Methods of Air Distribution

In Hospitals
Dan Int-Hout
Chief Engineer, Krueger

© 2012 Carrier Corporation

 Overview

Health Care Facilities include:

• Patient rooms
• Waiting rooms, lobbies and office areas
• Operating Rooms
• Laboratory spaces (often with hoods)
• High Ceiling Spaces (atria, lobbies)
All have different, specialized air distribution
system needs
 Air Distribution Device
Selection Guidelines
• The ASHRAE fundamentals handbook, chapter 20
(Air Distribution), provides guidance on several
methods of air distribution.
• Methods that are commonly used in Hospitals
include overhead fully mixed, as well as fully
stratified and partially mixed systems from below,
and laminar flow air delivery systems.
• Described delivery systems include constant and
variable volume, UFAD, displacement ventilation
and chilled beam systems.
• All have a proper place in a health care facility,
which must be understood by both the design
engineer and architect.
 Types of Air Delivery System in
Health Care Facilities

1) Overhead well mixed (patient rooms,

waiting areas, offices)
2) Laminar (pharmaceutical prep)
3) Laminar with air curtain (operating rooms)
4) Radial ceiling displacement (labs with
hoods)
5) Downward projection (high ceiling
lobbies, atria)
1.) Well Mixed Overhead Air Delivery

• Where: Patient rooms, offices, waiting

rooms
• Why: To provide a comfortable
environment.
• How: Proper selection of overhead air
distribution components.
 Overhead Air Distribution
Device Selection Guidelines

• For overhead well mixed systems, one

should select a unit with throw at max, and
minimum, flow that meets ADPI guidelines
based on diffuser spacing and T50 (throw
to 50 fpm).
• Additionally, select for maximum mixing:
• Noise can be good.
• Dirt on the ceiling is not bad.
• Air Distribution Effectiveness (ADE) is a
new term describing room air mixing, and
is a parameter with all delivery methods.
 Improperly Selected
Overhead Air Distribution

T-STAT
 Effective Overhead Air
Distribution

T-STAT
ASHRAE Journal, 2004, on overhead
air distribution selection
 Improper Overhead Heating Design

COLD
OUTSIDE

WINDOW
 Overhead Heating Perimeter
Considerations:
• Maximum delta-t for effective mixing when heating
from overhead, per ASHRAE handbook = ?.
• = 15°F (90°F discharge), continuous operation.
• Throw toward and away from glass.
• 150 FPM should reach 4-5 feet from the floor.
• ASHRAE 62.1 requires that ventilation be increased
by 25% when heating, if the above rules are not
followed.
• Typical perimeters require only 8°F Delta-t
@ 1cfm/sq.Ft.
 Perimeter Considerations:

See March 2007 ASHRAE Journal:

 Proper Perimeter Example

4’

< 90oF SUPPLY AIR, T150 > 8’

COLD
OUTSIDE
T-STAT
WINDOW
 Chilled Beams

Passive chilled beam

Chilled ceiling

Exposed Active Chilled Beam

Suspended Ceiling Active chilled beam

 Active Chilled Beams

• Remember – they are still diffusers

• The same selection rules apply as for other
slot diffusers
• Selecting for maximum capacity reduces
cost but raises possibility of reheat at part
load
• Beams have limited capability in perimeter
applications with poor building evnelopes.
 Schematic Diagram of a Chilled Beam System

Chilled Beams
Beams in Patient and Assisted Living Spaces

Primary Room
air supply air
supply
Water cooled
heat exchanger
Front
grille
Return air grille
Induced room air
and access panel
Plan B: The Chilled Fan Box
 Chilled Fan Box Summary

• Increased air distribution

flexibility
• Uses same mechanical
system as CB
• Complements CB by
addressing challenging
applications
– Atria
– Lobby
– High humidity locations
– Higher skin loads
• Minimal Contractor Training
• Guaranteed Performance
 2.) Laminar Air Delivery

• Where: Pharmaceutical Prep areas

• How: Perforated plate air outlet, low delta-t
• Why: To provide high volume, very clean
air for preparation and manufacture of
pharmaceuticals, measurement and
analysis of biological samples.
 Laminar Flow Device

Vertical Column of Air

• Velocity 30-100 fpm depending on T
• Can create very low particulate count
environments required for preparation
or mixing of prescriptions and
analyzing samples.
• Occupant comfort may be an issue
• HEPA filters have high pressure
requirtements
Animation of High Laminar Flow Diffuser
 Fan Filter Units

• Forward inclined centrifugal fan.

