Products & Services

Can your hospital handle the pressure?
Airborne isolation capacity ramps up nationwide

by Jeannie Akridge

When an emergency strikes and your hospital is faced with an influx of potentially contagious, panic-stricken victims and their families – how will your facility hold up?

Such a disaster, be it naturally occurring, or an act of bioterrorism, may come without warning; it may seem to instantly overwhelm your facility. And even the most dedicated healthcare worker may feel like walking out the door.

What can you do to help protect the safety of patients, coworkers, families, and the general public…and help ease the fears of caregivers who quite literally risk their lives to help those in need?

That’s the question hospital administrators everywhere are asking themselves. Committees nationwide are convening to discuss preparedness plans at every level. A big part of those discussions involves airborne isolation and surge capacity planning.

Isolation capacity refers to the ability to segregate patients with an infectious disease away from the rest of the patient population, to help prevent nosocomial transmission of disease.


Mintie Technologies’ IcoRoom

Key to isolating airborne contaminants in the hospital is the use of negative pressure isolation. A room that is under negative pressure has a lower pressure than adjacent areas. The airflow in the negatively pressured room is such that when the doors are opened, air is drawn into the room, rather than the contaminated air being pushed out of the room.

Surge capacity is defined as a healthcare system’s ability to expand quickly beyond normal services to meet an increased demand for medical care in the event of bioterrorism or other large-scale public health emergencies.1

A new round of federal funding from Health and Human Services announced in June has been earmarked for states to help "strengthen their capacity to respond to terrorism and other public health emergencies." In announcing an additional $1.2 billion for bioterrorism preparedness, HHS Secretary, Mike Leavitt, said, "All emergency incidents, whether naturally occurring, accidental, or terrorist-induced, begin as local matters and with this program, states and communities will build on the preparedness gains they’ve made over the past four years."

 Included in the new HHS funding, Health Resources and Services Administration (HRSA) is providing $450 million for states to develop medical surge capacity and capability to deal with mass casualty events. This includes the development of isolation capacity. HRSA’s National bioterrorism Hospital Preparedness Program, "Critical Benchmark #2-2 Surge Capacity: Isolation Capacity"2, states:

"Ensure that all participating hospitals have the capacity to maintain, in negative pressure isolation, at least one suspected case of a highly infectious disease..."

"...Awardees must identify at least one regional healthcare facility, in each awardee defined region, that is able to support the initial evaluation and treatment of at least 10 adult and pediatric patients at a time in negative pressure isolation within 3 hours post-event."

While this is the minimum criteria for surge capacity as defined by HRSA, "everybody is scrambling to figure out, ‘how much is enough?’" said Douglas Erickson, FASHE, healthcare specialist, Mintie Technologies (Los Angeles, CA).

Airborne isolation has also come to the fore of hospital concerns due to the potential for a pandemic of avian influenza.

Thomas Hart, director, product management, Mintie Technologies, explained the evolution of the company’s product line from portable containment solutions for construction and renovation, to portable anteroom solutions designed to increase hospital negative pressure isolation surge capacity. "It started out of a concern over controlling airborne contaminants during construction, and then as bioterrorism plans increased, we saw a corresponding increase in demand for our products. When this pandemic planning came into the radar screen, that’s when we saw a huge spike in interest in our products." 

 
Envirco IsoClean

CDC advises managing known and suspected cases of both SARS and avian influenza using isolation precautions. These include: "Airborne Precautions: Place the patient in an airborne isolation room (AIR). Such rooms should have monitored negative air pressure in relation to corridor, with 6 to 12 air changes per hour (ACH), and exhaust air directly outside or have recirculated air filtered by a high efficiency particulate air (HEPA) filter. If an AIR is unavailable, contact the health-care facility engineer to assist or use portable HEPA filters to augment the number of ACH." 3

While the preferred way to achieve negative pressure isolation is through a dedicated engineered airborne isolation room, also referred to as an airborne infection isolation (AII) room, this option is also the most costly. Few hospitals have enough AII rooms to accommodate any type of surge situation and it’s difficult and expensive to retrofit an existing patient room into an AII room, as well as to maintain it to standards.

