Protecting Hospital OT & Clean Rooms From Air Borne Infections

introduction• Al-med equipments started it operation

in 2003 as service and sales provider in Hospital medical equipments. Soon it associated with installation of many higher end medical

• Within two years of service, it incorporated additional service of installation of medical gas pipeline. During installation and commission of Medical gas Pipe Line, our team of engineers could practically interact with various doctors and Health Experts , who in long run help us to develop a strong foundation and opportunity to study various design aspects of Operation Theatres.

• With the in-depth study and survey database, our organization realized the concern of the micro-biologist and surgeons.

* Business Profile

• In the last 3 finanancial year, AL-MED EQUIPMENTS we have rebuilt our infrastructure and dedicated itself to the cause of reducing infection of all types through perfect design of Operation Theatres.

• Armed with trained designers and full fledged manufacturing unit, we incorporated the NABH guidelines in letter and spirit , strictly covering major aspects. In fact, AL_MED EQUIPMENTS was the first to understand the disadvantages of conventional Air Handling Unit with Duct.

Concept total solution for OT under one single roof

• Today, an ISO 9001:2008 certified manufacturing SSI unit and with most of OT equipment manufactured by us as marked CE .

• We provide total OT Solution from Flooring to ceiling.

Some of the premier products related to OT designed and manufactured at our factory

• Our list of products related to OT infrastructure include• Ductless Laminar Air Flow ‹‹• Ductless Positive Pressure System with Air Conditioning ‹‹• Surgeon Control Panel ‹‹• Pass Box ‹‹• OT Doors of all types ‹‹• OT wall of SS / PPGI puff panels‹‹ • Epoxy Flooring• RH Epoxy Wall Treatment• OT LED Light• Rotary and Fix Arm Pendants for Anesthesia and Surgeons• Medical Gas Pipe Line and Supporting controls for all gases. • OT Equipments

A reliable partner

• We undertake turnkey project of Operation Theatres in which designing, commissioning and after completion provide class validation of Operation Theatres from Third Party

* * Our initiative

• To overcome the challenge of infection due to Air Conditioning .

NABH Guidelines also says that

“WindowSplit A/c should not be used in any type of Operational Theatre.”

Air condition is one of the major sources of

infection in Operation Theatre • We implemented our basic model of ductless Laminar

Air Flow and Ductless Positive Pressure System with Air conditions with following key features which is as per standard norms and guidelines of NABH.

• which is user friendly, and easy to install.• which as per OT size• which has a system which ensure that HEPA perform

effectively for maximum life span• AIR CONDITION IS NOT FIXED WITH Laminar Air

Flow WHICH IN CONVENTIONAL DESIGN CAUSES PATIENT TO SHIVER

Second concern was the unawareness of

the demerits of Centralized Duct System. • Due to present of moisture as

result of condensation, long ducts are ideal breeding ground of Bacteria .Moreover, it is difficult to access, inspect and clean or sanitize the internal surfaces of the duct. Due to any reason, if the flow of air is not maintained in duct – there is vigorous bacterial and fungus growth. Moreover, moisture which accumulates in the duct due to condensation adds ideal environment for multiple growth of fungus and bacteria.

Second concern was the unawareness of

the demerits of Centralized Duct System.

Thumb-rule to be followed as per guidelines

• NABH guidelines say “AHU Blower (Fan) should be operational round the clock ,may be without temperature control” to reduce bacterial or fungus growth .

• But practically it is very difficult and found, not followed in many hospitals, keeping AHU ON to maintain Air Flow in the duct in that condition.

Ductless Positive Pressure System

In AL-Med designed CONCEPT OF DUCTLESS SYSTEM ELIMINATES

THE CHANCES OF DISEASES LIKE SURGICAL SITE INFECTION (SSI).

Our system is not centralized and dedicated for particular -single OT.

Thus ,unlike the convention Ductless system. Our designed system is NOT A SOURCE OF

CROSS CONTAMINATION OR CROSS INFECTION.

Third concern was to give effective and safe solution to control airborne infection inside OT by

replacing conventional fumigation methods.• Hospital in our country used chemical based OT Fumigation system which not only

take longer time but also the OT need to be kept idle or sealed till the poisonous effect comes down to permissible level. Immediately , after one surgery – the OT take minimum interval of 5 to 8 hours – till it is ready for the next surgery. .

• Chemical residue after fumigation and VOC is serious health concern for OT occupants. Surgeon and OT staff who are exposed to toxic residue and carcinogenic ,thus the occupants suffer from various irritation in Eyes, Skin , Nasal and respiratory tracks.

