Requirements and recommendations for the construction of emergency medical facilities

This document provides requirements and recommendations for the rapid construction of emergency medical facilities, including various categories of public health emergencies, for handling large numbers of casualties and patients. The functional composition of emergency medical facilities is determined by the characteristics of the emergencies. This document is applicable to new projects built on new sites or within existing medical institutions, where emergency medical facilities are constructed rapidly from steel-frames and prefabricated standard plates or box structures.

Exigences et recommandations relatives à la construction d'installations médicales d'urgence

General Information

Status
Published
Publication Date
19-Dec-2021
Current Stage
5060 - Close of voting Proof returned by Secretariat
Start Date
30-Nov-2021
Completion Date
07-Dec-2021
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INTERNATIONAL IWA
WORKSHOP 38
AGREEMENT
First edition
2022-01
Requirements and recommendations
for the construction of emergency
medical facilities
PROOF/ÉPREUVE
Reference number
IWA 38:2022(E)
© ISO 2022
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IWA 38:2022(E)
COPYRIGHT PROTECTED DOCUMENT
© ISO 2022

All rights reserved. Unless otherwise specified, or required in the context of its implementation, no part of this publication may

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Published in Switzerland
PROOF/ÉPREUVE © ISO 2022 – All rights reserved
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IWA 38:2022(E)
Contents Page

Foreword ..........................................................................................................................................................................................................................................v

Introduction .............................................................................................................................................................................................................................. vi

1 Scope ................................................................................................................................................................................................................................. 1

2 Normative references ..................................................................................................................................................................................... 1

3 Terms and definitions .................................................................................................................................................................................... 1

4 Abbreviated terms ............................................................................................................................................................................................. 2

5 Basic principles ..................................................................................................................................................................................................... 2

5.1 Sustainability ........................................................................................................................................................................................... 2

5.2 Programme and circulation ........................................................................................................................................................ 2

5.3 Structure, mechanical and electrical systems ........................................................................................................... 3

5.4 Products and components ............................................................................................................................................................ 3

5.5 Information technology .................................................................................................................................................................. 3

5.6 Safety............................................................................................................................................................................................................... 3

6 Site selection and planning ....................................................................................................................................................................... 3

6.1 Site selection ............................................................................................................................................................................................. 3

6.2 Building layout ........................................................................................................................................................................................ 3

6.3 Circulation .................................................................................................................................................................................................. 3

6.4 Entrances ..................................................................................................................................................................................................... 3

6.5 Preventing cross-contamination ............................................................................................................................................ 4

6.6 Medical staff living area ................................................................................................................................................................. 4

7 Architecture and structure system .................................................................................................................................................4

7.1 General provisions .............................................................................................................................................................................. 4

7.1.1 Zoning .......................................................................................................................................................................................... 4

7.1.2 Accessibility ............................................................................................................................................................................ 4

7.1.3 Construction method ..................................................................................................................................................... 4

7.1.4 Vertical circulation ........................................................................................................................................................... 4

7.1.5 Interior fittings and surfaces .................................................................................................................................. 4

7.1.6 Structural reliability ....................................................................................................................................................... 4

7.1.7 Structural system .............................................................................................................................................................. 5

7.1.8 Leak-proof ................................................................................................................................................................................ 5

7.1.9 Light-weight structure .................................................................................................................................................. 5

7.2 Specific requirements for respiratory infectious disease facilities ........................................................ 5

7.2.1 Zoning .......................................................................................................................................................................................... 5

7.2.2 Preventing cross-contamination ......................................................................................................................... 5

7.2.3 Building layout and airflow management.................................................................................................... 5

7.2.4 Negative pressure ward ............................................................................................................................................... 5

7.2.5 Medical waste ....................................................................................................................................................................... 5

7.2.6 Sealing.......................................................................................................................................................................................... 6

8 Water supply and drainage system ..................................................................................................................................................6

8.1 General provisions .............................................................................................................................................................................. 6

8.1.1 Safety ............................................................................................................................................................................................ 6

8.1.2 Water supply .......................................................................................................................................................................... 6

8.1.3 Water processing ............................................................................................................................................................... 6

8.1.4 Valves for maintenance ................................................................................................................................................ 6

8.1.5 Hands-free faucets ............................................................................................................................................................ 6

8.1.6 Plumbing fixtures .............................................................................................................................................................. 6

8.1.7 Trap seal ..................................................................................................................................................................................... 6

8.1.8 Wastewater treatment .................................................................................................................................................. 7

8.2 Specific requirements for respiratory infectious disease facilities ........................................................ 7

8.2.1 Sealing.......................................................................................................................................................................................... 7

8.2.2 Water supply pump station ....................................................................................................................................... 7

iii
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IWA 38:2022(E)

8.2.3 Water tank ............................................................................................................................................................................... 7

8.2.4 Water supply system....................................................................................................................................................... 7

8.2.5 Drainage system ................................................................................................................................................................. 7

8.2.6 Vent stack .................................................................................................................................................................................. 8

8.2.7 Outdoor sewage system ............................................................................................................................................... 8