For example, a study in December 2004 of the isolation capacity of hospitals in Minnesota, found that 85% of the hospitals’ AII rooms failed to meet AII functional criteria .4

TNPI saves the day

Fortunately for hospitals with tight budgets, regulations don’t require permanent AII rooms for surge capacity; they allow for alternative temporary solutions, sometimes referred to as Temporary Negative Pressure Isolation (TNPI). A much less expensive, easier-to-maintain, and flexible alternative to constructing a permanent isolation room, TNPI solutions are quickly gaining foothold in hospitals across the country.

TNPI can take on many forms, ranging from individual patient solutions to massive outdoor structures designed for surge capacity situations. While organizations such as the CDC provide general guidelines for establishing negative pressure isolation, it’s up to the facility to determine the best solution for their needs and to incorporate the solution into an overall preparedness plan.

A two-day workshop held last August, co-sponsored by the Department of Defense and Harvard University, discussed current needs and available technology for TNPI. Key findings from the meeting included: "Significantly more isolation capacity is required in hospitals and emergency management areas; there is a genuine and valid need for TNPI, but it must be as part of an integrated system; other aspects of TNPI, such as use of personal protective equipment and proper procedures, are as important as the TNPI itself, and many fundamental questions about the spread of disease, and the impact of isolation on it, still remain to be answered."

Karl-Hans Fuchs, CEO, Collective Protection Engineering Inc., (Baltimore, MD), notes that his company’s first mature isolation product was developed for use in Intensive Care Units (ICU) in Israel. "The need there is a given because the most severe part of the illness is treated in the ICU; the contact between patient and medical staff in ICU is the closest and most frequent – consequently the need for protection of the medical staff is the highest. There is no severe pandemic without urgent need for extensive use of isolation space in Intensive Care Units," he emphasized.

HEPA filtration

A key arsenal in fighting airborne contaminants, HEPA filters can be used to increase the ventilation rate of a room and clean the air, create or increase negative pressure, and may replace the need for additional exhaust. The CDC recommends that only HEPA filters that have a minimum removal efficiency of 99.97% of particles for particles 0.3 microns in diameter be used for infection control purposes.

Recirculating HEPA filters can be incorporated into a stand-alone portable air purification unit that can be wheeled into a room to provide the necessary air changes per hour and at the same time filter harmful airborne contaminants.


ECU2 from Mintie Technologies

In 2003, the Hong Kong Hospital Authority began using portable HEPA filtration units from IQAir (Santa Fe Springs, CA) as a tool for combating the SARS virus. IQAir’s Cleanroom H13 portable HEPA filtration unit includes inflow and outflow attachments that allow for quick conversion of a room to either negative or positive pressure, and provides a filtration efficiency of 99.997% at 0.3 microns for a standard size room.

IQAir’s new CleanZone HEPA filtration unit is a larger, more powerful version of the company’s flagship Cleanroom system that can cover a much larger area. The CleanZone can also be installed into a facility’s ductwork in order to create a permanent negative pressure room at a more affordable price than a standard room conversion. Glory Dolphin, CIE, CAFS, chief executive officer, IQAir North America Inc. noted that each IQAir HEPA filtration system is individually performance-certified prior to sale.

Envirco (Albuquerque, NM) began as a manufacturer of surgical hoods, and today offers a variety of indoor air quality solutions including the IsoClean HEPA air-cleaning device that can be wheeled into a standard patient room to help turn it into a negative pressure isolation room in less than a minute. Permanently mounted versions, the IsoCleanCM or AirCeil, can turn a standard patient room into a negative pressure isolation room with just a flip of a switch.

The IsoClean system uses a full size HEPA filter and a quiet but powerful motor to pull in contaminated air, clean the air, and exhaust clean air. This air can be exhausted back into the room, partially exhausted outside or into the HVAC system, or entirely outside or into the HVAC system. This last configuration is used to create negative pressure in a standard size (18’ x 12’ x 8’) patient room. Energy-efficient AirCeil is permanently mounted into the ceiling or wall, and is quieter than many units with the same capacity.

Brad Miller, medical market manager, Envirco, asks infection control practitioners to consider filter size and how it contributes to filtration efficiency. "Many units tout small size and low weight for their units. Unfortunately, small size usually means small HEPA filter. If a HEPA is too small or too thin, and the motor is pulling a great deal of air through the HEPA, something called ‘bleed through’ can occur. This is when more air is pulled through the HEPA than the manufacturer of the filter recommends. If this condition is reached, then the ability of that HEPA filter to do its job is greatly diminished," Miller explained.


