This article is designed to point out those
items of the hospital plumbing system which differ from plumbing systems
of other building types. Special care should be accorded the hospital
plumbing system because of its direct relationship to the provision
of adequate medical care and the need to protect hospital personnel
and patients from health hazards involved in such systems. It is understood
that this hospital plumbing system shall conform not only to the criteria
in this article but to the requirements contained in the body of the
Code.
Acceptable flush rim bedpan hoppers (clinic
sinks), bedpan washers, and/or other acceptable fixtures and equipment
shall be provided for the disposing of bedpan contents and the cleansing
and disinfection of bedpans in soiled utility (hopper) rooms.
A.
Clinic sink. A clinic sink shall have an integral
trap in which the upper portion of a visible trap seal provides a
water surface. The fixture shall be so designed as to permit complete
removal of the contents by siphonic and/or blowout action, and to
reseal the trap. A flushing rim shall provide water to cleanse the
interior surface. The fixtures shall have flushing and cleansing characteristics
similar to a water closet.
B.
Prohibited use of clinic sinks and service sinks.
A clinic sink serving a soiled utility room shall not be considered
as a substitute for, nor shall it be used as a janitor's service sink.
A janitor's service sink shall not be used for the disposal of urine,
fecal matter, or other human wastes.
C.
Ice prohibited in soiled utility rooms. No machine
for manufacturing ice, or any device for the handling or storage of
ice shall be located in a soiled utility room. Machines for manufacturing
ice, or devices for handling or storage of ice intended for either
human consumption or packs, may be located in clean utility room,
floor pantry, or diet kitchen.
D.
Sterilizer equipment requirements.
(1)
Descaling of equipment prohibited. It shall be unlawful
to descale or otherwise submit the interior of water sterilizers,
stills, or similar equipment to acid or other chemical solutions while
the equipment is connected to the water and/or drainage system.
(2)
ASME Standard. New pressure sterilizers and pressure
instrument washer-sterilizers hereafter installed shall display in
a location to be clearly visible at all times the ASME Standard symbol
and data plate.
(3)
Sterilizer piping. All sterilizer piping and/or devices
necessary for the operation of sterilizers shall be accessible for
inspection and maintenance.
(a)
Steam supply. Steam supplies to sterilizers,
including those connected by pipes from overhead mains or branches,
shall be drained to prevent any excess moisture from reaching the
sterilizer. The condensate drainage from the steam supply shall be
discharged by gravity.
(b)
Steam condensate return. Steam condensate return
from sterilizers shall not be connected to pressure or vacuum return
systems; only gravity return shall be acceptable. Steam condensate
returns from sterilizers shall not be connected to overhead mains
or branches.
(c)
Condensers.
[1]
Pressure sterilizers should be equipped with
an acceptable means of condensing and cooling the exhaust steam vapors.
[2]
Non pressure sterilizers should be equipped
with an acceptable device which will automatically control the vapors
in a manner to confine them within the vessel, or equipped with an
acceptable means of condensing and cooling the vapors.
(d)
Gas fired equipment. Gas fired equipment or
apparatus requiring either water or drainage connections or both shall
meet the Standards of the American Gas Association.
E.
Special elevations. Control valves, vacuum outlets,
and devices which protrude from a wall of an operating, emergency,
recovery, examining, or delivery room, or a corridor, and/or other
locations where patients may be transported on a wheeled stretcher,
shall be so located at an elevation which will preclude bumping the
patient or stretcher against the device. When necessary to install
at a low elevation, safety precautions should be taken to protect
the personnel.
F.
Plumbing in mental hospitals. In mental hospitals,
special consideration should be given to piping, controls, and fittings
of plumbing fixtures as required by the types of mental patients being
treated. No pipes or traps should be exposed and fixtures should be
substantially bolted through walls.
|
NOTE: Those fixtures not covered in this chapter having to do with hospital plumbing will be covered in Table 860-102A, "Minimum Number of Plumbing Fixtures."[1]
|
[1]
Editor's Note: Table 860-102A is included at the end of this chapter.
A.
Ice storage chest drains. Any drain serving an ice
chest or box shall discharge over an indirect waste receptor separate
from all other fixture wastes. Each terminal shall discharge through
an air gap above the receptor. The end shall be covered with a removable
screen of not less than ten mesh per inch; and if discharging vertically,
the terminal shall be cut at an angle of 45°.
