PUNJAB INSTITUTE OF MEDICAL SCIENCE

ELECTRICAL SYSTEM
NON-
Electrical system includes the following: ELECTRIC CONVENTIONAL
ELECTRIC
FILLINGS AND
ENERGY
• Nature and magnitude of load
SUPPLY INSTALLATIONS

• Source of electric supply

• Short circuit protection CVT/VOLTAGE ELECTRIC

• Alternative methods of electricity like standby generator, STABILIZER

• Inverters, etc. STEAM AND

• Load assessment, load distribution
AIR
HOTWATER CONDITIONING
SUPPLY LIFTS AND FIRE AND
• Lighting PROTECTION REFRIGERATION

• Air conditioning
• Isolation transformers for operation room complex
• Switchgears and control panels inside, in a shaded/dust
• free environment.
DUAL SUPPLY
IN ESSENTIAL
CONTROL
PANEL AND
• All important areas like emergency, OT, ICU to have dual supply.
MAIN
SOURCE AREAS POWER
CIRCUITS
• Standby DG sets (noise free) with SEB, SPCB approval.
• One electrical circuit for 10 lights/ fan points.
• One power circuit for two 15 Amp sockets/1800 Watts.
ELECTRICITY
• Use of appropriate MCB.
• Steel conduits tubes more preferable than PVC tubes.
CABLES AND
ALTERNATE
SOURCE • No socket/switches in anesthetic store room.
GENERATOR
•
TRANSFORMERS
SWITCHES
NON-
CONVENTIONAL
High illumination in Admin offices, nursing station, dietary store,
• examination rooms.
• Illumination standards for different areas.
FIRE FIGHTING SYSTEM

• A Multi-Storey Hospital requires the following fire safety measures as per National Building Code, Part IV.
• 1. Fire extinguishers as per BIS-2190.
• 2. Hose reel on all floors.
• 3. Wet riser system with landing values on all floors.
• 4. Yard Hydrant system.
• 5. Automatic sprinkler system.
• 6. Manually operated electric fire alarm systems.
• 7. Automatic Detection and alarm system.
• 8. Underground static water storage tank of 50,000/1, 00,000 1ts. Capacity.
• 9. Terrace water tank of 10,000/20,000 1ts. Capacity.
• 10. One electric and one diesel pump of 2280 LPM/min and one Jockey (electrical) pump of 180 lts/min.
• 11. Emergency lighting and exist sign boards.
FIRE FIGHTING SYSTEM
•A TOTAL NUMBER OF 16 STAIRCASES AND 16 LIFTS HAVE BEEN PROVIDED
• ALL FLOORS ARE CONNECTED VERTICALLY THROUGH CENTRALLY LOCATED RAMP.
•THE OPERATION THEATRE CONSISTS OF SEPARATE INTERNAL STAIRCASE FOR DOCTORS AND NURSES.
RAMP CONNECTED
TO ALLFLOORS

FIRE ESCAPE STAIRCASE

DISTANCE BETWEEN
TWO STAIRCASES-25M

ENTRANCE

STAIRCASE
RAMP
LIFTS

LIFTS CORE (2X 3.2 M)

ENTRANCE ENTRANCE
NO.OF WIDTH NO.OF LIFT NO.OF LIFTS
STAIRCASE CORES
16 2M 4 16
WATER SUPPLY
INTRODUCTION
The supply of safe and sufficient amounts of water is important in the
EXTERNAL
healthcare sector, as water is not only needed for consumption and SUPPLY RO INTERNAL
SUPPLY
SYSTEM
cleaning, but also for different medical and non-medical procedures and CORPORATION BOREWELL

processes, such as hydrotherapy, cooling water and haemodialysis.

STORAGE
TANK
Source of water Storage locations PERIODIC WATER
TESTING
WATER
SUPPLY
• Municipal main • Underground tanks
• Private water supply • Surface mounted tanks CHORINATION

• Own well/water catchment • Elevated tanks

OVERHEAD DISTRIBUTION
PUMP
TANKS TANK AND
TYPES OF WATER SUPPLY: PIPELINES
MOTORS

Normal water - Arrangement shall be made to supply the following

quantities of potable water per bed per day to meet all requirements (
including laundry ), except fire-fighting, in all categories of hospital. WATER REQUIREMENT

PATIENTS 30 LITRES/DAY
Hot water - Hot water supply to wards and
departments of the general hospital shall OTs 5 LITRES
be provided by means of electric storage
type water heaters or centralized hot PHYSIOTHERAPY 500 LITRES/DAY
water LABS 1000 LITRES/DAY