Collective Protection Engineering’s IsoArk

 

Abatement Technologies Inc. (Suwanee, GA), offers a complete line of patient isolation units, both portable & built-in, with solutions for both long-term and short- term, or surge isolation. Units are designed for continuous or "as needed" application. UV modules help augment HEPA filtration increasing the kill rate of microorganisms. Abatement also provides room pressure monitors that help facilities meet regulatory requirements for maintaining negative pressure in isolation rooms.

Abatement’s HEPA-CARE portable systems are easily moved and set up virtually anywhere in a facility. HEPA-CARE ceiling -mounted systems can be installed in existing patient rooms for a much lower cost than converting existing HVAC delivery, and can be available for use within days of receipt of the unit.

Honeywell International (Golden Valley, MN) also offers both permanent ceiling-mounted and portable isolation units that can covert a room to negative pressure, along with an entire suite of facility management products.

Anterooms and isolation chambers

The use of an "anteroom" or "airlock", while not a substitute for negative pressure in an AII room, "can reduce the escape of droplet nuclei during the opening and closing of the door to an AII room and can buffer an AII room from pressure fluctuations in the corridor", according to the CDC.5 It serves as a barrier between the isolation room and the general patient population, allowing workers to enter and leave without letting contaminated air escape into the hallway or compromise the room.

Collective Protection Engineering’s (CPE’s) IsoArk indoor negative pressure isolation chamber is available in a variety of sizes and includes an integrated anteroom airlock. The system includes several features designed to make it easy for healthcare workers to use and allows for treatment from outside of the chamber whenever possible. Airtight sleeves allow for placement of expensive equipment and tools outside of the isolation space, reducing contamination risk as well as reducing the need for decontamination of equipment. Glove boxes allow for treatment of the patient from outside of the isolation area without gowning and de-gowning, saving healthcare worker time and reducing the risk for cross contamination or compromising of the air in the chamber.

"Our goal is to exceed the CDC guidelines for air exchanges and filtration efficiency with all our products," added Fuchs. The CDC only requires 12 ACH, while CPE’s isolation solutions offer up to 140 ACH. He notes that requirements in countries such as Germany are generally much more stringent than in the U.S.

Fuchs emphasized, "Best protection of the medical staff, the most important asset in a fight against pandemic, is our goal." He noted that in Ontario there are still several hundred SARS-affected medical staff personnel that are unable to work. "Effective isolation products would have been much cheaper." He notes that permanent isolation rooms are anywhere from 3 to 7 times more expensive than CPE’s TNPI solutions, which range from $1,000 to $20,000 per person depending on the solution.

In addition to protecting staff, time savings for healthcare workers will be of utmost importance in a pandemic, said Fuchs. "The likelihood that medical staff members will not show up in the event of a pandemic event due to feeling unprepared has already been proven. If only 70% of [healthcare workers] show up, because they are ill, or they are afraid, and you have ten times more people [than normal] that have to be treated, time savings really is the most crucial thing."

In addition to the IsoArk isolation chamber, CPE offers a complete product line designed to provide negative pressure isolation protection through every stage of a pandemic.


CPE’s IsoArk Multi-hood system

CPE’s IsoArk Hood is a negative pressure hood with battery powered filtration system providing 99.97% HEPA filtration. It can be used after initial detection of the isolation need (e.g. in a doctor’s office, emergency room or waiting room), or when an airborne infected patient has to leave the isolation space temporarily to go to a washroom or for testing. IsoArk Multi connects up to 8 hoods to a filtration system with 99.995% HEPA efficiency. The system can be used for 900 hours with external power or up to 10 hours with self-charging batteries. In the event of a pandemic, the IsoArk Multi would allow for safe transport and treatment of many people.  

IsoArk N36 is a full-body chamber that completely covers a patient and can be used on the floor or on a bed or stretcher. It not only filters the patient’s breathing air, but also transports body heat and perspiration out of the chamber. This system could also be used to transport a patient in an ambulance.

