systems are tasked
with controlling air temperature, air flow, air quality and humidity.
Maintaining temperature is essential to the healing and recovery
process.
Operating rooms have specific requirements that include
pressurization and higher levels of air filtration in addition to
temperature and humidity control.

CIRCULATION:
Ventilation should be on the principle that the direction of air flow is
from the operation theatre towards the main entrance. There should
be no interchange air movement between one OT and another.
There are two types of air conditioning systems : re-circulating and
non-re-circulating.
Non re-circulating systems heat / cool the air as desired and convey
it into the operating room with ideally 20 air exchange per hour. Air
is then exhausted to outside. Anaesthetic agents in the OT air are
also automatically removed. These are thus ideal but are expensive.
The circulating system takes some or all of the air, adjusts the
temperature and circulates air back to the room.
The broad recommendations include:
20-30 air exchanges / hour for re-circulated air
Only up to 80% recirculation of air to prevent build-up of anaesthetic
and other gases
Ultraclean laminar air flow - the filtered air delivery must be 90%
efficient in removing particles more than 0.5m m.
Positive air pressure system in OT: It should ensure a positive
pressure of 5 cm H 2 O from ceiling of OT downwards and outwards,
to push out air from OT.

Relative humidity of 40-60% to be maintained


Temperature between 20 0 -24 0 C. Temperature should not be
adjusted for the comfort of OT personnel but for the requirement of
patient, especially in paediatric, geriatric, burns, neonatal cases etc.