8.2.8 Sewage treatment ........................................................................................................................................... ................... 8

9 Heating, ventilation and air conditioning system ............................................................................................................ 8

9.1 General provisions .............................................................................................................................................................................. 8

9.1.1 Heating and air conditioning ................................................................................................................................... 8

9.1.2 Natural ventilation ........................................................................................................................................................... 8

9.2 Specific requirements for respiratory infectious disease facilities ........................................................ 8

9.2.1 Mechanical ventilation .................................................................................................................................................. 8

9.2.2 Air filter ...................................................................................................................................................................................... 8

9.2.3 Air supply and exhaust outlets .............................................................................................................................. 8

9.2.4 Pressure monitor ............................................................................................................................................................... 9

9.2.5 Exhaust fans ........................................................................................................................................................................... 9

9.2.6 Exhaust discharge ............................................................................................................................................................. 9

9.2.7 Fresh air ..................................................................................................................................................................................... 9

9.2.8 Negative pressure operating room .................................................................................................................... 9

9.2.9 Condensate .............................................................................................................................................................................. 9

9.2.10 Intensive care unit ............................................................................................................................................................ 9

10 Electrical and intelligent systems ..................................................................................................................................................10

10.1 General provisions ........................................................................................................................................................................... 10

10.1.1 Power supply ....................................................................................................................................................................... 10

10.1.2 Lighting .................................................................................................................................................................................... 10

10.1.3 Equipotential bonding ................................................................................................................................................ 10

10.1.4 Lightning protection .................................................................................................................................................... 10

10.1.5 Intelligent building systems .................................................................................................................................. 10

10.1.6 Equipment selection ..................................................................................................................................................... 10

10.2 Specific requirements for respiratory infectious disease facilities ..................................................... 10

10.2.1 Emergency power supply......................................................................................................................................... 10

10.2.2 Sealing....................................................................................................................................................................................... 10

10.2.3 Disinfection and sterilization .............................................................................................................................. 11

10.2.4 Telemedicine ....................................................................................................................................................................... 11

10.2.5 Video monitoring ............................................................................................................................................................ 11

10.2.6 Access control .................................................................................................................................................................... 11

11 Medical gas system .........................................................................................................................................................................................11

11.1 General provisions ........................................................................................................................................................................... 11

11.1.1 Principle of configuration ....................................................................................................................................... 11

11.1.2 Medical gas source ......................................................................................................................................................... 11

11.1.3 Medical gas station ........................................................................................................................................................ 11

11.1.4 Pipeline and accessories ........................................................................................................................................... 11

11.1.5 Terminal units ................................................................................................................................................................... 11

11.1.6 Monitor and alarm system .....................................................................................................................................12

11.2 Specific requirements for respiratory infectious disease facilities .....................................................12

11.2.1 Medical vacuum system ............................................................................................................................................12

11.2.2 Medical air and oxygen systems ........................................................................................................................12

11.2.3 Other medical gas systems .....................................................................................................................................12

11.2.4 Calculating oxygen consumption......................................................................................................................12

11.2.5 Standby power supply ................................................................................................................................................12

11.2.6 Flow capacity ......................................................................................................................................................................12

11.2.7 Radiographic pipeline inspection ....................................................................................................................12

11.2.8 Pipeline testing ................................................................................................................................................................. 12

11.2.9 Uninterrupted supply .................................................................................................................................................12

Annex A (informative) Workshop contributors ....................................................................................................................................13

Bibliography .............................................................................................................................................................................................................................14

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IWA 38:2022(E)
Foreword

ISO (the International Organization for Standardization) is a worldwide federation of national standards

bodies (ISO member bodies). The work of preparing International Standards is normally carried out

through ISO technical committees. Each member body interested in a subject for which a technical

committee has been established has the right to be represented on that committee. International

organizations, governmental and non-governmental, in liaison with ISO, also take part in the work.

ISO collaborates closely with the International Electrotechnical Commission (IEC) on all matters of

electrotechnical standardization.

The procedures used to develop this document and those intended for its further maintenance are

described in the ISO/IEC Directives, Part 1. In particular, the different approval criteria needed for the

different types of ISO documents should be noted. This document was drafted in accordance with the

editorial rules of the ISO/IEC Directives, Part 2 (see www.iso.org/directives).

Attention is drawn to the possibility that some of the elements of this document may be the subject of

patent rights. ISO shall not be held responsible for identifying any or all such patent rights. Details of

any patent rights identified during the development of the document will be in the Introduction and/or

on the ISO list of patent declarations received (see www.iso.org/patents).

Any trade name used in this document is information given for the convenience of users and does not

constitute an endorsement.

For an explanation of the voluntary nature of standards, the meaning of ISO specific terms and

expressions related to conformity assessment, as well as information about ISO's adherence to

the World Trade Organization (WTO) principles in the Technical Barriers to Trade (TBT), see

www.iso.org/iso/foreword.html.

International Workshop Agreement IWA 38 was approved at a series of workshops hosted by

the Standardization Administration of China (SAC), in association with China IPPR International

Engineering Co., Ltd., held in Beijing, China, between January and April, 2021.