IsoArk Anak is CPE’s outdoor isolation solution. Based on rugged military shelter design, the configuration includes airlocks for stretchers and is air-conditioned. It is available for collective isolation (all patients have the same sort of illness and the medical staff working inside have to wear full protection) or for individual isolation where each patient has its own small negative pressure isolation space inside of a total negative pressure environment.

When triaging patients with unknown illnesses, it would benefit the hospital for liability purposes to initially employ an "individual isolation" policy, explained Fuchs. Later when individual cases evolve into a pandemic of people infected with the same illness, then collective isolation, or quarantine in a bigger unit may be in order.  

Mintie Technologies introduced its ECU2 unit late last year, which combines the benefits of the company’s ECU Ceiling Cavity and ECU Ante Room. The scalability of this solution enables facilities to prepare for mass isolation of large interior spaces, or to deploy in a variety of construction scenarios.

The ECU2 is stored folded to the size of a set of large golf clubs, rolled in, popped open, then racheted up to the ceiling for a secure fit. This creates an "anteroom" or "airlock" outside of the patient room in the corridor. A HEPA-filtered negative pressure air machine helps to create a negative pressure air room with the air pressure in the anteroom becoming an extension of the patient room. No building modification is needed for the ECU2 because contaminated air is drawn through a HEPA filter before being re-circulated back into the hospital.

A new accessory for the ECU2, the Corridor Flange, expands the benefits of the ECU2 and simplifies indoor mass airborne isolation by enabling rapid isolation of virtually any corridor segment or an entire wing of the hospital. Erickson notes that while the ECU2 solution with the corridor flange does not provide a true negative pressure isolation situation, it does provide an airlock or line of demarcation between the airborne isolation area and the general population area.

"It gives them an absolute stopping point. They can’t go beyond that and still think they’re in the general population. It’s a visual barrier along with a physical barrier," said Erickson.

"Mintie Technologies is focused at this point on helping hospitals address the challenge of increasing negative pressure isolation capacity whether it’s from an individual patient room perspective, or increasingly at the mass isolation level," said Hart. "If a lot of people were to descend on the hospital how would they deal with it – not just effectively, but cost-effectively?"

While specific situations such as a small pox outbreak, may warrant setting up surge capacity tents outdoors, Hart suggests that when feasible, setting up isolation capacity inside of the hospital will help to eliminate many logistical challenges. "It’s really a challenge for them to do this outside the facility. You’ve got all of your medical staff and all of the infrastructure that supports that environment of care, that makes it a hospital, it’s located inside the hospital. To move all of that to a tent that’s outside in the parking lot is going to be challenging at best, if not impossible to provide the quality of care that’s provided in the hospital."

Reasons that some hospitals may prefer to have an outdoor isolation solution, said Fuchs, include fear of liability for having to turn patients away in order to treat pandemic patients; fear of an unknown virus contaminating the facility; and the time it might take to decontaminate the building after an event.    

Mintie also recently introduced the IcoRoom which was specifically designed to help hospitals comply with guidelines for performing surgical procedures on patients who have either tested positive for tuberculosis (TB), or are a suspected case of TB. While TB cases may be relatively few and far between in most hospitals, new cases of multidrug-resistant (MDR) TB are causing concern among infectious disease experts.

Because operating rooms are required to be maintained at positive pressure, thus protecting the integrity of the air within the O.R., CDC has developed specific guidelines for operating on TB patients. These include scheduling the surgery for the last case of the day and allowing a certain amount of time to pass after extubating the patient before anyone can enter or exit the O.R.

"You can see the potential logistical and financial implications if you were to follow those procedures any time you had a suspected TB case, said Hart. "All of that can be done away with if you have an anteroom attached to your surgery room, but only a low percentage have that luxury, and they’re not building any additional anterooms in hospital new construction because of the space that is taken up by these anterooms and the expense to build them."  

Mintie’s IcoRoom solution is placed in the main entrance door to the O.R. A high-grade HEPA negative air machine pulls the contaminants out of the air in the O.R. before recirculating it back into the hospital’s air supply. "Essentially, the IcoRoom simulates the effectiveness of a fixed anteroom in a portable anteroom that can easily be stored until it’s needed," said Erickson.

TVI Corporation (Glenn Dale, MD) is another company that offers a complete line of domestic preparedness products that include rapidly deployable decontamination shelters and chemical/biological isolation shelters with the capacity to accommodate 50-60 beds or more.