B.
Bedpan washers and clinic sinks. Bedpan washers and clinic sinks shall be connected to the soil pipe system and vented following the requirements as applied to water closets except that bedpan washers require additional local vents. See § 860-192L(1).
C.
Sterilizer wastes.
(1)
Indirect wastes required.
(a)
All sterilizers shall be provided with individual
and separate indirect wastes, with air gaps of not less than two diameters
of the waste tailpiece. The upper rim of the receptor, funnel, or
basket type waste fitting shall be not less than two inches below
the vessel or piping, whichever is lower.
(2)
Floor drain required. In all recess rooms containing
the recessed, or concealed portions of sterilizers, not less than
one acceptable floor drain, connecting to the drainage system, shall
be installed in a manner to drain the entire floor area.
(3)
Recess room floor drains, trap seal maintenance. The
recess room floor drain waste and trap shall be a minimum diameter
of three inches. It shall receive the drainage from at least one sterilizer
within the recess room to assure maintenance of the floor drain trap
seal. The sterilizer drain shall be installed on a branch taken off
between the floor drain trap and the drain head. No individual sterilizer
waste trap shall be required on this type of installation.
(4)
Prohibited connections. Branch funnel and branch basket type fittings, except as provided in Subsection C(2), are prohibited on any new installation or when relocating existing equipment. Existing branch funnel or branch basket type installations shall be provided with an acceptable indirect waste below the branch connections.
(5)
Battery assemblies. A battery assembly of not more
than three sterilizer wastes may drain to one trap, provided the trap
and waste are sized according to the combined fixture unit rating;
the trap is located immediately below one of the indirect waste connections;
the developed distance of a branch does not exceed four feet; and
the branches change direction through a tee-wye or wye pattern fitting.
(6)
Bedpan streamers, additional trap required. A trap
with a minimum seal of three inches shall be provided in a bedpan
steamer drain located between the fixture and the indirect waste connection.
(7)
Pressure sterilizer. Except when an exhaust condenser
is used, a pressure sterilizer chamber drain may be connected to the
exhaust drip tube before terminating at the indirect waste connection.
If a vapor trap is used, it shall be designed and installed to prevent
moisture being aspirated into the sterilizer chamber. The jacket steam
condensate return, if not connected to a gravity steam condensate
return, shall be separately and indirectly wasted. If necessary to
cool a high temperature discharge, a cooling receiver, trapped on
its discharge side, may serve as the fixture trap.
(8)
Pressure sterilizer exhaust condensers. The drain
from the condenser shall be installed with an indirect waste as prescribed
in the Code. If condensers are used on pressure sterilizers, the chamber
drain shall have a separate indirect waste connection.
D.
Aspirators. In operating rooms, emergency rooms, recovery
rooms, delivery rooms, examining rooms, autopsy rooms, and other locations,
except laboratories where aspirators are installed for removing blood,
pus and/or other fluids, the discharge from any aspirator shall be
provided with a bottle or similar trap to protect the water supply.
E.
Vacuum system stations. Vacuum system stations location
shall be considered from a standpoint of convenience and practical
use. The receptacles should be built into cabinets or recesses, but
shall be visible and readily accessible.
F.
Bottle systems. Vacuum (fluid suction) systems intended
for collecting, removing and/or disposing of blood, pus and/or fluids
by the so-called bottle system shall be provided with receptacles
which are equipped with an overflow preventive device at each vacuum
outlet station. Each vacuum outlet station should be equipped with
a secondary safety receptacle as an additional safeguard against fluids,
other than air, entering the vacuum piping systems.
G.
Central disposal system equipment. Because of dependence
placed upon central vacuum (fluid suction) systems, all such systems
shall assure continuous service. Systems equipped with collecting
and/or control tanks shall provide for the draining and cleaning of
the tanks while the system is in operation. In hospitals or like institutions
having emergency power provisions, the system shall be capable of
remaining in service during the use of emergency power. The exhaust
from a vacuum pump used in connection with a vacuum (fluid suction)
system shall discharge separately to the outer atmosphere above the
roof. The exhaust discharge shall not create a nuisance and/or hazard
within, without, around and/or above premises.
H.
Central vacuum, and/or disposal system.
(1)
Wastes. The waste from a central vacuum (fluid suction)
system of the disposal type and/or which is connected to the drainage
system whether the disposal be by barometric leg, collecting tanks,
or bottles, shall be directly connected to the sanitary drainage system
through a trapped waste.
