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Operating Room Air Distribution & Ceiling Systems

Operating Room Solutions


Agenda Operating Room Solutions
Introduction Air Distribution Ceiling Systems Summary

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Introduction O.R. Solutions


Applicable Standards ASHRAE 170
Ventilation of Health Care Facilities (2008) First release of this standard Widely adopted in North America

Introduction O.R. Solutions


Applicable Standards ASHRAE 170
Ventilation of Health Care Facilities (2008) First release of this standard Widely adopted in North America

Facility Guidelines Institute (FGI)


Guidelines for Design and Construction of Health Care Facilities (2010) Supersedes AIA/FGI 2006 Guidelines Adopted ASHRAE 170 for all HVAC requirements

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Operating Room Solutions Air Distribution

Air Distribution O.R. Solutions


Systems Laminar Flow Systems Air Curtain Systems

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Air Distribution O.R. Solutions


Laminar Flow Systems Laminar Flow Systems
Laminar diffuser array concentrated above surgical zone Displace particulates to low-level returns

Air Distribution O.R. Solutions


Laminar Flow Systems Benefits
Widely accepted design Supporting research Optional integrated filters

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Air Distribution O.R. Solutions


Laminar Flow Systems Ceiling Space
Diffusers consuming valuable ceiling space 25 to 35 cfm/ft2 (fpm) average face velocity (ASHRAE 170 2008)

Air Distribution O.R. Solutions


Laminar Flow Systems

Hybrid O.R. Challenges

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Air Distribution O.R. Solutions


Laminar Flow Systems Acceleration
Result of T between supply and room air Archimedes principle
ASHRAE RP-1397

Air Distribution O.R. Solutions


Laminar Flow Systems Acceleration
Tapering column of supply air

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Air Distribution O.R. Solutions


Laminar Flow Systems

Air Distribution O.R. Solutions


Air Curtain Systems Air Curtain Systems
Smaller laminar array Perimeter slot diffusers
25 to 45 cfm/ft discharge (15 outward from vertical)

Displace particulates to low-level returns

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Air Distribution O.R. Solutions


ASHRAE 170 Requirements

Air Distribution O.R. Solutions


ASHRAE 170 Requirements

Laminar Flow Diffusers

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Air Distribution O.R. Solutions


ASHRAE 170 Requirements

Primary Laminar Flow Diffuser discharge velocity

Air Distribution O.R. Solutions


ASHRAE 170 Requirements

Primary Laminar Flow Diffuser minimum coverage

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Air Distribution O.R. Solutions


ASHRAE 170 Requirements

ANY vertical discharge diffuser (i.e. Laminar Flow Diffuser or Perimeter Air Curtain Diffusers)

Air Distribution O.R. Solutions System Sizing Example


480 ft2 room 10 ft ceiling 20 ach 1600 cfm

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Air Distribution O.R. Solutions System Sizing Example


12 offset from surgical table
(per ASHRAE 170, 2008)

Air Distribution O.R. Solutions System Sizing Example


Laminar flow diffusers only in Primary Supply Diffuser Array Area
(per ASHRAE 170, 2008)

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Air Distribution O.R. Solutions System Sizing Example


MAX 30% for non-diffuser equipment 25 to 35 cfm/ft2
(per ASHRAE 170, 2008)

25 cfm/ft2 = 600 cfm

Air Distribution O.R. Solutions System Sizing Example


Diffuser layout flexible if minimum coverage satisfied

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Air Distribution O.R. Solutions System Sizing Example


Inside perimeter of air curtain diffusers:
2 ft offset from Primary Diffuser Array Area 3 ft offset from surgical table

Air Distribution O.R. Solutions System Sizing Example


Active linear slot 40 ft Air curtain flow (min.)
1600 cfm 600 cfm = 1000 cfm 1000 cfm / 40 ft = 25 cfm/ft

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Air Distribution O.R. Solutions System Sizing Example

Air Curtain System

480 ft2 20 ach

Laminar System

Air Distribution O.R. Solutions System Sizing Example

Air Curtain System

600 ft2 20 ach

Laminar System

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Air Distribution O.R. Solutions System Sizing Example