Filtered and soft water - Filtered and soft water supply is required LAUNDRY 50 LITRES/BED/DAY
in pathology laboratories and shell be supplied as requirements. ATTENDANTS 15 LITRES/BED/DAY
Cold water - Cold water supply is needed for processing tanks in film KITCHEN 10 LITRES/BED/DAY
developing room and shall be supplied as required.
WATER SUPPLY

UNDERGROUND WATER TANK

PUMP ROOM

MUNICIPAL MAIN

• R.O. plant is there for filtration of

water and supply it to the special
areas
• Fully automatic steam boilers are
there for hot water supply
WASTE WATER MANAGEMENT
INTRODUCTION
Healthcare wastewater is any water that has been adversely affected in quality by
anthropogenic influence during providing healthcare services. It is mainly liquid
waste, containing some solids produced by humans (staff and patients) or during
healthcare related processes including cooking, cleaning or laundry.

SOURCES OF HOSPITAL WASTEWATER

• Patient wards & administration unit

• Kitchen/canteen and laundry
• Operating rooms and ICUs
• Radiology & dialysis section
• Laboratories

TYPES WASTE WATER

• Black water- sewage
• Grey water- sullage
• Storm water

MANAGEMENT OF WASTE WATER

• Different system installation for each type
• Pre-treatment of wastewater
• Discharge in municipal main
• On site waste-water treatment
• Disposal of sludge
MEDICAL GAS DISTRIBUTION SYSTEM

• Medical Gas Distribution System is a central supply system to supply a medical gas (O2, N2O, N2), medical air, and
medical vacuum to each ward of hospital safely and conveniently through a central supply piping from medical
gas supply sources.

Design
• The outside walls of rooms for cylinder supply systems shall be
built of materials having a fire rating of at least 1 hour.
• Doors to the room shall open outwards and personnel shall be able to
open the doors from the inside without a key.
• Electrical wall fixtures in rooms for supply systems shall be positioned at
least 1.5 m (5 ft) above the floor to avoid physical damage.
• The ambient temperature in rooms for supply systems shall not exceed 40°C
for any gas and shall not be less than 15°C for nitrous oxide and carbon
dioxide.
• Ventilation: Provided that the room has venting with a
total free area of at least 465 cm2.
• The outlets of pressure relief vent pipes shall be at least 3 m from any door,
operable window, or ventilation intake
and located so that discharges will not endanger passersby.
• The ducts run throughout the buildings, branching along every kind of wards and
units.
MEDICAL GAS DISTRIBUTION SYSTEM

Color Codes:
Provided pipelines
- Nitrous Oxide N2O - Blue colored pipes
- Medical Vacuum - Yellow colored pipes
- Carbon Dioxide CO2 - Grey colored pipes

GAS PIPELINE GUIDELINES

1. Pipelines and electrical services shall either
a) run in separate compartments, or
b) be separated by more than 50 mm

2. If pipelines are placed underground, they shall be placed in tunnels or ducts.

Duct size: 2’-6” x 2’-0”

3. All pipelines for medical gases shall be routed in such a way that they are not
exposed to a temperature less than 50 C
above the dew point of the gas at pipeline pressure.
Maximum intervals between supports for gas pipes
MEDICAL GAS DISTRIBUTION SYSTEM

Components Provided:
• Medical Gas Pipelines
• Shutoff valves
• Warning and Alarm System
• Bedhead Units
• Vacuum Pipe

Bedhead Unit

Warning & Alarm System Medical Gas Pipeline Medical Gas duct
MEDICAL GAS DISTRIBUTION SYSTEM
GAS SUPPLY