(2)
Piping. The piping of a central vacuum (fluid suction)
system shall be of corrosion resistant material having a smooth interior
surface. No branch shall be less than one-half inch for one outlet
and sized according to the number of vacuum outlets, and no main shall
be less than one inch. The pipe sizing shall be increased according
to the manufacturer's recommendation as stations are increased. All
piping shall be provided with adequate and accessible clean-out facilities
on mains and branches, and shall be accessible for inspection, maintenance,
and replacements.
I.
Water systems for space cooling and heating condensate
drains. The lowest point of a condensate riser or risers shall be
trapped and discharged over an indirect waste sink. The trap may be
either "P" or a "running trap" with a cleanout. A branch shall be
installed upstream from the condensate drain trap for flushing and
resealing purposes. The condensate drain and trap shall be located
above the lowest floor level of the building.
J.
Vent material. Material for local vents serving bedpan washers and sterilizer vents serving sterilizers, shall be sufficiently rust proof, erosion and corrosion resistant to withstand intermittent wetting and drying from steam vapors, to withstand the distilled water solvent action of the steam vapors, and to withstand frequent and immediate changes of temperatures. Such material shall be not less in quality than the requirements specified for sanitary vents as outlined in Article V, § 860-64.
K.
Vent connections prohibited. Connections between local
vents serving bedpan washers and sterilizer vents serving sterilizing
apparatus, and/or normal sanitary plumbing systems, are prohibited.
Furthermore, only one type of apparatus shall be served by a given
vent.
L.
Local vents and stacks.
(1)
Bedpan washers. Bedpan washers shall be vented to
the outer atmosphere above the roof by means of one or more local
vents. The local vent for a bedpan washer shall be not less than a
two inch diameter pipe. A local vent serving a single bedpan washer
may drain to the fixture served.
(2)
Multiple installations. Where bedpan washers are located
above each other on more than one floor, a local vent stack may be
installed to receive the local vent on the various floors. Not more
than three bedpan washers shall be connected to a two inch local vent
stack; six to a three inch local vent stack; and 12 to a four inch
local vent stack. In multiple installations, the connections between
a bedpan washer local vent and a local vent stack shall be made by
use of the tee or tee-wye sanitary pattern drainage fittings, installed
in an upright position.
(3)
Trap required. The bottom of the local vent stack,
except when serving only one bedpan washer, shall be drained by means
of a trapped and vented waste connection to the plumbing sanitary
drainage system. The trap and waste shall be the same size as the
local vent stack.
(4)
Trap seal maintenance. A water supply of not less
than 1/4 inch minimum tubing shall be taken from the flush supply
of each bedpan washer on the discharge or fixture side of the vacuum
breaker, trapped to form not less than a three inch seal, and connected
to the local vent stack on each floor. The water supply shall be so
installed as to provide a supply of water to the local vent stack
for cleansing and drain trap seal maintenance each time a bedpan washer
is flushed. Alternate method may be utilized with the approval of
the Administrative Authority.
M.
Sterilizer vents and stacks.
(1)
Connections. Multiple installations of pressure and
nonpressure sterilizers shall have their vent connections to the sterilizer
vent stack made by means of inverted wye fittings. Such vent connections
shall be accessible for inspection and maintenance.
(2)
Drainage. The connection between sterilizer vent and/or
exhaust openings and the sterilizer vent stack shall be designed and
installed to drain to the funnel or basket-type waste fitting. In
multiple installations, the sterilizer vent stack shall be drained
separately to the lowest sterilizer funnel or basket type waste fitting
or receptor.
N.
Sterilizer vent stack sizes.
(1)
Bedpan steamers. The minimum size of a sterilizer
vent serving a bedpan steamer shall be 1 1/2 inches in diameter.
Multiple installations shall be sized according to Table 860-192N(2),
"Stack Sizes for Bedpan Steamers and Boiling Type Sterilizers."