Air Curtain System

600 ft2 25 ach

Laminar System

Air Distribution O.R. Solutions


Air Curtain Systems Isolation of surgical zone

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Air Distribution O.R. Solutions


Air Curtain Systems

Air Distribution O.R. Solutions


Air Curtain Systems

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Air Distribution O.R. Solutions


Air Curtain Systems Why worry about velocity?
Contamination from surgical team Match thermal plume Comfort

Air Distribution O.R. Solutions


Air Curtain Systems Draft potential
Consider the locations of staff in the O.R. (i.e. Anesthesiologist)

Duct configuration
Ensure laminar flow and perimeter air curtain diffusers are fed from separate duct branches

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Air Distribution O.R. Solutions


Air Curtain Systems

Air Distribution O.R. Solutions


Air Curtain Systems

J. Swift, E. Avis, B. Millard, T.M. Lawrence. Air Distribution Strategy Impact on Operating Room Infection Control. 2007

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Air Distribution O.R. Solutions


Air Curtain Systems

J. Swift, E. Avis, B. Millard, T.M. Lawrence. Air Distribution Strategy Impact on Operating Room Infection Control. 2007

Air Distribution O.R. Solutions


Slot Style & Configuration

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Operating Room Solutions Ceiling Systems

1920s

1960s

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2000s

Now

Ceiling Systems O.R. Solutions


Introduction O.R. Grid Ceiling Systems
Extruded aluminum profiles Variety of finishes Closed cell gasket Removable panels Customizable layout

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Ceiling Systems O.R. Solutions


Advantages Advantages of O.R. Ceiling Systems
Improved aesthetics Convenient ceiling plenum access Better use of ceiling space Reduced construction time / cost

Ceiling Systems O.R. Solutions


FGI 2010 Guidelines

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Ceiling Systems O.R. Solutions


FGI 2010 Guidelines
Sheetrock

Ceiling Systems O.R. Solutions


FGI 2010 Guidelines
Sheetrock

Exception for gasketed ceilings

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Ceiling Systems O.R. Solutions


Fill-in Panels

Standard

Extruded frame

Ceiling Systems O.R. Solutions


Fill-in Panels

Flush Mount

Diffuser Match

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Ceiling Systems O.R. Solutions


Finish Options

Brushed Aluminum White Powder Coat Clear Anodized

Ceiling Systems O.R. Solutions


Ceiling Types Unistrut Integration
Mounting of C-Arm support tracks Cath. labs Hybrid operating rooms

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Ceiling Systems O.R. Solutions


Ceiling Types Integrated Plenum Systems
Pressurized common plenum reduces duct connection requirements Easy balancing Custom designs to suit each operating room

Ceiling Systems O.R. Solutions


Ceiling Types Integrated Plenum Systems

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Ceiling Systems O.R. Solutions


Cost Comparison
Surface Mounting Gasketed Grid Ceiling

38 penetrations - 378 linear feet

7 penetrations - 90 linear feet

Ceiling Systems O.R. Solutions


Cost Comparison
Surface Mounting
Surface Mounting Number of openings Cut, finish, frame openings Plaster frames (installed cost) Access doors Estimated Total 38 $14,700 $3,100 $1,100 $18,900

Estimates by installing contractor

38 penetrations - 378 linear feet

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Ceiling Systems O.R. Solutions


Cost Comparison
Gasketed Grid Ceiling

Factory Welded Grid System Number of openings Factory Welded Grid Cut, finish, frame openings Fill-in panels Grid/panel installation Actual Total 7 (6 can lights) $6,300 $3,800 $1,300 $3,500 $14,900 7 penetrations - 90 linear feet

Ceiling Systems O.R. Solutions


Cost Comparison
Surface Mounting Gasketed Grid Ceiling

$18,900 installed (excluding diffusers)

$14,900 installed (excluding diffusers) > 20% savings over surface mounting

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Operating Room Solutions Summary

Operating Room Solutions


Summary Both air curtain and full laminar flow systems can offer effective protection for the patient if designed correctly Grid ceiling systems offer significant benefits over conventional sheetrock ceilings

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Questions?

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