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Old 05-21-2011, 10:01 AM   #1
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Default Emergency Receptacles in a Hospital

A hospital is remodeling their emergency department and setting up a temporary emergency location while work in progress.

They're going to use six small exam rooms and they're cutting down on addmittance ( no ambulances - just a very basic emergency for walk in's etc while work in progress )

They are requesting one emergency receptacle per exam room ( just want us to replace a normal receptacle with an emergency receptacle on any of the four walls )

These Emerg receptacle will remain there permanently after they move back to their new location.

What would this area be classed as? ( general care - critical etc )
Can the emerg receptacle be anywhere or do they have be at head of bed? ( what if bed moves )
We only have three spare circuits left in critical panel. Is it in writing anywhere that specifies what these rooms will require circuit wise? ( no big loads to plug in ) ( can't add another panel as 60amp feeding current 100amp panel and wire #6 )



Thanks folks!

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Old 05-21-2011, 12:01 PM   #2
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In my opinion, the hospital should tell you exactly what they want and what panels they want it out of. It has always been that way when I've worked in hospitals. They always need everything EXACTLY like they need it and never leave it up to out interpretation.

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Old 05-21-2011, 02:50 PM   #3
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The answer to your question isn't available. It will be governed by minimally 6 different government agencies that have never agreed on what day of week it is.

The only solution here is to let the hospital spec exactly what they want where and buiild it. You have no idea what equipment uses how much power. Every damn thing in a hospital is on wheels and believe me when I tell you even though a nurse can disassemble the engine of a D-8 CAT with bandage scissors nurses have no concept of load calculations.

The hospital has a construction coordinator on the job, find him or her and let them make the decision. Be aware that coordinator cannot and will not hear a damn thing you say. Give them what they ask for. DOCUMENT the order and prepare to smile a lot.
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Old 05-21-2011, 10:26 PM   #4
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Thanks guys,

However if I could offer my suggestion from an electrical code point of view and an electrical recommendation instead of a "I'm only paid from the neck down kind of answer " I'd feel a little more professional and also gain a little knowledge while doing so....

Anybody with a good understanding of hospitals and their demands???

Cheers guys!!
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Old 05-22-2011, 12:24 AM   #5
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Unfortunately, I am well acquainted with hospital electrical use, and even better acquainted with hospital plant engineers. In this learning process I have also devoted hours to becoming better acquainted with multiple nurses, several techs and a delicious female doctor.

Let me make it real simple, Hospital engineers are LOOSER JERK OFFS who managed to BS their way into a job they can barely spell. Unfortunately Hospital Administrators and Boards of Directors all buy into the information supplied by the Engineer with Dunning Krueger disease. My personal favorite remains the Ghynogeneer who spent 2 years arguing there was no need to determine if the louvers making up 1 wall of the generator room operated from PoCo power or Emergency power. Making the determination wouldn't have cost $100-.

When the PoCo crapped out the CAT genset came to life and took load within design parameters. Since the Hospital believes in it's automation, NOBODY bothered to go check on the CAT. 22 minutes later the Genset shut down when the over temp safety kicked. DARK HOSPITAL RUNNING ON BATTERIES.

FIRE DEPARTMENT arrived and did their thing. 2 3" hoses spraying water onto the CAT and its cooling system. A couple firemen figured out the machine went over temp because the louvers didn't open, so they opened them. The County showed up with a couple 250k military surplus machines to help out. NO CONNECTION POINT OR EQUIPMENT AVAILABLE = No Help.

The Hospital Engineer did a forced restart on the CAT & it stayed on line, damn good thing because those batterys were running low.

Total Damage to CAT + louvers $37,000 labor + parts.

The Hospital engineer presented her report to the Board of Dolts a month later. The generator functioned exactly as it was designed to. It over heated and shut down. Firemen arrived to assist and using a "special tool" they carry on the big red truck they managed to open the louvers that failed to perform to design. They also assisted by cooling the CAT so it could be restarted.

The Board of Dolts thought she was brilliant. Six months later Hospital Administrators got a report from CAT pointing out how many times the Ghynogeneer had refused to conduct a test that would have prevented the problem.

She was replaced, and yes they did manage to find a dumber one who formerly worked for the County.

Hospitals NEVER furnish reliable information. They can't because nobody working for the hospital has any.
They will tell you the temporary situation will have low current draw, in their mind it will. The people telling you have no damn idea what a 100# Nurse can and will shove into that room when she thinks she needs it. Nurses run hospitals, not engineers and not administrators.

If you have time to spend, walk into the current ED situation and read nameplates for current consumption. Pay particular attention to things like Vents and portable HEPA units as well as lights. Ask if they have a Bear Hugger, that baby can consume watts. Ask how many of each machine they have, believe me, they have cube taps stashed like you won't believe.

Unless you're fully prepared to do a complete study yourself, follow the damn print and forget looking smart. Don't forget the microwave, pizza warmer, toaster oven and coffee equipment. Don't ask the Department head, come in on the night shift and talk to the night supervisor. Bring pizza and she will help you out.
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Old 05-22-2011, 06:13 AM   #6
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You don't require a load test on genny?
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Old 05-22-2011, 08:14 AM   #7
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Originally Posted by oldschoolvdub View Post
In my opinion, the hospital should tell you exactly what they want and what panels they want it out of. It has always been that way when I've worked in hospitals. They always need everything EXACTLY like they need it and never leave it up to out interpretation.
Why limit your knowledge to what someone else can offer. If I operated like that 1/2 my work would be completed by others. Lead be being the best not by following what someone else wants you to do.
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Old 05-22-2011, 08:20 AM   #8
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Originally Posted by Phil DeBlanc View Post
Unfortunately, I am well acquainted with hospital electrical use, and even better acquainted with hospital plant engineers. In this learning process I have also devoted hours to becoming better acquainted with multiple nurses, several techs and a delicious female doctor.
Unfortunately, why? you dislike work?

