[AC] [EL] 問﹕醫院Hospital Design 上有啲乜要留意？

答﹕

[AC]

一啲地方如Magnetic Resonance Imaging MRI Room 個Sensible Heat 會好大；
科普下﹕MRI 睇軟組織，即係對水同脂肪既嘢係清楚啲；CT原理係X光一樣，但唔係平掃可切片，MRI係CT高級版；PET-CT 主要係睇癌症轉移，食啲F-18混葡萄糖結構既嘢落肚後，衰變正電子，撞電子後出兩個方向既Gamma Way Detect成像；以上呢堆都可以3D成像；一般係平掃一張、側掃一張，Axial嗰張就Depends; X光只可以平掃；


Operation Room 
- Possitive Pressure;
- min. 20 ACH;
- min. 4 Outdoor ACH;
- min. Filter Efficiency: MERV-14
- Exhaust 都要經Filter

Protective Environment (PE) (Immunocompromise 抵抗力弱，Leukemia 白血病, Burns,HIV etc.)

- Possitive Pressure;
- min. 12 ACH;
- min. 2 Outdoor ACH;
- min. Filter Efficiency: HEPA (我估應該係指EU H13, 即係MERV 17)



*要裝個Device monitor住裡面同出面個Pressure Difference

Airborne Infection Isolation (空氣傳染病隔離)

- Negative Pressure (-2.5Pa);
- min. 12 ACH;
- min. 2 Outdoor ACH;
- min. Filter Efficiency: MERV-14
* All Room Air Exhausted Directly to Outdoors
Also refer: https://elvissharing.blogspot.com/2020/03/ac-isolation-room-mvac.html

普遍溫濕度都要控制，大概响21-24度，60% R.H. 內。
好多唔同病房可能有唔同Requirements, For Example, 
Upper Respiratory Disease, minimum 30% R.H.; 
Burn Patients, room temperatures up to 32°C db and relative humidity up to 95%;

用Air Cooled Chiller 相對會可靠啲；

睇DH本Guideline個要求似乎係所有地方既空氣都唔Recirculate

如果又唔用Thermal Wheel Recover 的話，個Ventilation Load 就係Outdoor嗰點同Design 嗰點

Filter Standard

ASHRAE 52.2 Minimum Efficiency Report Value MERV 17 大概係等於EU H13, 即係≧ 0.3µm 的話可以隔到99.97%;

AHU會先經一隻MERV 6 Disposable Panel Pre Filter


再經MERV 13 Disposable Bag Main Filter

之後再睇下經唔經HEPA

Ultra Low Particulate Air ULPA係比 High Efficiency Particulate Air HEPA再高一個檔次 (MERV 17 係HEPA, MERV18係ULPA);
*用0.3µm做參考既原因係再大粒啲，可以靠物理阻隔；再細粒啲，又可以靠靜電力黏住；係呢種Size最難隔所以攞嚟做參考標準

同時亦睇到，換氣次數越高，達到Removal Efficiency 99% 既時間就越短

Design上要留意呢啲Filter個Pressure Drop會好大

Reference: 

ASHRAE 170 Ventilation of Health Care Facilities; 

2019 ASHRAE Handbook Application - Chapter 9; 

HTM 03-01(MVAC); 

Guidelines for Healthcare Engineering System of Private Hospitals - Department of Health

[EL]

- Redundancy Design refer http://elvissharing.blogspot.com/2020/03/el-how-to-plan-design-electricity.html

- Equipment requiring 3 phase supply, permanently connected to a separate sub-circuit; (HBN 10-02)

- Genset full 100% backup;

- Critical care areas (Life Support / Complex Surgery / Critical Medical Equipment / Lighting / IT System / Medical Gas / Call System(有個call operator, 好似接線生咁)/ CCMS), UPS supply; (如果出現Earth Fault 都跳UPS, 應該即係Isolated Power Supply, 唔知有冇理解錯). UPS refer https://elvissharing.blogspot.com/2020/04/el-uninterruptible-power-supply-ups.html

- Night Lighting, 每個病床位5 lux, 夜晚睇嘢唔會影响到其他病人；

- Light Design reference CIBSE Lighting Code

Reference: 

HTM 06-01 (EL);

Health Building Notes HBN 10-02: Day Surgery Facilities;

[PD]

Plumbing

1. Separate water supply system (Twin Tank) provided for General water supply (Lav.) / water supply for medical equipment system

2. UV steriliser / Revise Osmosis RO water system provided for medical equipment water supply. Must be off tank water supply. (即係有個儲水箱？)

Drainage

3. Grey epoxy coated cast iron drainage pipe to enhance the durability and corrosion resistance for chemical discharge.

4. Separate drainage stack for medical / general lav discharge, Two pipe system shall be used. (洗手盆、浴缸等用一條落；馬桶有固體既用另一條Drain落)

[Gas] (Medical Gas Pipeline System MGPS; Dental Air and Vacuum System DAVS)

- Source 要分Primary, Secondary & Reserve;
- Pipe size are selected to ensure pressure loss below 5%;
- T&C都係試Gas 種類，Quality (particulate contamination), Quantity, System Function, valve function, 嗰啲嘢；
- Medical Gas 設計見下表，都係類似Fire Hydrant, 邊個位邊度一開就要見要幾多Pressure幾多Flow

Medical Air 就好似蒸餾水咁，一啲好乾淨既空氣；
Helium 用嚟醫Respiratory?;
Nitrogen 係用响空氣手術刀；
Oxygen唔洗講掛；
Nitrous Oxide 麻醉Anaes.用；
Vacuum 唔係氣體嚟，純綷係用嚟幫手抽走一啲嘢如Nitrous Oxide;

Reference:

HTM 02-01 Medical Gas;

Cap. 295 Dangerous Goods Ordinance;

[Pneumatic Tube System]
快速將啲Blood Sample / Documents 由一個地方經氣動裝置去到另一個地方，大概傳到5kg, 以5 meter per second

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2019年後，有條新法例 Cap. 633 Private Healthcare Facilities Ordinance 通過 (舊有Cap. 165 醫院、護養院及留產院註冊條例及Cap. 343 診療所條例由新呢條Cap.633取代(唔知有冇理解錯))

呢條條例將醫院分為三類﹕1. Hospitals, 可以Lodging or childbirth; 2. Day Procedure Centres, 可以Medical Procedures without Lodging; 3. Clinics, Medical Procedures or Lodging都唔得

*Medical Procedures including 外科、內窺鏡、化療、放療、麻醉 etc.

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(鳴謝﹕紅豆，K；Source: Guidelines for Healthcare Engineering System of Private Hospitals - Department of Health)