13/06/2023
Burns Unit Intensive Care Units
By Kamva Ndlala
In healthcare, Heating, Ventilation, and Air-Conditioning (HVAC) systems are crucial to the well-being and recovery of patients. The multifaceted role involves having complete control over how the patient, nurses, and visitors will react to the air that is being delivered.
The level of thermal comfort varies depending on the individual and the ailment for which the patient is being admitted. The type of clothes worn; the movement of air around the person; the heat of surfaces in the immediate surroundings; moisture contained in the air; and the metabolism rate which includes the layers of skin, all contribute to the “temperatures” felt, which is why this is the case.
Patients in an intensive care unit (ICU) for burns, are people who have suffered severe burns. Burns reduce skin surface area, which impairs the body’s ability to regulate its internal temperature (Fernandez, 2021). Hypothermia can affect the vast majority of patients. Therefore, it is crucial to maintain temperatures at a minimum standard range of 26 – 28 °C and a minimum of 50% relative humidity (IUSS, 2014) since hypothermia can increase the patient’s risk of mortality (Page, 2014).
Healthcare facilities need an accurate and higher air change rate even if they are similar to other structures. Healthcare facilities need air circulation that is preferably free of contaminants. If the air is appropriately positioned and filtered where necessary, it can be regarded as being free of contaminants.
A burns unit ICU requires a three-stage filtration system to make sure that no outdoor air particles interfere with the patients’ ability to heal, by spreading infections and external contaminants. As a result, the ICU’s area needs to have positive pressure to reduce the amount of unfiltered air that enters the room (Lavedrine, 2005). It is best practice to maintain a high air change rate to reduce external contaminants and reduce cross contamination of airborne infections even if it is extremely improbable that a patient who has been rushed to an ICU will be diagnosed with an airborne illness like tuberculosis (TB) prior to admission (Saran, 2020).
How do the thermal comfort and fresh air requirements play a role in a burn’s unit energy and water efficiency?
The high temperature control, strict humidity control, and frequent air change, play an overarching role in the energy consumption of the burns unit. Fortunately, in South Africa we have a long summer season and short winter season thereby reducing the need for heating energy consumption. However, the consumption becomes apparent in the winter season where heating is heavily required.
The heating coils need to heat the air to temperature differences of sometimes higher than 20°C, this in turn, calls for the need of a humidifier to increase the humidity levels provided, which consumes a high rate of water.
Recirculation of the air which is at the required conditions is not considered safe. Although the energy and water consumption are reduced.
One can argue, that the dilution of return air with a significantly higher amount of fresh air and further filtering through the three-stage filtration system will give an acceptable air quality.
Recommendations and Tips
It is crucial that, in the design of a burn’s unit ICU, we consider the electrical capacity together with the water availability of the area. Fortunately, South Africa has more warmer than colder nights.
It is recommended that we work together with doctors and nurses. Records of different complaints; and cross contamination cases are to be kept. This will then increase the available data and allow for a set standard of design.
Where a set standard is produced, different technologies such as Thermally Activated Building Services (TABS) can be used to reduce the overall energy and water consumption.