(2)
Stack sizes for bedpan steamers and boiling type sterilizers.
|
Table 860-192N(2)
Number of Connections of Various Sized
Sterilizer Vent Stacks
| |||
|---|---|---|---|
|
Connection Size
| |||
|
Stack Size
|
1 1/2"
|
2"
| |
|
1 1/2 inch1
|
1 or
|
0
| |
|
2 inch1
|
2 or
|
1
| |
|
2 inch2
|
1 and
|
1
| |
|
3 inch1
|
4 or
|
2
| |
|
3 inch2
|
2 and
|
2
| |
|
4 inch1
|
8 or
|
4
| |
|
4 inch2
|
4 and
|
4
| |
|
NOTES:
| ||
|---|---|---|
|
1.
|
Total of each size.
| |
|
2.
|
Combination of sizes.
| |
(a)
Boiling type sterilizers. The minimum size of
a sterilizer vent stack shall be two inches in diameter when serving
a utensil sterilizer, and 1 1/2 inches in diameter when serving
an instrument sterilizer. Combinations of boiling type sterilizer
vent connections shall be based on Table 860-192N(2), "Stack Sizes
for Bedpan Steamers and Boiling Type Sterilizers."
(b)
Pressure sterilizers. Sterilizer vent stacks
shall be two and one-half inches minimum; those serving combinations
of pressure sterilizer exhaust connections shall be sized according
to Table 860-192N(2), "Stack Sizes for Pressure Sterilizers."
(c)
Pressure instrument washer-sterilizer sizes.
The minimum size of a sterilizer vent stack serving an instrument
washer-sterilizer shall be two inches in diameter. Not more than two
sterilizers shall be installed on a two-inch stack, and not more than
four on a three-inch stack.
(3)
Stack sizes for pressure sterilizers.
|
Table 860-192N(3)
Number of Connections of Various Sizes
Permitted to Various Sized Vent Stacks
| |||||
|---|---|---|---|---|---|
|
Connection Size
| |||||
|
Stack Size
|
3/4"
|
1"
|
1 1/4"
|
1 1/2"
| |
|
1 1/2 inches1
|
3 or
|
2 or
|
1
| ||
|
1 1/2 inches2
|
2 and
|
1
| |||
|
2 inches1
|
6 or
|
3 or
|
2 or
|
1
| |
|
2 inches2
|
3 and
|
2
| |||
|
2 inches2
|
2 and
|
1 and
|
1
| ||
|
2 inches2
|
1 and
|
1 and
|
1
| ||
|
3 inches1
|
15 or
|
7 or
|
5 or
|
3
| |
|
3 inches2
|
1 and
|
2 and
|
2
| ||
|
3 inches2
|
1 and
|
5 and
|
1
| ||
|
NOTES:
| ||
|---|---|---|
|
1.
|
Combination of sizes.
| |
|
2.
|
Total of each size.
| |
O.
Radioactive materials. All radioactive materials shall
be disposed of in a manner so as to create no hazard to operation
and maintenance personnel of the institution or to the public. Specific
permission shall be secured from the Administrative Authority to dispose
of any radioactive material to the drainage system.
A.
Water service. All hospitals shall have dual water
services installed, where dual services are available; installed in
a manner to provide an uninterrupted supply of water in case of a
main break.
B.
Hot water heater and tanks. The hot water heating
equipment shall have sufficient capacity to supply six and one-half
gallons of water at 125° F. per hour per bed for kitchens; four
and one-half gallons of water at 180° F. per bed for laundry.
The hot water storage tank or tanks shall have an adequate storage
and heating capacity to satisfy the above needs. Consideration of
dual water heating services should be given so as to provide an uninterrupted
supply of hot water in the event one system is down for repair.
C.
Hot water system. Hot water circulating mains and
risers should be run from the hot water storage tank to a point directly
below the highest fixture at the end of each branch main. Where the
building is higher than three stories, each rise shall be circulated.
Each main, branch main, riser and branch to a group of fixtures of
the water system shall be valved.
D.
Vacuum breaker installations.
(1)
Hose connections. For ordinary hose connections the
maximum height at which any hose is to be used shall be treated as
its flood level.
(2)
Low volume flows. Where low volume flows might cause
leaking or spitting at the vacuum breaker parts, back pressure may
be developed by installing an acceptable minimum orifice valve on
the discharge side of the vacuum breaker. This shall be in addition
to the regular control valve. This type of installation shall be subject
to review and acceptance by the Administrative Authority before installation.
E.
Prohibited water closet and clinic sink supply. No
jet or water supplied orifices, except those supplied by the flush
connection, shall be located in and/or connected with a water closet
bowl or clinic sink. This section shall not prohibit an acceptable
bidet installation.