• HEPA and ULPA filters available.
• Snap-in prefilter.
• IEST-RP CC001.5 and IEST-RP CC0034.3 compliant.
• UL900 filters.
• Multiple material options.
• Walkable plenums.
 ECM Motors

The use of ECM motors can reduce the true energy consumption of
fan filter units.
• An ECM motor is a brushless DC motor, with an integral computer
controlled inverter.
• At reduced RPM and load, an ECM motor can use as little as 60%
of the watts of a standard Permanent Split / Capacitor Start (PSC)
motor.
• ECM motors in fan filter units are programmed to be pressure
independent, resulting in true constant volume performance,
easier balancing, and even DDC controlled performance.
 ECM Motors

Cautions:
• An ECM motor can add $350 to the purchase price of a fan
powered terminal.
• Power consumption CAN be greater than an equivalent PSC
motor, and the connected load requirement is usually higher
because of this.
• There are issues with the power factor of these types of devices,
which may cloud true energy savings.
• In typical use, however, the ECM fan filter unit will use
significantly less power than a PSC unit, with far greater safety
due to its inherent constant air flow capability.
 Fan Filter Unit Options

• Forward inclined centrifugal fan. • Airflow indicator light.

• HEPA and ULPA filters available. • On board of handheld remote
controllability.
• Snap-in prefilter.
• BMS integration.
• IEST-RP CC001.5 and IEST-RP
CC0034.3 compliant. • Challenge and test ports.
• UL900 filters.
• Multiple material options.
• Walkable plenums.
• Solid State or Digital Speed
Control.
• Power cords.
 3.) Laminar + Air Curtain Systems

• Where: Surgical Procedure Areas

• How: Combination of laminar panels and
vertical slots
• Why: Minimize contamination of patient
during surgery
 Goal of Operating Room Air Distribution Design-
Prevent infection:

• Preventing airborne pathogenic organisms from

contaminating patient, surgical wound and surgical
staff-
• Minimizing particulates entering the surgery site from the
air distribution system and surgical staff
• Providing compliance with hospital design standard room
air velocity requirement at the surgery site- typically 35
FPM maximum
• Assuring unidirectional airflow at the surgery site
 Typical Operating Rooms-Current Concepts

Equipment and utilities in operating rooms and building

design frequently limit ceiling space available for air
distribution
 Operating Rooms Based on Clean Room Air
Distribution Concepts?
In typical vertical cleanroom
applications laminar flow is
dependent on several factors:

• The entire ceiling is used for

supply air using only laminar
supply air panels.
• The entire floor is used for
return.
• Nearly isothermal supply air
temperature.
None of these conditions
exist in the operating room!
 Operating Rooms Based on Clean Room Air
Distribution Concepts?

Instead, typical operating rooms have:

• Only part of ceiling is available for air supply with
gaps in the laminar panel array required to provide
space for lighting and medical equipment.
• Exhaust is located low on the walls.
• Non isothermal cooling requirements (Typical room
temperature to supply air temperature ΔT=10-15ºF)-
causing supply air to accelerate after discharging
from ceiling outlets.
 Operating Rooms-Actual Conditions

Typical operating rooms:

• The surgical staff is a source of
contamination.
• HEPA filtration cannot address this source.
Traditional vertical laminar supply panels,
when installed as stand alone devices in
operating rooms, have characteristics that
make them undesirable…..
 Operating Rooms Employing Stand Alone Laminar
Panels
• The cool supply air accelerates on entering the room
and induces room air into the laminar supply air
stream.
• How much it accelerates depends on the ΔT between
supply air and room temperature as well as laminar
array size.
• This acceleration will likely result in air velocity at the
patient exceeding the recommended 35 feet per
minute with 80-100 FPM probable.
• This is enough to entrain room air and room
contaminants and introduce them at the patient.
Using Only Laminar Diffusers in Operating Rooms
Can Result in:

• Local areas of positive pressure causing

recirculation.
• If air is recirculating, it’s gathering particles.
• The concentrated laminar array and low
return/exhaust aggravate these conditions.
• The result can be contaminated air entrained
into the clean flow.
• Stratified air at ceiling when heating room
 Using Only Laminar Diffusers in Operating
Rooms Results

ASHRAE 170-2008 requires low sidewall exhaust grilles

Desired effect

But, in an ACTUAL surgical situation with

temperature gradients, surgeons, surgical
equipment, and… the patient you usually get this:

The indicated air recirculation is alleviated by

providing laminar coverage at appropriate velocities
and control of the air supply through the laminar
panels.
 How The Air Curtain System Works

•A specially designed air curtain is

placed around the center laminar
panels-typically providing 60%-67% LAMINAR
of total room supply air. PANELS
•Laminar panels, not necessarily
adjacent to each other, typically
provide 33%-40% of room supply
air. Panel spacing provides room for
lighting and other equipment without
compromising conditions at the
patient. PERIMETER SLOTS
•Both the laminar panels and air
curtain slots incorporate equalizers
to assure even airflow across the
faces of the outlets.
 How The Air Curtain System Works

