• Title/Summary/Keyword: Negative Pressure Operating Room

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A Numerical Study on Pressure Fluctuation and Air Exchange Volume of Door Opening and Closing Speeds in Negative Pressure Isolation Room (음압격리병실에서의 병실 문의 개폐속도에 따른 실간 압력변동 및 공기교환량에 대한 해석적 연구)

  • Kim, Jun Young;Hong, Jin Kwan
    • Journal of The Korea Institute of Healthcare Architecture
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    • v.24 no.1
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    • pp.51-58
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    • 2018
  • Purpose: In this study, through the comparison of the pressure fluctuation and air exchange volume in negative isolation room according to the type of the door and door opening/closing speeds, which is one of the main factors causing the cross contamination of the negative pressure isolation room, establishes standard operating procedures to prevent cross contamination in high risk infectious diseases and isolation room design. Methods: In this study, the air flow each of the room is analyzed using ANASYS CFX CODE for flow analysis. In addition, the grid configuration of the door is constructed by applying Immersed Solid Methods. Results: The pressure fluctuation due to the opening and closing of the hinged door was very large when the moment of the hinged door opened and closed. Especially, at the moment when the door is closed, a pressure reversal phenomenon occurs in which the pressure in the isolation room is larger than the pressure in the anteroom. On the other hand, the pressure fluctuation due to the opening and closing of the sliding door appeared only when the door was closed, but the pressure reversal phenomenon not occurred at the moment when the sliding door was closed, unlike the hinged door. As the opening and closing speed of the hinged door increases, the air exchange volume is increased. However, as the opening and closing speed of the sliding door is decreased, the air exchange volume is increased. Implications: According to the results of this study, it can be concluded that the pressure fluctuation due to the opening and closing of the hinged door is greater than the pressure fluctuation due to the opening and closing of the sliding door. In addition, it can be confirmed that the pressure reversal phenomenon, which may cause to reduce the containment effect in negative pressure isolation room, is caused by the closing of the hinged door. Therefore, it is recommended to install a sliding door to maintain a stable differential pressure in the negative isolation room. Also, as the opening and closing speed of the hinged door is slower and the opening and closing speed of the sliding door is faster, the possibility of cross contamination of the room can be reduced. It is therefore necessary to establish standard operating procedures for negative isolation room for door opening and closing speeds.

Infection prevention measures and outcomes for surgical patients during a COVID-19 outbreak in a tertiary hospital in Daegu, South Korea: a retrospective observational study

  • Kwak, Kyung-Hwa;Kim, Jay Kyoung;Kwon, Ki Tae;Yeo, Jinseok
    • Journal of Yeungnam Medical Science
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    • v.39 no.3
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    • pp.223-229
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    • 2022
  • Background: The first large coronavirus disease 2019 (COVID-19) outbreak outside China occurred in Daegu. In response, we developed infection prevention measures for surgical patients during the outbreak at our hospital and retrospectively reviewed the outcomes of COVID-19-related surgical patients. Methods: We reviewed the medical records of 118 COVID-19-related surgical patients and monitored their clinical outcomes until March 31, 2021. We also interviewed healthcare workers who participated in their perioperative care at Kyungpook National University Chilgok Hospital. The perioperative management guidelines for COVID-19-related patients were prepared through multidisciplinary discussions, including the infection control department, surgical departments, and anesthesiology department before and during the COVID-19 outbreak. Results: One standard operating room was temporarily converted to a negative-pressure room by increasing the exhaust air volume, creating a relative pressure of -11.3 Pa. The healthcare workers were equipped with personal protective equipment according to the patient's classification of the risk of COVID-19 transmission. The 118 COVID-19-related patients underwent emergent surgery in the negative-pressure room, including three COVID-19-confirmed patients and five COVID-19-exposed patients. Conclusion: All surgeries of the COVID-19-related patients were performed without specific adverse events or perioperative COVID-19 transmission. Our experience setting up a negative-pressure operating room and conservative perioperative protocol to prevent COVID-19 transmission will help plan and execute infection control measures in the future.

