Oct 05 2017

Mobile OR Trailer

Category: Operating Room,Questions and Answers,TrailerBKeyes @ 12:00 am
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Q: A hospital is building a small addition that will serve as a corridor to a mobile OR unit. ICC construction type of addition is I-B. The mobile OR will be attached to this corridor with a water tight seal. I am researching this issue based on the IBC and IFC, but was hopeful you could help me with the Life Safety Code and best practices when it comes to issues such as connection of fire alarm system and rating of doors between the mobile OR and the new corridor and/or the main hospital.

A: What I can tell you would likely be the same thing that your design professional is telling you. Let’s examine three distinct issues concerning hospitals, additions and trailers:

Occupancy Classification

What occupancy classification have you designated the OR trailer? Healthcare occupancy? Ambulatory healthcare occupancy? That would drive the classification of the addition to connect the hospital to the trailer. If the OR trailer occupancy classification is the same as the addition and the area of the hospital here it connects to, then there would not be a requirement for a 2-hour fire rated barrier separating occupancies. However, if the occupancy classification is different between the hospital and the addition, or if the occupancy classification is different between the addition and the OR trailer, then a 2-hour fire rated barrier is required.

Building Construction Type

You say the addition is ICC Type I-B which is comparable to NFPA 220 Type II (222) construction type. When a healthcare occupancy building connects to another building with a construction type that is less that what the first building’s construction type is, it must have a 2-hour fire rated vertical barrier separating the different construction types. Trailers are typically not constructed to meet the Type II (222) construction type of hospitals. Otherwise, they would likely be too heavy to transport on wheels. That means the construction type of the trailer is likely going to be less than the Type II (222) of the addition, and a 2-hour fire rated barrier is required to separate the addition from the trailer. This can be done at the end where the addition connects to the trailer. What about the construction type for the trailer? Since it houses patients, it has to comply with the construction type requirements found in chapter 18 for healthcare occupancy and/or chapter 20 for ambulatory healthcare occupancy. This means the trailer may have to be protected with sprinklers. How are you going to connect fire protection water to a portable trailer? You may be able to utilize a clean agent fire suppression system in lieu of water-based sprinklers, but which clean agent is suitable in a  location where a patient is incapable of self-preservation?  I’m no expert on fire suppression systems, but I suspect FM-200 and other clean agent  suppression systems are not suitable for this application. What does your state agency in charge of hospital construction say about this?

Means of Egress

You say the addition is going to serve as a corridor between the hospital and the OR trailer. Is it designated a corridor? If so, then the OR trailer must be separated from the addition because patient treatment activities are not permitted to be open to the corridor. What about exiting? If the addition is a corridor, there must be an exit near the end of the corridor where the OR trailer connects to the addition. Otherwise, you would have a long dead-end corridor, and chapter 18 of the LSC does not allow a dead-end corridor greater than 30 feet. Is it possible to designate the addition and the OR trailer as a suite of rooms? That would help with corridor clutter, as if the addition is a corridor (and not a suite) then you must maintain 8 feet clearance if the addition is a healthcare occupancy. A suite designation may not be possible depending on the travel distance from the furthest point in the OR trailer to a door in the hospital to an exit access corridor, as that is limited to 100 feet.

But what about exiting from the OR trailer? You will need stairs with handrails on both sides of the stairs even if you are using a lift system to raise the patient into the trailer. As far as connections for fire alarm system, I would be surprised if the manufacturer of the OR trailer does not have a recommendation. You would need to have all of the required fire alarm occupant notification devices as well as the initiation devices connected to the main hospital fire alarm system. I have dealt with issues involving healthcare trailers before (although this is the first time I’ve heard of a portable OR) and they are a challenge. Be aware that if you only get your state and/or local AHJ to approve the installation, you may still have a problem with your accreditor and/or your state CMS agency. It would be best to discuss this project with every AHJ you have to determine what they are going to require that you must install.