CODING
tems is key to ensuring that they will oper- ate properly when needed and is required in existing facilities. Unlike gas and vac- uum systems, these requirements for exist- ing facilities are prescriptive in the time- frames prescribed. In facilities requiring an emergency
power supply—typically a generator— the power is required to be restored within 10 seconds after the loss of nor- mal power. The purpose of the testing is to ensure that this restoration time can be met. The code requires generator sets be tested (per NFPA 110) 12 times per year at intervals not less than 20 days nor more than 40 days. Another impor- tant test, required by NFPA 110, is a once-every-three-years test required to be run for a minimum of four hours at 30 percent of the rating of the generator set.
Operating Rooms
A significant change in the 2012 edi- tion of the code says that all operating rooms are considered to be “wet proce- dure locations” unless a risk assessment is performed that determines otherwise. This is applied retroactively. Wet Procedure Location. The area in a patient care room where a procedure is performed that is normally subject to wet condi- tions while patients are present, including standing fluids on the floor or drenching of the work area, either of which condition is intimate to the patient or staff. The impact here is that wet procedure locations increase the risk of shock and electrocution to patients and staff under a fault situation. For this reason, they must be provided with an isolated power system or ground-fault circuit interrupt- ers. If existing operating rooms do not currently have this
protection, a risk
assessment must be performed to deter- mine if they are or are not wet procedure locations. If it is determined that these areas do not meet that definition, these rooms can be maintained as is; but if the rooms are wet procedure locations, the protection must be provided.
Electrical Equipment Electrical current that is not dangerous to healthy adults can be very danger- ous to those who are already in weak- ened states. NFPA 99 includes detailed requirements on testing of electrical equipment used in delivering patient care or that is likely to come into con- tact with patients. Because this test- ing is typically performed by biomed- ical equipment technicians, I will not get into details on those requirements. Intervals of testing should be deter- mined by the facility and other rules, such as those for alternative equipment maintenance (AEM) programs stipu- lated by CMS, should be observed. One issue of note, however, is
the use of extension cords, as well as relocatable power taps (power strips) within health care facilities. NFPA 99 allows extension cords to be used in health care facilities for the connection of patient care-related electrical equip- ment, provided the cabling meets cer- tain requirements. Relocatable power taps are permitted only in very specific use in patient care areas for connection with
patient care-related equipment.
Among other requirements, a power tap must be permanently attached to the equipment assembly. NFPA 99 does not prohibit or regulate their use in loca- tions where patients will not be treated.
Gas Equipment
Gas equipment addressed in NFPA 99 refers mostly to cylinders of nonflam-
mable gases that are not the source of a medical gas system as described ear- lier. These cylinders present hazards if they are mechanically damaged, and they present potential fire hazards if they leak and increase oxygen levels in the air. Where the volume of gas stored is between 300 cubic feet and 3,000 cubic feet, the location for that storage must meet several requirements including maintaining separation from flammable or combustible materials. Precautionary signs warning of the contents in the room must be placed on the doors or gates of these storage locations. Storage of gases where the volume is less than 300 cubic feet (approximately 12 E-cylinders) within a single smoke compartment is not required to be in an enclosure. Additional requirements include policies for elimination of sources of ignition, servicing and maintenance of oxygen equipment, transfilling of cyl- inders, use of the cylinders, purchase specifications, enforcement and, finally, special precautions on the storage of the cylinders, such as segregating empty cylinders to avoid confusion.
Closing
The design and construction of a system can be perfectly acceptable at the time of installation, but it is the daily oper- ational precautions and the inspection, testing and maintenance that ensure the effectiveness over the life of a system. These are the types of provisions that are identified by NFPA 99 as applying to existing ASCs. It is not meant to be overly burdensome by requiring that all existing facilities be brought up to the latest standards, but rather to ensure that ongoing operational and maintenance activities keep systems and equipment operating reliably and safely. For more information on NFPA 99 and for access to the code, visit
www.nfpa.org/99.
Jonathan Hart is a principal engineer for the National Fire Protection Association (NFPA) in Quincy, Massachusetts. Write him at
JHart@nfpa.org.
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