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  • Friday, May 20, 2022 9:39 AM
    Reply # 12787724 on 12785336

    Wow.  Thought this would be a simple one....

    So: in an attempt to reduce this to a 6060 mini lecture:

    There is no such thing anymore as a "Category 1 Facility" we must make all these decisions by Category of the Patient Care Space(s).  Al is also remembering the old language "vital life support and critical care" which gave us more "wiggle room". Au revoir to that.

    Zones valves are required by any of:

    1. paragraph,

    2. paragraph,

    3. because the facility specifically desired one. 

    Alarms don't have an equivalent to item 2, so therefore is entirely possible to have patient care spaces which will have a zone valve but no alarm.   

    Remember though - it it NOT our decision.  This is explicit in 2021 NFPA 99 and for 6060's it is essential this be understood: 

    "the health care facility's governing body ... shall establish ... category"

    So, the Designer must be told by the G.B. what Category.  If they say Category 1, then that attracts the requirement for a zone valve ( and an alarm ( If they say Category 2 or Category 3, there may be a Zone valve - for either of the other two reasons, and there may be an alarm because the facility particularly desires it, but neither is required because of the Category.

    As Verifiers, we need to know the instruction that was provided the Designer so we can correctly evaluate the Patient Care Space:

    1. What Category,

    2. Is it an anesthetizing location,

    3. If so, what depth of anesthesia.

    As a side note, FGI's imaging classes really have no direct relationship in this. Nowhere does NFPA require they be considered.  Naturally, the G.B. may include that in their decision making, but it would be their call. 

  • Saturday, May 21, 2022 12:38 AM
    Reply # 12788771 on 12785336

    Mark, you just confuse the heck out of me. I will re-look at your statement as a 6060 instructor and respond accordingly.

    You started off stating there are no longer categories but patient space and then refer to the hospitals making a decision on what categories they have? I think I understand what you’re trying to say I just don’t think it was said very well. In any case it still comes down to the fact that you do not have to have an alarm at every zone valve box.

    Last modified: Saturday, May 21, 2022 12:46 AM | Don Holden
  • Saturday, May 21, 2022 3:38 PM
    Reply # 12789233 on 12785336
    Al Moon (Administrator)

    I have always in the past, tried not to quote the ANNEX.

    But that was the past, today and in the future.

    If the question comes up !

    ? Do all medical gases, medical support gas and/or medical surgical vacuum Zone Valve Boxes require an area alarm panel ?

    This is what, I will send or verbalize to the industry:

    NFPA 99 THE 2021 EDITION ANNEX Explamatory Material

    A.3.3.140 Patient Care Space. Business offices, corridors,
    lounges, day rooms, dining rooms, or similar areas typically are
    not classified as patient care spaces.

    A. Category 1 Space. These spaces, formerly known
    as critical care rooms, are typically where patients are intended
    to be subjected to invasive procedures and connected to line-
    operated, patient care-related appliances. Examples include,
    but are not limited to, special care patient rooms used for

    critical care, intensive care, and special care treatment rooms such
    as angiography laboratories, cardiac catheterization

    laboratories, delivery rooms, operating rooms, post-anesthesia care
    units, trauma rooms, and other similar rooms.

    A. Category 2 Space. These spaces were formerly
    known as general care rooms. Examples include, but are not
    limited to, inpatient bedrooms, dialysis rooms, in vitro

    fertilization rooms, procedural rooms, and similar rooms.

    A. Category 3 Space. These spaces, formerly known
    as basic care rooms, are typically where basic medical or dental
    care, treatment, or examinations are performed. Examples
    include, but are not limited to, examination or treatment
    rooms in clinics, medical and dental offices, nursing homes,
    and limited care facilities.

    A. Category 4 Space. These spaces were formerly
    known as support rooms. Examples of support spaces include,
    but are not limited to, anesthesia work rooms, sterile supply,
    laboratories, morgues, waiting rooms, utility rooms,
    and lounges. (FUN)

  • Monday, May 23, 2022 12:36 PM
    Reply # 12790767 on 12785336

    Well Don, if I confuse you then I agree I did say something badly!

    My statement is an attempt to work the question through purely by the logic in the code, and I suppose that in attempting to simplify it I may have overreached. After all, this subject takes hours in the actual 6060 program. 

