3.22.23 – SSI – Shane Clary
Next time you’re in a hospital, remember there is more to the eye than just waiting areas, corridors and patient rooms.
This month’s article was not planned for until I had a bit of a medical adventure at the end of February into the first few days of March. I spent several days in an acute care hospital as a patient. While I have spent many hours in medical facilities performing fire protection work, this was only the second time as a patient and the first time to be admitted for that long. The other occurrence was for an outpatient procedure.
The primary mission of a hospital, or a skilled nursing facility, is to provide medical care to the patients through trained professionals and advanced equipment, procedures and medications, as may be warranted by each individual case.
The hospital itself, the building, is a very complex occupancy with many systems installed within. This includes but is not limited to the delivery of O2 and other medical gases, suction, consistent 120VAC and other required voltages, grounding, surge and lightning protection, clean air and the list goes on. Included, but perhaps not be at the forethought of the staff, are fire suppression, detection, smoke control and fire resistive construction.
In addition to all the medical equipment built into my room were various features required to protect me and the other patients should there be a fire. The NFPA promulgates most of the codes and standards that are used during the design, construction and maintenance of these facilities.
The two primary documents for suppression and detection are NFPA 13, Standard for the Installation of Sprinkler Systems and NFPA 72, National Fire Alarm and Signaling Code. Depending on the size of the facility or what may be contained within, other standards related to suppression may be required. These, to name just a few, include:
- NFPA 10, Standard for Portable Fire Extinguishers
- NFPA 14, Standard for the Installation of Standpipe and Hose Systems
- NFPA 15, Standard for Water Spray Fixed Systems for Fire Protection
- NFPA 17, Standard for Dry Chemical Extinguishing Systems
- NFPA 17A, Standard for Wet Chemical Extinguishing Systems
- NFPA 20, Standard for the Installation of Stationary Pumps for Fire Protection
- NFPA 22, Standard for Water Tanks for Private Fire Protection
- NFPA 2001, Standard on Clean Agent Fire Extinguishing Systems
These documents advise the designer and installer as to how to install the systems, but not where to install them. There are other standards that detail passive fire protection, which is an important component of the overall fire protection solutions installed within these occupancies. These include fire and smoke doors, fire windows, fire curtains, fire dampers, smoke dampers and fire stopping systems. The use and locations for horizontal exits is most critical in the overall design.
Many More Standards May Need Review
Depending on the location of the facility, employ NFPA 1, Fire Code or the International Fire Code as published by the International Code Council as a starting point as to where the various fire prevention and detection systems should be installed. NFPA 101, Life Safety Code is also to be used. In addition to the core chapters, consult Chapter 18, New Health Care Occupancies and Chapter 19, Existing Health Care Occupancies. For facilities that have ambulatory patients, also review Chapters 20 and 21.
In addition to NFPA 101, NFPA 99, Health Care Facilities Code needs to be reviewed. Not only for protection covered as found within Chapter 16, but for other subsystems that make up a hospital such as gas and vacuum systems, electrical, plumbing and HVAC systems.
Electrical systems are a major part of any medical facility. As such, NFPA 70, National Electrical Code is to be followed. For health care facilities, consult Article 517 in addition to the core chapters and articles. Within the occupancy, follow Article 647, Sensitive Electronic Equipment, Article 660, X-Ray Equipment and Article 695.
All these systems need to be inspected, tested and maintained. For water-based systems, the standard of care is NFPA 25, Standard for the Inspection, Testing and Maintenance o Water-Based Fire Protection Systems. For detection systems, it would be Chapter 14, Inspection, Testing and Maintenance within NFPA 72. The service provider should review NFPA 4, Standard for Integrated Fire Protection and Life Safety System Testing.
In addition, the Joint Commission standards and protocols should also be reviewed before starting any project at an acute care hospital. These facilities must meet their requirements to become accredited and maintain their accreditations. Next time you’re in one, remember there is more to the eye than just waiting rooms, corridors and patient rooms. I would like to thank the staff of Eden Hospital in Castro Valley (Calif.) for providing care during my visit.