D.G.SET

BASEMENT FLOOR PLAN GROUND FLOOR PLAN

HVAC SYSTEM
INTRODUCTION
• Hospitals need a functional HVAC system to stay operational.
This is especially true for places like a clean room or an
operating room. Air-exchange, humidity, pressure and
temperature have to be precise in such environments to
minimize the risk of infection for patients.
• However, even outside of the operating room, HVAC systems
are required to not only keep high IAQ levels, but maintain
specific temperatures to minimize bacterial growth throughout
the hospital. HVAC in
• Some of the special HVAC equipment's used are: operating
1. HEPA filtration systems. theatre
2. Re-circulating air ceiling systems for operating rooms.
3. Special ventilation using filter fan units, fiber filters, and quiet
air-mixing systems.
4. Wall heating/cooling units that are built in to the walls.
5. Static cooling systems that provide cooling without moving air. HEPA
6. Adjustable multiplex air jet outlet systems that target air flow filter
exactly to desired locations in a room.
HVAC SYSTEM
COMPONENTS OF HVAC SYSTEM
Chiller system is used in the hospital. Chiller, Cooling Tower and Air Handling Unit work
together to provide air conditioning (HVAC) to a building.
Chiller – It will usually be located either in the basement or on the roof and this depends
on what type of chiller is used. Roof top chillers are usually “Air cooled” which is used to
generate cold water for air conditioning by removing the unwanted heat from the
building.
AHU - An air handling unit (often abbreviated to AHU), is a device used to regulate and
circulate air as part of a heating, ventilating, and air-conditioning system.
Cooling tower -The cooling tower is usually located up on the roof and is the final Chiller unit
destination for the unwanted heat in the building. The cooling tower contains a large fan
which blows air through the unit.
Ductwork - These unseen parts of the HVAC system are responsible for distributing
air. Ductwork is typically located in the walls or ceiling, ending at the vents and registers in
the home’s rooms.

Ductwork AHU
 HVAC SYSTEM
AREAS CONSIDER FOR HVAC DESIGN:
Critical Care Spaces:
• single duct terminal reheat or double duct systems is used.
• Simultaneous temperature, humidity, and pressurization control requirements for
these spaces preclude the use of other types of systems.
Administrative Areas:
• single duct reheat, multi-zone, VAV, or dual-duct systems, with perimeter radiation
when required.
Outpatient Clinics:
General ward in patient
• single duct reheat, dual duct, VAV, or multi-zone systems can be used.
• Outpatient clinics may be served by single duct reheat, dual duct, VAV, or multi-zone
systems.
Patient Bedrooms:
• dual duct, multi-zone, VAV, or single duct reheat systems can be used.
• Perimeter radiation systems (radiant panels) may be considered in conjunction with
these air systems.
Patient Isolation Bedrooms:
• airflow systems can be used.
• Pressurization control equipment serving Protective Isolation and Disease Isolation
Bedrooms shall be connected to the emergency electrical power system. Patient isolation bedroom
SINGLE DUCT SYSTEM
• The simplest and most common of the “All-
Air” central systems
• either hot air or cold air flows, but not both
simultaneously
• control is based on temperature and humidity
ratio measured at a single point

DUAL DUCT SYSTEM

• The dual-duct system employs two air ducts,
one cold air duct and one warm air duct.
• the supply air fan splits the flow into two
streams. One stream flow through the cooling
coil and gets cooled and dehumidified to
about 52°F, while the other stream flows thru
the heating coil and is heated to about 95–
110°F.

VAV SYSTEM
• system delivers a constant air volume to the
conditioned space irrespective of load.
• The air conditioner cycles “on and off”, or
chilled water is modulated for a chilled water
cooling coil, as the load varies.
• system changes the quantity of air supplied to
a space in response to changes in loads.
HVAC SYSTEM
COOLERS ARE ALSO PROVION
• For air conditioning a chill water system was installed. THE TERRACE TO COOL
• A.C. Plant room was located in the basement . SUMMERS.(STACK EFFECT)
• Four air chilled centrifugal chillers were there to provide chilled water supply to A.H.U.
• Three hot water generator of 400 kw capacity were provided for
Heating .
• There are 4 no’s condenser water pumps and 3 no’s hot water pumps located in the
plant room.
• A.C. Ducts were covered by metallic false ceiling .
• All A.C. Ducts were properly insulated by glass wool .

A.C PLANT A.C DUCTS CHILLERS

HVAC SYSTEM

AHU room Locations

GROUND FLOOR PLAN
HVAC SYSTEM

AHU room Locations

FIRST FLOOR PLAN
HVAC SYSTEM

AHU room Locations

SECOND FLOOR PLAN
HVAC SYSTEM

AHU room Locations

THIRD FLOOR PLAN
HVAC SYSTEM

AHU room Locations

FOURTH FLOOR PLAN
MEDICAL WASTE MANAGEMENT
INTRODUCTION
Medical waste is defined as: potentially infectious waste materials generated at health
care facilities, such as hospitals, clinics, physician's offices, dental practices, blood banks, and
veterinary hospitals/clinics, as well as medical research facilities and laboratories.

TYPES OF MEDICAL WASTE.

