NFPA 99 Health Care Facilities Code
Technical Bulletin Last updated 05/07/20191.1 Scope. 1.1.1 The scope of this code is to establish minimum criteria as follows in 1.1.2 through 1.1.13. 1.1.2 Fundamentals. Chapter 4 establishes criteria for levels of health care services or systems based on risk to the patients, staff, or visitors in health care facilities. 1.1.3 Gas and Vacuum Systems. 1.1.3.1 Chapter 5 covers the performance, maintenance, installation, and testing of the following: (1) Nonflammable medical gas systems with operating pressures below a gauge pressure of 2068 kPa (300 psi) (2) Vacuum systems in health care facilities (3) Waste anesthetic gas disposal (WAGD) systems, also referred to as scavenging (4) Manufactured assemblies that are intended for connection to the medical gas, vacuum, or WAGD systems (also referred to as scavenging) 1.1.3.2 Requirements for portable compressed gas systems are covered in Chapter 11. 1.1.4 Electrical Systems. 1.1.4.1 Chapter 6 covers the performance, maintenance, and testing of electrical systems (both normal and essential) in health care facilities. 1.1.4.2 The following areas are not addressed in this code, but are addressed in other NFPA documents: (1) Specific requirements for wiring and installation of equipment are covered in NFPA 70, National Electrical Code. (2) Requirements for illumination and identification of means of egress in health care facilities are covered in NFPA 101, Life Safety Code. (3) Requirements for installation, testing, and maintenance of fire protection signaling systems are covered in NFPA 72, National Fire Alarm and Signaling Code. (4) Requirements for installation of fire pumps are covered in NFPA 20, Standard for the Installation of Stationary Pumps for Fire Protection, except that the alternate source of power are permitted to be the essential electrical system. (5) Requirements for installation of stationary engines and gas turbines are covered in NFPA 37, Standard for the Installation and Use of Stationary Combustion Engines and Gas Turbines. 1.1.5 Information Technology and Communications Systems. Chapter 7 covers the performance, maintenance, and testing of information technology and communications systems in health care facilities. 1.1.6 Plumbing. Chapter 8 covers the performance, maintenance, and testing of plumbing systems in health care facilities. 1.1.7 HVAC Systems. Chapter 9 covers the performance, maintenance, and testing of heating, cooling, and ventilating in health care facilities. 1.1.8 Electrical Equipment. Chapter 10 covers the performance, maintenance, and testing of electrical equipment in health care facilities. 1.1.9 Gas Equipment. Chapter 11 covers the performance, maintenance, and testing of gas equipment in health care facilities. 1.1.10* Emergency Management. Chapter 12 establishes criteria for emergency management in the development of a program for effective disaster preparedness, response, mitigation, and recovery in health care facilities. A.1.1.10 Because no single model of an emergency management plan is feasible for every health care facility, this chapter is intended to provide criteria for the preparation and implementation of an individual plan. The principles involved are universally applicable; the implementation needs to be tailored to the specific facility. 1.1.11 Security Management. Chapter 13 covers the performance, maintenance, and testing of security equipment and systems in health care facilities. 1.1.12* Hyperbaric Facilities. Chapter 14 covers the recognition of, and protection against, hazards of an electrical, explosive, or implosive nature, as well as fire hazards associated with hyperbaric chambers and associated facilities that are used, or intended to be used, for medical applications and experimental procedures at gauge pressures from 0 kPa to 690 kPa (0 psi to 100 psi). A.1.1.12 During the past 20 years, there has been a widespread interest in the use of oxygen at elevated environmental pressure to increase the partial pressure of oxygen in a patient’s tissues in order to treat certain medical conditions or to prepare a patient for surgery. These techniques are also employed widely for the treatment of decompression sickness (e.g., bends, caisson worker’s disease) and carbon monoxide poisoning. Recently, however, the level of knowledge and expertise has increased so dramatically that the codes are in need of updating. By the end of 1988, there were 218 hyperbaric facilities in operation in the United States and Canada. These facilities supported hyperbaric medical treatments for 62,548 patients between 1971 and 1987. As these facilities provide therapy for disorders indicated for treatment, these numbers will continue to increase. As the number of facilities increases, the number of patients treated will also increase. Such treatment involves placement of the patient, with or without attendants, in a hyperbaric chamber or pressure vessel, the pressure of which is raised above ambient pressure. In the course of the treatment, the patient breathes up to 100 percent oxygen. In addition to being used for patient care, these chambers also are being employed for research purposes using experimental animals and, in some instances, humans. The partial pressure of oxygen present in a gaseous mixture is the determinate factor in the amount of available oxygen. This pressure will rise if the volume percentage of oxygen present increases, if the total pressure of a given gas mixture containing oxygen increases, or if both these factors increase. Because the sole purpose of the hyperbaric technique of treatment is to raise the total pressure within the treatment chamber, an increased partial pressure of oxygen always is available during treatment, unless positive means are taken to limit the oxygen content. In addition, the patient is often given an oxygen-enriched atmosphere to breathe. The need for human diligence in the establishment, operation, and maintenance of hyperbaric facilities is continual. The chief administrator of the facility possessing the hyperbaric chamber is responsible to adopt and enforce appropriate regulations for hyperbaric facilities. In formulating and administering the program, full use should be made of technical personnel highly qualified in hyperbaric chamber operations and safety. It is essential that personnel having responsibility for the hyperbaric facility establish and enforce appropriate programs to fulfill the provisions of Chapter 14. Potential hazards can be controlled only when continually recognized and understood by all pertinent personnel. The purpose of Chapter 14 is to set forth minimum safeguards for the protection of patients or others subject to, and personnel who administer, hyperbaric therapy and experimental procedures. Its purpose is also to offer some guidance for rescue personnel who are not ordinarily involved in hyperbaric chamber operation, but who could become so involved in an emergency. Requirements cited in 1.1.12 are minimum requirements. Discretion on the part of chamber operators and others might dictate the establishment of more stringent regulations. 1.1.13 Features of Fire Protection. Chapter 15 covers the performance, maintenance, and testing of fire protection equipment in health care facilities. Fee required
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