A Numerical Study on Coughed Particle Dispersion and Deposition in Negative Pressure Isolation Room according to Particle Size (음압격리병실에서의 기침 토출입자의 입경에 따른 확산 및 침적에 대한 수치해석 연구)

  • Jung, Minji;Hong, Jin Kwan
    • Journal of The Korea Institute of Healthcare Architecture
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    • v.24 no.2
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    • pp.37-44
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    • 2018
  • Purpose: This study investigates the influences of coughing direction and healthcare worker's location on the transport characteristics of coughed particles in airborne infection isolation room (AIIR), which is commonly called negative pressure isolation room, with a downward ventilation system. Methods: Computational Fluid Dynamics (CFD) was used to simulate the airflow and for tracing the behavior of particles. Results: The results show that the airflow pattern and coughing direction have a significant influence on the characteristics of particle dispersion and deposition. When healthcare workers are in the isolation room with the patient who is lying on the bed, it is recommended to be located far from the anteroom to reduce the exposures from infectious particles. And when the patient is lying, it is more effective in removing particles than when the patient is in Fowler's position. Although it is an isolation room that produces unidirectional flow, coughing particles can spread to the whole room and a large number of particles can be deposited onto patient, bed, side rails, healthcare worker, ceiling, floor, and sidewall. Implications: Following the patients' discharge or transfer, terminal cleaning of the vacated room, furniture, and all clinical equipment is essential. Also, it is necessary to establish detailed standard operating procedure (SOP) in order to reduce the risk of cross-contamination.

Analysis of Minimum Airflow Differences between Supply and Exhaust Air according to Airtightness of Rapidly Converted Temporary Negative Pressure Isolation Rooms (긴급전환형 임시음압격리병실의 기밀도에 따른 최소 급배기 유량차 평가)

  • Shin, Hee Won;Kim, Dong Wook;Kim, Ji Min;Jung, Hyo Beom;Kang, Dong Hwa
    • Journal of The Korea Institute of Healthcare Architecture
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    • v.29 no.4
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    • pp.69-77
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    • 2023
  • Purpose: During the COVID-19 pandemic, there have been many cases of converting regular hospital wards into temporary negative pressure isolation wards. The purpose of this study is to evaluate the minimum airflow differences that satisfies the pressure difference criteria(-2.5 Pa) according to airtightness of switching type wards, in preparation for utilization of aging regular wards as negative pressure isolation wards. Methods: Visual inspection and field measurements were conducted using blower door to evaluate airtightness of 5 hospital wards. CONTAM simulation was used to assess the airflow differences when pressure difference between the corridor and wards met the criteria at various levels of airtightness. Results: The ACH50 of evaluated wards ranged from 19.3 to 50.1 h-1 with an average of 37.0 h-1, indicating more than four times leakier than other building types. The minimum airflow differences increased as the airtightness of the wards decreased and the size of the wards increased. Implications: When operating rapidly converted negative pressure isolation wards, understanding airtightness is crucial for determining the minimum airflow differences to maintain the pressure differences. The analysis of this study suggests that improving the airtightness of aging rooms is essential and the minimum airflow differences should be suggested considering both the airtightness and size of rooms.

Computational Analysis for Improving Internal Flow of High Pressure Methanol Steam Reformer Pressure Vessel (고압형 메탄올 수증기 개질기 압력용기의 내부 유동 개선을 위한 전산 해석)

  • YU, DONGJIN;JI, HYUNJIN;YU, SANGSEOK
    • Transactions of the Korean hydrogen and new energy society
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    • v.31 no.5
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    • pp.411-418
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    • 2020
  • A reformer is a device for producing hydrogen used in fuel cells. Among them, methanol steam reformer uses methanol as fuel, which is present as a liquid at room temperature. It has the advantage of low operating temperature, high energy density, and high hydrogen production. The purpose of this study is to improve the internal flow of the pressure vessel when a bundle of methanol steam reformer in the pressure vessel goes out to a single outlet. An analysis of equilibrium reaction to methanol steam reforming reaction was conducted using Aspen HYSYS® (Aspen Technology Inc., Bedford, USA), and based on the results, computational analysis was conducted using ANSYS Fluent® (ANSYS, Inc., Canonsburg, USA). For comparison of the results, the height of the pressure vessel, outlet diameter, and fillet was set as variables, and the optimum geometry was selected by comparing the effects of gravity and the amount of negative pressure.