• General Medical Waste- (This includes paper, plastic, and office
waste.)
• Infectious Medical Waste- It’s generated by the diagnosis,
treatment, and immunization of human beings or animals, which
have likely been contaminated by a disease-causing organism.
Examples of infectious medical waste include body parts, blood,
blood products, a patient’s bedding, or even a culture of an
infectious agent.
• Pathological Waste - Human Tissue or fluid eg: body parts, blood,
body fluids etc.
• Sharp waste - eg: Needle, staples, knives, blades etc. Which may
transmit bacterial, viral or parasitic disease tohuman being.
• Chemical waste - eg. Laboratory reagent, disinfectants, Film
Developer.
MEDICAL WASTE MANAGEMENT

STAGES OF WASTE MANAGEMENT

• Stage 1: Collection and Segregation

-collection of waste should be at the point of generation
-Eg-carrying a bloody gauze from the patient’s bed to a
waste container at the end of the room may lead to
drips along the way, and is therefore impractical.
• Stage 2: storage and transportation
-Storage areas should be chosen carefully and should be
inaccessible to the general public.
-The way containers are transported to and from the storage
site is also important, because you don’t want to damage them
in the process and cause a spill. If you are working with a
medical waste removal company, be sure to choose a good
one.
-You are responsible for your medical waste until it’s been safely
processed, and some unprofessional companies have been
caught dumping such waste in places where it doesn’t belong.
MEDICAL WASTE MANAGEMENT
• Stage 3: Treatment and Disposal
-There are different ways medical waste can be treated and
decontaminated.
- Incineration is a common approach that can be used on site
or off site to both treat and dispose of waste at the same
time. However, you can also decontaminate waste with
thermal processing (autoclaving), irradiative, chemical or
biological (enzyme) treatments.
-Chemical treatment is often used to decontaminate liquid
waste, so that it can be disposed of locally.
The rest of the methods can be used to decontaminate waste
before it can be land-filled.

BASEMENT FLOOR PLAN

INCINERATOR ROOM
APOLLO HOSPITAL,CHENNAI
FIRE FIGHTING SYSTEM

DG ROOM

LIFT LOBBY
STAIRCASE
FIRE DUCTS
WATER SUPPLY

STP

UHT AND PUMP ROOM

MUNICIPAL MAIN
MEDICAL GAS DISTRIBUTION SYSTEM

DG YARD OXYGEN
MANIFOLD

BASEMENT FLOOR PLAN GROUND FLOOR PLAN

HVAC SYSTEM

AHU UNIT
AHU room are provided near spaces which have centralized
air conditioning Spaces such as-
• MRI room
• CT scan room
• cardio
• Labs
• emergency room
• lobby
• OPD
AHU ROOMS
MEDICAL WASTE MANAGEMENT

VACCUM ROOM
WASTE COLLECTION AREA
D.Y.PATIL HOSPITAL,NERUL
FIRE FIGHTING SYSTEM
SITE HYDRANT LOCATION

DISTANCE BETWEEN
BUILDING HYDRANT IS 15 M

DISTANCE BETWEEN TWO

SITE HYDRANT IS 30 M.
FIRE FIGHTING SYSTEM
 FIRE FIGHTING SYSTEM
Sprinkler system:
• This system was used only in one part of the building i.e.
the Ayurveda department.
• The centre to centre distance between the sprinklers
was 3 meters.
Smoke detectors:
The centre to centre distance between two smoke detectors
is approximately 10 meters.
Hose reel:
Smoke detectors Sprinkler system
Hose reel is placed opposite to the lift lobby on every floor.
Fire extinguishers:
Fire extinguishers are placed at regular intervals on every floor.

Fire alarm Fire exit

WATER SUPPLY
DOMESTIC

FIRE FIGHTING

PUMP ROOM

UNDERGROUND WATER TANK UNDERGROUND TANKS : PUMP ROOM EQUIPMENTS

• DOMESTIC USE • INCOMER PUMP
PUMP ROOM
• SANITATION • ELECTRICAL SUPPLY PANEL
MUNICIPAL MAIN LINE • FIRE FIGHTING • MAIN PUMP
• JOCKEY PUMP WATER TREATMENT PLANT FOR
• BOOSTER PUMP ELECTRIC SUPPLY PANEL LABORATORIES
MEDICAL GAS DISTRIBUTION SYSTEM

Design of gas station area

• It is placed in backyard of hospital and open to
sky.
• It has more space for circulation of gas truck and
also for safety purpose.
• Advantage of placing in backyard, it is away from
parking area for safety purpose.

GAS STATION
MEDICAL WASTE MANAGEMENT

BIO MEDICAL WASTE DEPARTMENT

VENTILATION SYSTEM