Electromechanical systems in Hospitals

1. Electromechanical Systems
in Hospitals
By
Moustafa M. Elsayed
(Consultant)

2. Mechanical Systems
• HVAC System
• Smoke Control System
• Fire Protection System
• Medical Gases System
• Hot & Cold Water
System

3. 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

4. HVAC System
Objectives
• Comfort
• Indoor Air Quality
• Cross contamination
• Smoke control in fire

5. HVAC System
Comfort
• Temperature & humidity control:
single and multi-zones
• Air distribution: supply & return
terminals
• Air distribution: terminal velocity
• Insufficient oxygen
• Noise

6. 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

7. 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

8. HVAC System
Cross Contamination
• Kitchen: negative pressure
• Toilets: negative pressure
• Corridors & patient rooms:
positive and negative pressure
• Hospital building: positive
pressure

9. HVAC System
Energy Saving
• Design and construction
• Temperature control
• Occupancy sensors
• Excessive & insufficient outdoor
• Energy recovery equipment
• Economizer cycle

10. Smoke Control System
• Stair case pressurization
• Smoke removal
• Smoke migration
• Make up air

11. Hot & Cold Water
Uses
• Domestic
• Cleaning
• Process
• Heat removal of
equipment

12. Hot & Cold Water
Legionnaires’ Disease
Occurred after persons
have breathed mists that
come from a water source
contaminated with
Legionella bacteria.

13. Hot & Cold Water
Sources of Legionella Bacteria
• Cooling towers
• Shower heads
• HVAC humidifiers
• Respiratory-care equipment
• Warm stagnant water

14. 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

15. Hot & Cold Water
Heating Sources
• Electrical heaters
• Steam boilers
• Hot water boilers
• Heat pumps
• Chillers Heat rejection

16. 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.

17. 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

18. 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

19. Medical Gas Systems
Typical Bulk
Supply System

20. Medical Gas Systems
Medical
Air
System

21. Medical Gas Systems
Typical Medical Vacuum System

22. Fire Protection Systems
Objectives
Protection of:
people
properties

23. 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

24. Fire Protection Systems
Possible Systems
• Automatic sprinkler system
• Automatic gas suppression system
• Automatic mist system
• Manual: standpipe system
• Manual: portable extinguishers

25. Sprinkler Heads: Pendent & Upright
Fire Protection Systems

26. Fire Protection Systems
Automatic Sprinkler System

27. Fire Protection Systems
Automatic Sprinkler System

28. Fire Protection Systems
Gas Suppression System

29. Fire Protection Systems
Manual fire fighting equipment

30. Comparison
SprinklerExtinguishersItem
Very HighLowInitial Cost
High ProtectionNo
Protection at
Unoccupied Areas
HighLow
Operating Cost &
Maintenance
LowLow
Need for Training
Personal
High Protection
Depends on the
occupancy
Response Time
Fire Protection Systems

31. 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

32. Lighting System
Quality factors in lighting
• Free from glare
• Properly distributed
• Adequate illumination levels
• Good color rendition
• Quiet and controllable

33. 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

34. 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

35. Lighting System
Operating rooms lighting
Indirect corridor lighting

36. 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

37. 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

38. Electrical power system
Objectives of Power systems
Power systems for health care facilities require a
high degree of:
• Safety
• Maintainability
• Expandability
• Flexibility
• Reliability

39. 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.

40. 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

41. Electrical power system
• Non-essential
electrical system.
• Essential electrical
system.
– Emergency System
– Equipment System
Distribution circuits

42. Electrical power system
Life Safety Branch
• Illumination of Means of Egress
• Exit Signs
• Alarm and Alerting Systems
Emergency System

43. Electrical power system
Network service

44. Electrical power system
Emergency 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

45. 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

46. 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.

47. 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

48. 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.

49. Grounding System

50. 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

51. 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

52. Telephone systems
• Speed dialing
• Intercom
• Direct inward dialing (DID)
• Voice mail
• Automatic route selection
System features

53. Telephone systems
• ISDN compatibility
• Station message detail
recording (SMDR) and
station message detail
accounting (SMDA)
• Tandem switching
• Remote diagnostics
System features

54. 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.

55. Nurse-call system
• Type of nurse call system
– visual system
– audiovisual system
• Which rooms or areas
need to communicate with
each other
Design criteria

56. 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

57. Nurse-call system
• Patient bed station
• Toilet emergency
station
• Duty station
• Dome Light (corridor or
bed)
• Master station
annunciator
visual system components

58. 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

59. 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

60. 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

61. 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

62. Fire Alarm System
Conventional system schematic diagram

63. 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

64. Fire Alarm System
Addressable system schematic diagram

65. 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

66. 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

67. 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

68. Fire Alarm System
Schematic Block Diagram

69. Security Systems
Objectives
• Passive physical and staff monitoring
provisions.
• Protect from staff leaving through
unmonitored exits

70. Security Systems
• Metal-detection system
• Intrusion-detection
system
• Closed-circuit television
system
Security System Types

71. 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

72. Security Systems
Include:
• Door switches
• Motion detectors
• Capacitance detectors
• Photoelectric beams
• Pressure mats
Intrusion-detection system
Motion Sensor
Break Glass Sensor

73. 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.

74. Security Systems
CCTV System Including:
• Digital cameras
• Matrix switchers
• Multiplexer
• Digital video recorder
(DVR)
• Monitors
• Controller
Closed-circuit television system (CCTV)

75. Security Systems
Television cameras are located in:
• Main lobbies
• Waiting areas
• Cashiers and counters
• Loading docks
• Parking areas.
Closed-circuit television system (CCTV)

76. 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

77. Security Systems
Card Reader Biometrics
Door Alarm
Live Camera
Feeds
Card Reader
Database
Door Alarm
Database
Biometrics
Database
SmartCatch
Vision
Central Matrix Switch
ALERTS
RULES
Card Reader
signal

78. Master Antenna and Television
System (MATV)
• Transmit visual and, when
desired, audio data over
cable circuits
• Obtain commercial
entertainment programming
or both
System Objectives

79. 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

80. 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

81. Master Antenna and Television System
(MATV)
Schematic Diagram

82. 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

83. Data processing systems
Data processing facilities shall be provided to
• All central control stations
• Nursing stations
• Patient rooms
• Laboratories
• Administrative areas
• Departmental offices

84. 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

85. 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

86. Paging Systems
• Voice paging system
(public address system)
• Radio paging system
• Flashing annunciator
paging
Type of Paging System

87. 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

88. Paging Systems
Voice paging system
System performance is measured by:
• Reliability
• Control of signal sources
• Correct distribution and syllabic
articulation of voice

89. 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

90. 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

91. Paging Systems
Schematic Diagram
Tuner
Central rack
Speakers
zones
Cassette
player
CD player

92. 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

93. 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

94. Paging Systems
Radio paging systems
• System input or encoder
• On-site pagers
• Pager batteries and chargers
• Transmitter
• Base station
• Antenna systems
System components

95. Clock system
• Provide accurate and reliable
time indication
• Efficient and safe operation of
health care facilities
• Provide accurate and reliable
synchronized time indication
Objectives

96. 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

97. Clock system
• Individual clocks
• Elapsed-time clocks
• Central clock system
System Types

98. Clock system
System Components:
• Master clock unit
• Slave clocks
• Networking (cables)
Central Clock System

99. Clock system
System Schematic Diagram

100. 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

101. Electrical
System
Mechanical
System

102. Ventilation
system
Domestic water
system
Sanitary drainage
system
Water Treatment
system
Mechanical
Systems
Air conditioning
system

103. 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

104. 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