Any feedback or questions on this document should be directed to the user’s national standards body. A

complete listing of these bodies can be found at www.iso.org/members.html.
© ISO 2022 – All rights reserved PROOF/ÉPREUVE
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IWA 38:2022(E)
Introduction

Over the past few decades, natural disasters, industrial accidents and severe epidemics have frequently

occurred and caused great losses of human life and properties. In order to deal with these emergency

issues, the construction of emergency medical facilities is very important and has practical significance.

In China, the Beijing Xiaotangshan Hospital (612 beds) was constructed in 7 days when SARS broke out

in 2003. In 2020, the Wuhan Huoshenshan Hospital (1 000 beds) and the Wuhan Leishenshan Hospital

(1 600 beds) were constructed in 10 days. These emergency medical facilities played an important role

in fighting COVID-19.

This document summarizes the successful experiences accumulated from the construction of several

emergency medical facilities including the projects mentioned above, studies the new problems

revealed in different types of emergencies in the past, and develops a set of technical guidelines for the

design of emergency medical facilities.

This document is intended to provide technical support for the safe, appropriate and rapid construction

of emergency medical facilities. In the design of an emergency medical facility, its function and scale are

determined by the type, characteristics, rescue plans and actual needs of the emergency. The site plan

is set in a scientific and reasonable way. The various traffic flows in the facility are organized efficiently,

and it should have a degree of flexibility, so as to meet the uncertainty in emergencies.

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International Workshop Agreement IWA 38:2022(E)
Requirements and recommendations for the construction
of emergency medical facilities
1 Scope

This document provides requirements and recommendations for the rapid construction of emergency

medical facilities, including various categories of public health emergencies, for handling large numbers

of casualties and patients. The functional composition of emergency medical facilities is determined by

the characteristics of the emergencies.

This document is applicable to new projects built on new sites or within existing medical institutions,

where emergency medical facilities are constructed rapidly from steel-frames and prefabricated

standard plates or box structures.
2 Normative references

The following documents are referred to in the text in such a way that some or all of their content

constitutes requirements of this document. For dated references, only the edition cited applies. For

undated references, the latest edition of the referenced document (including any amendments) applies.

ISO 16890-1, Air filters for general ventilation — Part 1: Technical specifications, requirements and

classification system based upon particulate matter efficiency (ePM)

ISO 29463-1, High efficiency filters and filter media for removing particles from air — Part 1: Classification,

performance, testing and marking
3 Terms and definitions
For the purposes of this document, the following terms and definitions apply.

ISO and IEC maintain terminology databases for use in standardization at the following addresses:

— ISO Online browsing platform: available at https:// www .iso .org/ obp
— IEC Electropedia: available at https:// www .electropedia .org/
3.1
emergency medical facility

medical facility which is built rapidly and completed in limited time in response to public health issues

3.2
reception area

area where patients and the injured are received for preliminary assessment, screening, triaging and

filling in related forms
3.3
clean area
area where medical staff rest and live

Note 1 to entry: Respiratory infectious disease facilities are divided into different zones based on different

sanitation and safety levels.
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IWA 38:2022(E)
3.4
semi-contaminated area

working area for medical staff, which is accessible via the hygienic pass-through area (3.8)

EXAMPLE Offices, meeting rooms, treatment preparation rooms.
3.5
contaminated area

area where medical staff wearing personal protective equipment treat patients, including where

patients enter or stay
EXAMPLE Consultation rooms, exam rooms, wards, waste storage.
3.6
negative pressure ward

separated ward equipped with a ventilation system which controls the air flow direction to ensure that

its indoor static pressure is always lower than that of surrounding areas
3.7
buffer room

isolated small room where air flow in adjacent spaces is directed to form a sanitation and safety barrier

3.8
hygienic pass-through area

passage space set up at the entrance of contaminated areas (3.5), connecting areas of different sanitation

and safety levels, where medical staff change shoes, put on/remove gowns, wash hands, shower, put on/

remove personal protective equipment, etc.
3.9
medical quarantine area

buildings and facilities that are suitable for individual quarantine and medical observation in

accordance with relevant regulations and requirements for epidemic prevention and control

4 Abbreviated terms
CT Computerized Tomography
5 Basic principles
5.1 Sustainability

With case-specific considerations on local resources and actual needs for medical treatment, emergency

medical facilities shall respond to local conditions, make the best use of local materials, collaborate and

share resources with local health systems, and operate efficiently.
5.2 Programme and circulation

In emergency medical facilities, spaces for rapid screening, triaging and treatment shall be strengthened.

Access to imaging tests such as computerized tomography (CT) scan and surgical operation shall be

unobstructed and efficient. For respiratory infectious disease facilities, negative pressure wards,

negative pressure intensive care units and negative pressure operating rooms shall be set up when

necessary.
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IWA 38:2022(E)
5.3 Structure, mechanical and electrical systems

Reliable technology shall be adopted for the structural, mechanical and electrical systems of emergency

medical facilities. Prefabricated modular structures, integrated components and pre-wired cabinets

should be used.
...

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