F.
Special equipment, water supply protection. Table
1803.6, "Fixtures and Their Water Supply Protection," sets forth the
requirements which shall be followed in protecting the water supply
for hospital fixtures against backflow or back-siphonage.
|
Table 860-193F
Fixtures and Their Water Supply Protection
| |||
|---|---|---|---|
|
Fixtures
|
Type of Protection1
|
Remarks
| |
|
Aspirators:
| |||
|
Laboratory
|
Vacuum breaker
| ||
|
Portable
|
Vacuum breaker
| ||
|
Vacuum system
|
Vacuum breaker
| ||
|
Bedpan:
| |||
|
Washers
|
Vacuum breaker
| ||
|
Washer hose
|
Vacuum breaker
|
Locate 5 feet above floor
| |
|
Boiling type sterilizer
|
Air gap
|
Not less than twice the effective opening of
the water supply
| |
|
Exhaust condenser
|
Vacuum breaker
| ||
|
Flush floor drain
|
Vacuum breaker
| ||
|
Hose connection
|
Vacuum breaker
|
Locate 6 feet above floor
| |
|
Pressure instrument washer-sterilizer
|
Vacuum breaker
| ||
|
Vacuum system:
| |||
|
Cleaning
|
Air gap or vacuum breaker
| ||
|
Fluid suction
|
Air gap or vacuum breaker
| ||
|
NOTE:
| ||
|---|---|---|
|
1
|
Where vacuum breakers are used, they shall be
installed after the last control valve.
| |
G.
Clinical, hydrotherapeutic and radiological equipment.
(1)
All clinical, hydrotherapeutic, radiological, or any
equipment, whether mentioned or not, which is water supplied and/or
discharges to the waste system, shall meet the requirements of this
section and the Code covering cross-connections, air gaps, vacuum
breakers, and check valves.
(2)
Special equipment and devices found under these classes
include:
|
Clinical
|
Hydrotherapeutic
|
Radiological
|
Other
| |
|---|---|---|---|---|
|
Dental cuspidors
|
Control Units
|
Violet Rays
| ||
|
Surgical cuspidors
|
Arm bath
|
Diagnostic X-ray
| ||
|
Dental (flush rim) lavatories
|
Leg bath
|
Therapy X-ray
| ||
|
Colonic irrigation
|
Foot bath
| |||
|
Sitz bath
|
Tub bath
|
X-ray transformers
| ||
|
Emergency bath
|
Immersion bath
|
X-ray oil tank
| ||
|
Receiving bath
|
Shower bath
|
Diffraction
| ||
|
Prenatal bath
|
Needle bath
| |||
|
Infant bath
|
Tank
|
X-ray developing
| ||
|
Prophylaxis
|
Pool
|
Photographic developing
| ||
|
Shampoo
|
Hose
|
Film developing Microscopic
| ||
|
Massage
|
Syringe Douche
|
H.
Condensate drain trap seal. A water supply shall be
provided for cleaning, flushing and resealing the condensate trap.
The source of the water supply shall be a refrigerator condenser discharge,
a drinking fountain waste, or other acceptable method of flushing
and resealing the trap. The water supply shall be not less that 1/2
inch diameter pipe, and shall discharge through an air gap not less
than twice the diameter of the supply pipe.
I.
Valve leakage diverter. Each water sterilizer, which
may be filled with water through directly connected piping, shall
be equipped with an acceptable leakage diverter and/or bleed-line
on the water supply control valve to indicate and conduct any leakage
of unsterile water away from the sterile zone.
J.
Water supply for fire protection.
(1)
Stand pipe systems. The stand pipe system shall be
installed as required by the Administrative Authority. Where no codes
are in force, the stand pipe system should comply with the requirements
of the National Board of Fire Underwriters, Pamphlet No. 14.
(2)
Sprinkler system. Automatic sprinkler systems shall
be installed in those area considered hazardous from a fire safety
point of view. Such hazardous areas may include the soiled linen rooms,
basement corridors, paint shops, wood working shops, trash rooms,
storage rooms, accessible attics, laundry and trash chutes. Sprinkler
systems should comply with the requirements of the National Fire Protective
Association, Pamphlet No. 13.
Where oxygen systems are installed, the oxygen
piping, outlets, manifold rooms and storage rooms should be installed
in accordance with the requirements of the National Fire Bulletins
No. 56 and 565.