Pulling double-duty

Hospitals that purchase TNPI solutions such as portable HEPA filtration machines, don’t have to store them away for a rainy day, so to speak. HEPA filtration can be useful under a number of circumstances to provide better air quality and prevent cross-contamination throughout the hospital.

A recent study by the Department of Microbiology, Nottingham City Hospital, UK, proved the effectiveness of IQAir’s Cleanroom H13 HEPA filtration unit in reducing methicillin-resistant Staphylococcus aureus (MRSA) environmental contamination on horizontal surfaces. The researchers concluded: "this portable HEPA-filtration unit can significantly reduce MRSA environmental contamination within patient isolation rooms, and this may prove to be a useful addition to existing MRSA infection control measures."6

IQAir’s Cleanroom H13 was also recently used at the Los Angeles Zoo to help an ailing orangutan named Minyak. The rare orangutan had a chronic infection of the air sac at the base of his neck that eventually led to chronic pneumonia. Minyak spent two years in solitary confinement at a primate reasearch center in Atlanta, and was almost euthanized due to his long-term illnesses, before being transferred to the Los Angeles Zoo. There he had his infected air sac removed and recovered well from the surgery, but was still experiencing problems after returning to the zoo’s orangutan habitat. The zoo called on IQAir to see what they could do to improve the air quality of Minyak’s habitat. An air sampling inspection found that dust from the fiberglass insulation in the HVAC system was blowing into Minyak’s bedroom. By encapsulating the fiberglass insulation in the HVAC system and installing a Cleanroom H13 air purifier, Minyak recovered remarkably and was able to enter the zoo’s breeding program – he recently fathered a healthy baby orangutan!

Patients with respiratory illnesses or immuno-compromised patients such as those in cancer or burn wards may also benefit from an "ultra-clean" air environment such as can be provided by HEPA filtration units.

David J. Willyard, vice president, Abatement, noted that the company’s HEPA-CARE Air Purification Systems could be used to provide air filtration in common areas, such as waiting rooms or treatment rooms, and nurses station during cold and flu season. Portable HEPA-CARE Air Purification Systems & HEPA-AIRE Portable Air Scrubbers can be used during construction and/or renovation projects to protect at- risk patients and personnel from airborne pathogens. They could also be used for odor removal in rooms with patients having respiratory sensitivities.

One advantage to using air purification equipment on a routine basis is that the staff will become familiar with how the systems operate so they can act quickly in an emergency.

Mintie Technologies’ ECU2 can also be used for environmental containment during construction or renovation activities. "People are drawn to this product because even though they may be purchasing it for isolation and using federal money to do that, they don’t have to put this in a closet like so much emergency equipment," said Hart. "If they choose to use this on a daily basis not only does it increase their return on investment, but it also enables the staff to be familiar with the equipment if and when that emergency situation arrives."

Look for units that are "easy to set-up, inexpensive to operate, require minimal preventive maintenance, deliver a high quality of air filtration (HEPA filters are tested and certified) and have powerful blowers to maintain consistent airflow," said Willyard.

Fuchs notes that CPE’s isolation products are simple-to-use and require no tools for assembly. While minimal training is required for his company’s individual systems, "a total system exercise is mandatory as well. It is of utmost importance that the training is done regularly and that it covers all aspects of isolation: From the spot of detection, overland transport, internal transport, triage, treatment in ICU, even morgue storage."

Exactly how preparedness plans are carried out is ultimately up to the individual facility, but more planning is definitely needed, JCAHO warns in a new study of the nation’s community and hospital emergency preparedness plans.7 The study found many hospitals reporting "no community plans to augment hospital-based surge capacity in the area of pharmaceuticals, supplies, equipment, and isolation. Lack of sufficient plans in these areas could have severe consequences if a serious incident occurs (such as an outbreak of severe acute respiratory syndrome)." HPN

REFERENCES:  

1. Agency for Healthcare Research and Quality, “Addressing Surge Capacity in a Mass Casualty Event. Bioterrorism and Health System Preparedness, Issue Brief No. 9.” AHRQ Publication No. 06-0027, January 2006, http://www.ahrq.gov/news/
ulp/btbriefs/btbrief9.htm. 

