PRECISION I
Surgical
Air purity and infection control are matters of life and death in an operating theatre. Steve Hunt explains the key design requirements for ventilation and air movement systems in these highly specialised spaces
n a standard working environment – such as an offi ce or a hotel – the design and installation of a ventilation and air movement system is all about
Of course, not all air quality considerations relate to infection control and air purity; temperature control is equally vital
three things: cost, energy effi ciency and comfort. In an operating theatre, all of those considerations still apply, but so much more needs to be factored in. The specifi cation has to be incredibly sophisticated to cope with the increased risk of infection and the vulnerability of the patients it serves. What’s more, not all operating theatres are the same: increasingly, hospitals allocate specialist procedures – and specialist equipment – to specifi c theatres. So how should a ventilation and air movement system be designed to cope with these exacting demands?
Under pressure The varying nature of operating theatres across the UK’s hospital estates means that some are more easily upgraded to best- practice standards than others. Already such projects are under signifi cant time constraints, as it is logistically diffi cult for any hospital to have an operating theatre out of action for even the shortest of refurbishment programmes. For theatre refurbishments, therefore, the building services design must take account of ease and speed of installation, as well as the type of theatre, its location within the building and the design layout. These factors will affect the viability of pressure regimes, and whether the system can be integrated with existing plant services. Pressure regimes manage the differences in
air pressure between the operating theatre, the anaesthesia room and the patient preparation
60 CIBSE Journal March 2014
area. The premise is that the air movement system will create a positive pressure in the operating theatre by feeding more clean air into the space than it is extracting, contributing to infection control. An optimum pressure regime will generate positive pressures of 25Pa in a standard operating theatre, with 20Pa in the anaesthesia room, 5Pa in the patient preparation area and 0Pa in the corridors. The diffi culty for many older hospitals is
that pressure regimes are a relatively recent concept, and the design layout may not support their implementation because there is no airtight seal between the different spaces. Even in more modern theatres, pressure
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