Experimental Study on the Surface Pressure Characteristics of a Rear-Guider for the Various Design Factors of a Cross-Flow Fan (관류홴의 설계인자 변화에 따른 리어가이더의 표면압력 특성에 관한 실험적 연구)

  • Kim, J.K.
    • Journal of Power System Engineering
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    • v.9 no.3
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    • pp.50-57
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    • 2005
  • A cross-flow fan is strongly influenced by the various design factors of a rear-guider and a stabilizer. The purpose of this paper is to investigate the effects of a rear-guider and a stabilizer on the surface pressure of a rear-guider in an indoor room air-conditioner using a cross-flow fan. The design factors considered in this paper are a rear-guider clearance, a stabilizer clearance, and a stabilizer setup angle, respectively. The operating condition of a cross-flow fan was controlled by changing the static pressure and flowrate using a fan tester. All surface pressures of a rear-guider are differently distributed according to the stabilizer setup angle, and show a zero value in the flow coefficient, ${\Phi}{\fallingdotseq}0.5$ only of a stabilizer setup angle, $45^{\circ}$. Especially, they show a big negative value in the expansion angle larger than $34^{\circ}$ regardless of a rear-guider clearance, a stabilizer clearance, and a stabilizer setup angle. On the other hand, surface pressures for various stabilizer cutoff clearances are better than those for various rear-guider clearances.

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A Development of Design Guidelines for the Negative Pressured Isolation Units Controlling Severe Respiratory Infectious Disease (중증 호흡기 감염병 진료를 고려한 음압격리병동부의 건축계획)

  • Kwon, Soon Jung;Yoon, Hyungjin
    • Journal of The Korea Institute of Healthcare Architecture
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    • v.22 no.3
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    • pp.45-56
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    • 2016
  • Purpose: The MERS(Middle East Respiratory Syndrome) outbreaks in Korea highlighted dramatically the failings of traditional hospital environment for controlling or preventing infections among both patients and healthcare workers. MERS is transmitted by droplets that can be airborne over a limited area. The point should be emphasized that MERS in South Korea was predominantly a hospital-acquired (not a community-acquired) infection, because approximately 93% of MERS cases were resulted from exposure in hospital settings. This paper tries to suggest the design guidelines of negative pressured isolation ward for the sake of proper control of severe respiratory infectious diseases. Methods: Literature survey on the design guideline and regulations of airborne infection wards in Korea, Europe U.K. and CDC of U.S. have been carries out. 4 special infection wards in Hongkong, Germany, Japan and Korea have been surveyed in order to make the best use of the experiences related to facility design and operations. Results: Operating system influencing the facility design, space organizations of infectious ward including required space and zoning, and circulations of patients, staffs and materials are proposed. Implications: The results of this paper can be the basic data for the design of the airborne infection ward and relevant regulations. Afterwards in-depth study such as the development of space standards for the single bedroom, locker room and so on could be explored.

The Application of B-Type Natriuretic Peptide Level of the Dyspneic Patients : Differentiation Between Cor Pulmonale and Left Ventricular Dysfunction (호흡곤란을 주소로 내원한 환자에서 혈청 B-type Natriuretic Peptide 검사의 유용성 : 폐성심과 좌심부전의 감별에 대하여)

  • Park, Hong-Hoon;Kim, Sehyun;Choi, Jeongeun;Kim, Kang-Ho;Cheon, Seok-Cheol;Lee, Jihyun;Lee, Yong-Gu;Kim, In-Jae;Cha, Dong-Hoon;Hong, Sang-Bum;Lee, Ji-Hyun
    • Tuberculosis and Respiratory Diseases
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    • v.54 no.3
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    • pp.320-329
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    • 2003
  • Background : The serum B-type natriuretic peptide (BNP) is released from the ventricles as a response to volume or pressure overload of the ventricles. A few studies have reported that the BNP measurements are useful in differentiating between heart failure and pulmonary causes in patients who visited the emergency department with dyspnea as the chief complaint. It is difficult to differentiate a right heart failure from a left heart failure in the emergency room. However, there is no report on the application of a BNP assay to differentiate in right heart failure from left heart failure. In this study, the BNP levels were measured from dyspneic patients in the emergency department to determine whether or not the BNP level would be useful in differentiating the cause of the dyspnea from right ventricular failure and left ventricular failure. Method : 89 patients who visited emergency department of the Bundang Cha Hospital with dyspnea from June 2002 to March 2003 were selected. The 29 patients from the outpatient clinics and inpatients were randomly selected as the control. Results : The BNP levels of patients in the left heart failure group were significantly different from that of the patients in the right heart failure group ($682{\pm}314$ pg/mL vs. $149{\pm}94$ pg/mL, p=0.000). When the BNP cut-off level was designated as 219 pg/mL using the receiver operating characteristic curve, the sensitivity was 94.3%, and specificity was 92.9%. In addition, the positive predictive value was 97% and the negative predictive value was 86.7% in differentiating right heart failure from left heart failure. Conclusion : Measurements of the serum BNP levels is an accurate and rapid method that can aid in distinguishing between right heart failure and left heart failure.