2. U.S. Department of Health and Human Services, Health Resources and Services Administration, FY 2005. Continuation Guidance National Bioterrorism Hospital Preparedness Program, Critical Benchmark #2-2: Surge Capacity: Isolation Capacity, http://www.hrsa.gov/bioterrorism/
hrsa05001.htm.

3. Centers for Disease Control and Prevention, “Interim Recommendations for Infection Control in Health-Care Facilities Caring for Patients with Known or Suspected Avian Influenza,” http://www.cdc.gov/flu/avian/professional/
infect-control.htm.

4. “Minnesota BHPP Airborne Infection Isolation Capacity Project”, University of Minnesota, December 2004. 

5. Centers for Disease Control and Prevention, Guidelines for Preventing the Transmission of Mycobacterium tuberculosis in Health-Care Settings, 2005, http://www.cdc.gov/mmwr/preview/
mmwrhtml/rr5417a1.htm. 

6. “Reduction in MRSA environmental contamination with a portable HEPA-filtration unit”, T.C. Boswell, P.C. Fox, Department of Microbiology, Nottingham City Hospital, UK, Journal of Hospital Infection, received 27 May 2005; accepted 22 November 2005. 

7. Joint Commission on Accreditation of Healthcare Organizations, “Integrating Hospitals into Community Emergency Preparedness Planning” by Barbara I. Braun, Ph.D.; Nicole V. Wineman, M.A., M.P.H., M.B.A.; Nicole L. Finn, M.A.; Joseph A. Barbera, M.D.; Stephen P. Schmaltz, Ph.D.; and Jerod M. Loeb, Ph.D., June 6, 2006, Annals of Internal Medicine, http://www.annals.org/cgi/content/full/
144/11/799.

August 2006

 

Operation Clean Air

Surgical smoke as a byproduct of laser surgery or electrosurgery is a fact of life in the operating room. It’s been estimated that as much as 95% of procedures produce some type of smoke. And it’s been proven that surgical smoke contains toxic gases and vapors such as benzene, hydrogen cyanide, formaldehyde, bioaerosols, dead and live cellular material (including blood fragments), and viruses.

"At higher concentrations the smoke can cause ocular and upper respiratory tract irritation in healthcare personnel, and creates visual problems for the surgeon," said Kelly Steinkirchner, product manager, Buffalo Filter (Buffalo, NY). "Unpleasant odors and toxic gases in surgical smoke have also been reported to cause nausea, headache, dizziness, and fatigue in exposed persons," she added.


Pall LSF

CDC/NIOSH specifically states that smoke plume is a hazardous byproduct that should be evacuated with either a smoke evacuator or wall-suction with in-line filtration. And OSHA dictates that "each employer shall furnish to each of his employees employment and a place of employment which are free from recognized hazards that are causing or are likely to cause death or serious physical harm to his employees."

"We also anticipate a heightened awareness due to the recent government publications on the dangers of second hand smoke from cigarettes. One study on surgical smoke suggests that one gram of tissue irradiated by laser is equal to three cigarettes, and one gram of tissue heated by ESU releases a plume that is equal to six cigarettes," Steinkirchner added.

In addition to educating healthcare workers on the hazards of surgical smoke through Continuing Education courses, tradeshows and other venues, Buffalo Filter focuses product enhancements on features designed to make their smoke evacuation systems more user-friendly and efficient.


Buffalo Filter LapEvac

For example, Buffalo Filter recently incorporated two-way radio frequency identification (RFID) into its TURBO Auto-Sense smoke evacuator. RFID technology allows the filter and smoke evacuator to communicate and store information such as filter life, lot number, serial number, filter model, etc. This allows users to purchase longer life filters without having to worry about tracking filter life. It also avoids having users throw away filters that still have life remaining on them.

Buffalo Filter’s PenAdapt was launched in 2004. This specialty tube adapts to electrosurgical pencils and allows users to capture smoke as they cut/cauterize without having to hold tubing at the surgical site.

The company also recently launched the LapEvac for laparoscopic surgery, a disposable, battery powered smoke evacuator that creates a closed loop to filter and re-circulate gas into the peritoneal cavity. This small, sterile unit connects to two trocars and quietly runs throughout the surgical procedure. LapEvac keeps the surgeon’s view clear from smoke, minimizes the amount of CO2 gas needed to keep the patient’s cavity distended, and also helps to reduce the amount of plume byproducts absorbed into the patient’s cavity.