• Many think that the air curtain as only a

protective barrier.
• It is, but it’s much more…
• It is the exhaust for the laminar flow, making
it behave better, thereby resulting in he
laminar array to be interrupted at the ceiling
without compromising the desired air pattern
at the patient.
• It acts as a protective barrier to keep
recirculating contaminated air away from the
laminar flow.
 4.) Radial Ceiling Displacement

• Where: Spaces with operable fume hoods

• Why: To avoid creating drafts at the face of
a fume hood which might extract
contaminants into the room
• How: Provide radial ceiling air distribution
devices that minimize room induction
 Laboratory HVAC Design Parameters

• Define Air Change Rate requirements

• Suppress & Remove Airborne Contaminants
• Optimize Air Change Effectiveness
• Control and Direct Room Air Motion
• Provide Occupant Comfort
• Room Controls
• Aid in Fume Hood Containment
 Control and Direct Room Air Motion

Controlled Flow to avoid:

• Excessive Drafts
• Recirculation
• Hot and Cold Spots
• Interference with Experiments
• Compromise Fume Hood Safety
• Temperature Swings
 Fume Hood Containment

ASHRAE Standard 110: 4.11.2 Supply Air Distribution -

“Supply air distribution shall be provided to create air jet
velocities {distributed towards the hoods}less than half
(preferably less than one-third) of the capture or face
velocity of the exhaust hoods.”

Fume Hood Face Velocity = 100 fpm

 Fume Hood Containment

Fume Hood Locations

• Avoid walkways
– Prevent spillage due to walking wake
• Avoid fume hoods near exits
– Spills or accidents
may increase the
danger
 Why not a Laminar Flow Device in the
Laboratory?

• Vertical Column of Air

• Velocity 30-100 fpm depending on T
• Turbulence in space
• Fume Hood Face Velocity Disturbance
• No Occupant comfort
• Operational Efficiency is Sacrificed
• Results in higher ACR to reduce particle counts
• Non Uniform SpaceTemperature
 Why Use a Radial Displacement Diffuser in a
Laboratory?

• Creates a low velocity radial air flow pattern

• Suppresses mixing & re-circulation of air
• particles and gases pushed down and away from work area
toward exhausts
• minimal age of air (one-pass-then-out)
• Operational Efficiency
• ACE vs. ACR improved
• Occupant comfort
• Uniform Temperatures
• Improved Acoustics
• Minimal Fume Hood
interference
 Performance Matters

• Notice Jets
– Competition photo
published in ASHRAE
magazine

• Perforated Metal Physics

– Air wants to travel Horizontal or Vertical to the face of
the perforated metal
– The larger the  T the more difficult it is to throw at a
45° angle
 5.) High Ceiling Air Distribution

• Where: Lobbies, reception, atria and

waiting rooms.
• Why: High ceiling are a challenge to heat
and cool with a single system
• How: Proper selection of air quantities and
delta-t along with dynamic system
modification.
 Special Applications

High Bay Application - Ceilings Over 12’ High

• Heating is a challenge due to buoyancy.
– Take advantage of vertical stratification where possible.
– Required Heating airflow rate may exceed cooling airflow
rate.
– Keep heating supply air temperature to room temperature
ΔT to a minimum.
• If supplying air distribution from the ceiling, consider
using round diffusers, drum louvers, or diffusers with
some vertical projection.
• One cannot use ADPI to predict heating performance.
• Consider Displacement Ventilation
 Diffuser Selection & Buoyancy

• ADPI isn’t always the best way to analyze, select and

place diffusers, especially with heating and high bay
applications.
• One can estimate Throw as a function of ΔT and
buoyancy.
• Simple rule: Distance to 75 ft/min is affected by
1% / degree(F) ΔT.
Example:
1. 20°ΔT Cooling, Vertical Down = +20% projection
2. 20°ΔT Heating, Vertical Down = -20% projection
3. 20°ΔT Heating, Along Ceiling = +20% projection
 Side Wall Selection & Buoyancy

Horizontal Free Jet:

• Vertical change @ 75 ft/min is affected by 1% of 75 fpm
throw/F0 ΔT.

Example: 15oF Delta T heating

15% T75

T75

Note: T150 is not affected by Delta-t

 Summary

• Hospitals have several different air distribution needs

• Overhead Well mixed is recommended for patient rooms,
offices and waiting areas
• Laboratories requiring an ultra clean environment should
use an array of laminar outlets. Fan Filter units can provide
an effective solution.
• Fume Hood labs, however, should employ radial air
distribution to avoid compromising hood safety.
• Operating Rooms are not clean rooms, and an air curtain
can decrease the risk of contamination of the patient.
• High ceilings require special considerations of air
temperature and volume to both avoid cooling drafts and
heating stratification.