    The point is that originally, Levels/Category was done by FACILITY.  No more.  Now it must be done by each separate Patient Care Space.  Back when it was decided by the facility type, the old language (vital life support, etc) was how we decided where to put valves and alarms.  Now we must observe the designation of category given to us by the "Governing Body of the Healthcare Facility".  Several scenarios arise:

    1. The GB may designate an area we would consider "Vital life support" as Category 1. Everything is how it always has been, we give it a zone valve and an alarm. Easy.

    2. The GB may designate an area as category 2 or 3. Do we give it a zone valve and an alarm? Based on Category alone ( and, No. But for zone valves, other rules also need to be considered, primarily, which says you cannot have a terminal without a zone valve. The chances are quite good that you will end up placing a zone valve for this reason - entirely irrespective of the Category of the Patient Care Area. But alarms have no equivalent to, so you need not place an alarm. 

    3. The GB may designate an area we might consider "Vital life support" as category 2 or 3. Everything is upset. This appears to be Al's predicament. However, the Code is clear - the designation of Category is the prerogative of the GB. We may advise, we may argue, but unless the AHJ has heartburn with the GB's designation, as designers we are expected to act accordingly and we would follow Scenario 2, above.   

    The upshot is that yes, there can and probably will be zones with no alarms in a properly designed, fully compliant medical gas system.  

  • Wednesday, May 25, 2022 9:53 AM
    Reply # 12793244 on 12785336
    Cary Darden (Administrator)

    We (as verifiers) need not turn ourselves into pretzels trying to solve this issue.  The issue isn't ours to solve, as Mark stated it is the Governing Body (GB) of the Healthcare Facility (HCF).  

    So back to my original question, and I should've added the sentence in blue when I first asked it.

    The question below needs to be posed to the GB of the HCF:

    What will the impact to the patient be if the oxygen is lost while they are undergoing care inside of this x-ray room?

    Will the loss of gas result in:

    1.) major injury or death

    2.) minor injury

    3.) not likely to cause injury, but may cause discomfort

    4.) no impact on patient care

  • Thursday, May 26, 2022 6:22 AM
    Reply # 12794580 on 12785336

    Got it in one Cary.  

  • Thursday, May 26, 2022 7:23 AM
    Reply # 12794658 on 12785336

    Cary brings up an important point.  This is up to the hospital.

    I would just add the other question to ask is will deep sedation or general anesthesia be administered in the space.  That is also an easy way to determine if it is category 1 or not.

  • Thursday, May 26, 2022 7:35 PM
    Reply # 12795650 on 12785336

    As I read the NFPA 99 Health Care Facilities code 2021 Origin and development of NFPA 99 it reads as though it is changing from a national fire protection to more of a national patient care.

    So if I understand this correctly the board of governors convey with the physicians who work with the various departments to help determine the patient category spaces. Then the board of governors work with the AHJ who then works with the architect and engineer who then works with the facilities who then works with manufacturer for the installation of the equipment. Then this information is given to the responsible authority of the facility. Who now works with the installing contractor and the 6020 inspector, who now has to work with the responsible facility authority. All this information and equipment supplied now needs to be made available to the 6030 doing the verification.

    Tell me what could go wrong in this chain of events?

  • Friday, May 27, 2022 7:46 AM
    Reply # 12796004 on 12785336

    Wow, so glad Ohio is stuck in 2015 and I will be retired by the time they move on to 2027.

  • Sunday, May 29, 2022 1:25 PM
    Reply # 12798040 on 12785336

    3.3.140* Patient Care Space. Any space of a health care facility wherein patients are intended to be examined or treated. (FUN)* Category 1 Space. Space in which failure of equipment or a system is likely to cause major injury or death of patients, staff, or visitors. (FUN)

    Where in a medical facility can someone not be injured? As simple as someone on suction and there is a failure there could be deaths. If somebody has a reaction to a drug. Power loss. Getting from the car to the ER. It is likely to cause major injury or death any place in the facility where there is a failure.

    So based on this article dental offices should be category one.

    1 file
    Last modified: Monday, May 30, 2022 1:43 PM | Don Holden
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