VENTILATION SYSTEMS
State-of-the-art, ultra-clean ventilation at Karolinska Solna.
solution was tested first in a demo room with a number of simulated operations, with the aim of checking the cfu level in operation, recovery time, and other factors.
It was also important to take into consideration the need of personnel to move around the room, and this differs according to type of procedures. In orthopaedics, personnel may be positioned on two sides of the operating table, while bariatric surgery and neurosurgery, for example, may require different positioning and movement around the table.
In each case, instruments are located behind or to the side of surgeons. This can mean the instrument tables are located outside of the traditionally understood sterile area. Alternatively, if they are located within the sterile area, they are often not in the optimal position for the team to operate. All too often, instruments and tables cross the lines that are not supposed to be crossed.
Installing flexibility
So, what does ‘Ultra-Clean’ actually mean? In the New Karolinska Hospital this is below 5 cfu/m3
, significantly cleaner
than the standard required in Sweden (which is double this level), as well as other countries. This highly advanced solution was required to meet the future demands of the hospital, taking into consideration the fact that the rules and standards may become more stringent over time.
Modern medicine is characterised by the increasing amount of advanced medical equipment within the OR space. Advanced diagnostics, non-invasive procedures, and precision surgery require a multitude of screens, laparoscopic equipment, angiographs, and robots. The tools required are ever-changing and advancing, so the OR is constantly evolving over time.
It is therefore crucial to ensure enough 26 Health Estate Journal November 2020 The Halton Vita OR ventilation system.
resolved by placing each air re-circulation unit in one of the room’s corners, and to keep only the primary air (1000 m3
/h)
The ventilation system allows maximum space in critical ceiling areas.
space inside the OR, but also on the walls and on the ceiling, to ensure flexibility – both now and in the future. New ideas on how to position the ventilation system were welcomed, to release as much space as possible in critical ceiling areas. The chosen solution leaves the middle part of the ceiling free for lamps, pendants, and other equipment. At the same time, it is able to ensure an ultraclean level over critical spaces, where human concentration is highest (and thus the microbiological contamination is at its greatest).
Wellbeing and safety for tomorrow A common issue in many buildings is the fact that technical areas are located some distance from the operating rooms. So, how do you run large ventilation ducts throughout the building? This was
delivered from the main machinery room. This gives flexibility for future adjustments, even if some rooms would have to move around the building. Also, by making the high-pressure duct extremely short, specific fan power (SFP) factors are significantly reduced. Personal wellbeing must also be taken into account. Several factors – such as the use of daylight, spacious rooms, and the acoustic environment – were taken into consideration. A very demanding target of 35 dB(A) was set for the general ventilation noise emission, and this level was achieved by the chosen solution. It is not only important for personnel to properly focus, but also to ensure effective communication, reducing the potential for errors.
The chosen system
The current Swedish standard for OR ventilation (SIS-TS 39-2015) allows two types of ventilation solutions: inside OR – laminar (UDF) and mixing. The main aim is to be able to ensure below 10 cfu/m3
.
Key project team member, Johan Nordenadler, explains: “In my doctoral studies at KTH, I discovered that laminar flow systems, that use air velocities under 0.4 m/s, do not work as described, and
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