"Using LapEvac will help reduce many of the risks associated with poor vision and loss of distension due to smoke and efforts to clear smoke from the patient’s cavity," said Steinkirchner.

Pall Medical (East Hills, NY) offers a "passive" smoke evacuation system that may provide a convenient option for smoke evacuation on the fly. The Laparoshield Smoke Filtration System uses activated carbon to remove particulates, cells, virus and odors causing chemicals from surgical smoke generated in laparoscopic procedures while maintaining a clear field of vision. It can be used during any minimally invasive surgery involving insufflation, electrocautery, laser or ultrasonic scalpel use. The filter is connected directly to the trocar, and can be implemented at any point in a surgical case.

Dan Mueller, senior director, U.S. hospital sales, Pall Medical, notes that the Laparoshield is an easy-to-implement solution that costs less than $25 per procedure.

W. L. Gore & Associates (Elkton, MD), recently introduced a new filter media that’s designed to improve performance and streamline design for manufacturers of smoke evacuation systems. The GORE Medical Membrane for Surgical Smoke Filtration features a unique all-in-one design that combines high particle-holding capability and long life with a robust contamination barrier to provide the highest level of available protection to health care workers, patients and equipment. It is designed to prevent breakthrough of pathogens found in smoke and aerosolized fluids and is suitable for surgical smoke filtration applications for both laparoscopic and invasive procedures.

The multilayer design that includes a microfiberglass prefilter helps to provide fine filtration capabilities while also allowing strong suction to be maintained throughout the surgical procedure. This all-in-one design eliminates the need for separate coarse and high-efficiency filters, making new device designs simpler and cost-effective. HPN

 

How the right window film can enhance indoor air quality and save energy

by Marty Watts 

Too much heat in the indoor environment can reduce building occupant productivity and well being and increase the off-gassing of equipment, furnishings and building components that degrade indoor air quality. Worse still, when indoor humidity is high, ambient heat increases the growth of bacteria-generating mold that presents a health threat.

Ironically, many of the measures taken to increase energy efficiency such as “tightening” buildings to reduce both air infiltration and outflow have degraded a building’s air quality. These problems may be solved by air conditioning that may require upgrading existing air systems and result in increased operational cost.

According to the California Energy Commission, 30% of a building’s cooling requirements is from heat entering through existing windows. If that is the case, why is reducing heat in a building usually considered to be an exclusive function of air conditioning? As a supplement to air conditioning, stopping heat at the window using heat-blocking window film, can not only reduce air conditioning operating frequency and cost, but can also placate many building occupants who believe “conditioned” air is less desirable and healthy to work or live in than non-conditioned air.

According to the Common Colds Centre, Cardiff School of Biosciences at Cardiff University in the UK, air conditioning itself may contribute to infection with common cold viruses. The Centre’s web site contends that “The lining of the nose is covered with a thin layer of mucus which protects against infection. Since air conditioners extract moisture from the air they may cause some drying of the protective mucous blanket in the nose and predispose to infection. The cold air may also help viruses to establish a hold in the nose as they reproduce better in a cold nose.”

The good news is that window film can reduce the impact of solar heat through existing glass, resulting in lower temperatures and better indoor air quality often without the need to increase air conditioning capacity. An added plus is the reduction of air conditioning operational cost.

The bad news is that the use of conventional tinted and reflective window film can reduce the amount of natural light entering a facility. Studies indicate that denying building occupants adequate natural light reduces productivity and well being. Worse still, darkened facilities often require increased illumination that may generate more heat that can cause more air quality problems as it negates the cost-saving benefits of window film.

Fortunately, spectrally selective window film will block solar heat without reducing adequate natural light. Spectrally selective refers to the window film’s ability to transmit light while blocking heat. In combination with existing air conditioning, spectrally selective window film can reduce ambient heat, off-gassing and mold formation while not increasing energy costs. HPN

Marty Watts is President and CEO of V-Kool, Inc., Houston, TX, a sales and marketing distribution company of spectrally selective applied window films. For information contact V-Kool, Inc., at 800 217-7046.