• We took the initiative to apply the ozone dosing in post operative OT and could practically demonstrate the merits of Ozone .Not only Ozone reduces VOC , but after some time converts into oxygen. The costing of ozone dosing was cost effective,

and after an hour application in the OT, the level of air borne microbes and aerosols in air got drastically reduced and gave excellent test result. The reason behind the success story is because of the properties of Ozone. Ozone (nascent Oxygen) interferes with the metabolism of bacterial cells and blocking the operation of the enzymatic control system. Ozone destroy viruses by diffusing through the protein coat into nucleic acid coat, resulting in damage of viral RNA .At higher concentration, ozone destroy capsid or exterior protein cell by oxidation.

In a nutshell, Ozone is effective in all types of bacteria , fungus , virus and molds and clears in few seconds and sanitization can be achieved in one hour in a standard Modular

OT.

• After successful practical trials , we

introduced O 3 MAGIC DISINFECTANT .Today ,many critical operation Superspeciality OT are using O3 Magic Disinfectant to sanitize the OT.

* Three Key Achievement:

• When we introduced the concept of Ductless Laminar Air Flow System and Ductless Positive Pressure system with Air Conditional system, we faced series of questions as we went against very popular Centralized System. We successfully maintain both the Velocity of Air at HEPA Level (90 t0 100 FPM) at Laminar Air Flow and 30 Air cycle per Hour from Positive Pressure System .Also , we have ensure that Air Flow patterns does not interfere and disturb air patterns and fulfill the basic requirement of NABH guidelines for Air Handling.

Both Ductless LAF and PPS are independent in function.

Surgeons are now having full confidence on the performance of the Ductless System,

• Now, when many critical operations like Joint replacement surgery is being conducted with absolute success and approved by many Laparoscopic Surgeon,

• Approval itself at the initial stage is an achievement, for us as the concept of Ductless is getting popular.

To reduce Air Infection ( Post Operative) with zero hazardous residue effect

• Thirdly , with the introduction of O3 Gen , we have achieved minimum time of OT remaining ideal , thus many critical operation can conducted in the same day. Any hospital generally plan the operation schedule or routine based on the level of infection.

• Even few years back, tumor or infection borne operation are schedule in the later part of the day and normally , less infection are scheduled in the earlier part of the day.

• Now with the combination of ductless system and O3 magic , the convention mentioned above practice need not be followed.

* Three Key Challenges while implementing the Product and how they were overcome.

• 1)• The biggest and the most challenging aspect was to maintain both the speed of 90 to

110 FPM .from HEPA and to simultaneously maintain Air Cycle of 30 Air Cycles per Hour (ACH).

• LAMIAR AIR FLOW was designed in such a fashion that it will only be responsible for maintaining the air tent and velocity of filter Air from HEPA.

• To develop the Positive Pressure ,the PPS design take care of 30 Air cycle per Hour norms.

• This would have been impossible for a common system of Duct. Since, the machine performs separately; it is simple and easy to achieve both the criteria of NABH guideline.

• Through our Positive Pressure Dampers we could implement the fresh air cycle (5 ACH of fresh air in 30 ACH ie approx 16%).Control dozing of Ozone inside Positive Pressure System help to control VOC and microbiological count inside the Positive Pressure. Ozone gas produced by ozone producing UV Light which give 0.21 ppm dosing for 5 minutes in every 30 minutes.

• This on line dosing is not continuous and preset timing based, so there is absolutely no difficulties for OT occupants

* Three Key Challenges while implementing the Product and how they were overcome.

(cont..)

• 2) Achievement of Air Conditioning Tonnage.

• The cooling of OT (21+/- 3 ○ C) is maintained / achieved with 3 Tonns as compare.to

• Ducted AHU where , minimum 8 to 12 tonnage is required .

•

* Three Key Challenges while implementing the Product and how they were overcome.

(Cont..)

• Our system need not be kept “ON” for 24 hours.The system is put “ON” ,one hours before the schedule operation , thus saving lot of Electricity.

•

Latest achievement is that we have concluded and synchronized the noise level to 70 db which is very

closed to the norms.

Our Client list in INDIA

• Mercury Superspeciality Hospital Location Nashik (Maharashtra)

• Dr Nadkarni 21ST Century Hospital Location Vapi (Gujrat)

• Millenium Lifeline Hospital Location Sanpada ( Navi Mumbai)

Product catelogue and xerox validation certificate of OT Enclosed

• Product Catelogues of Positive Pressure System

• Product Catelogues of Laminar Air Flow• Product Catelogue of O2 Magic gen• Test certificate of OT