Quote:
Let me make it real simple, Hospital engineers are LOOSER JERK OFFS who managed to BS their way into a job they can barely spell. Unfortunately Hospital Administrators and Boards of Directors all buy into the information supplied by the Engineer with Dunning Krueger disease. My personal favorite remains the Ghynogeneer who spent 2 years arguing there was no need to determine if the louvers making up 1 wall of the generator room operated from PoCo power or Emergency power. Making the determination wouldn't have cost $100-.
I do work in many hospitals and seldom to never have problems, the engineers are typically limited in knowledge BUT if they were smart they would not need us. I make it a habit to make money off their limited knowledge.

Quote:
When the PoCo crapped out the CAT genset came to life and took load within design parameters. Since the Hospital believes in it's automation, NOBODY bothered to go check on the CAT. 22 minutes later the Genset shut down when the over temp safety kicked. DARK HOSPITAL RUNNING ON BATTERIES.
The hospitals we work at and service their engines are loaded tested regularly, service regularly and batteries replaced every 18-24 months. If this is your company you are missing a chance to make money.
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Old 05-22-2011, 03:18 PM   #9
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So you would let an ego Pi$$ contest get in the way of a Life Safety Issue? (to Fill)

Last edited by bobelectric; 05-22-2011 at 03:21 PM.
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Old 05-22-2011, 09:09 PM   #10
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Quote:
Originally Posted by blinkers
A hospital is remodeling their emergency department and setting up a temporary emergency location while work in progress.

They're going to use six small exam rooms and they're cutting down on addmittance ( no ambulances - just a very basic emergency for walk in's etc while work in progress )

They are requesting one emergency receptacle per exam room ( just want us to replace a normal receptacle with an emergency receptacle on any of the four walls )

These Emerg receptacle will remain there permanently after they move back to their new location.

What would this area be classed as? ( general care - critical etc )
Can the emerg receptacle be anywhere or do they have be at head of bed? ( what if bed moves )
We only have three spare circuits left in critical panel. Is it in writing anywhere that specifies what these rooms will require circuit wise? ( no big loads to plug in ) ( can't add another panel as 60amp feeding current 100amp panel and wire #6 )

Thanks folks!
Your new to this position, based on your last posting. It seems that they are leaning to you for the answers. Keep in mind a hospital is a liability lawsuit in the closet waiting.
A facility can do almost anything they need to with the approval of your AHJ.
If your facility is ramping down services for remodeling then the AHU can designate those rooms as exam rooms and not treatment rooms or ER rooms. The rules are different for each.
When we remodeled and went into Bypass for several months, we had to keep two rooms ER treatment ready. We just placed all their circuits on pri-1 riser.
We had three priority risers and could shift automatically or manually as needed.
That was a big plus for weekly gen set loading.
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Old 05-22-2011, 10:35 PM   #11
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Unfortunately, why? you dislike work?



I do work in many hospitals and seldom to never have problems, the engineers are typically limited in knowledge BUT if they were smart they would not need us. I make it a habit to make money off their limited knowledge.
I love work and I love money, so I'll be damned if I attend endless meetings where the same crap is repeated over and over by a mindless twitt pretending she's an engineer. I barely tolerate "engineers" who are so compartmentalized they only deal with a single component of a system. We're rapidly approaching the time it will take 6 engineers to drive a single car.

I learned 30 years ago my advice only has weight when i'm being paid to give it. Free advice is discarded because it can't be right if it didn't cost.

I also don't have much tolerance for a clown pretending he's a qualified power plant engineer because he holds a steam plant engineers license issued by the City with a refrigeration endorsement. Hospital Administrators may love him because he sits in 10 meetings a week, but the man can't cut it when the automatics crap the bed. The only thng he's good at is screaming into the phone.

Rule #1 in my book is Define the job, in writing, then get out of my way. Discussion of what needs to be accomplished should either be complete when I arrive, or somebody is going to pay me to listen.




The hospitals we work at and service their engines are loaded tested regularly, service regularly and batteries replaced every 18-24 months. If this is your company you are missing a chance to make money.
You're working in a very nice place. My experience with hospitals and gensets is very different. Most believe if the set fired up on the programmed run it met all testing requirements. My bud who works for CAT tells me more than half of the sets he runs tests on won't function long when they are needed because the install was screwed up. In most cases the screwup was connecting the louvers to PoCo power at install. That screwup is also rarely detected in test and loadbanking because the louvers operate.


Bobelectric, DAMN Right! My ego is a product of a life of experience, mine. If you aren't willing to pay for the answer from me get it from somebody else. Sooner or later you'll pay. Life safety, I care about mine. I care as much about anybody else's as my insurance carrier cares about mine. I stop paying premiums they stop paying claims, and they don't care.
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Old 05-23-2011, 07:02 AM   #12
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Quote:
Originally Posted by Phil DeBlanc

You're working in a very nice place. My experience with hospitals and gensets is very different. Most believe if the set fired up on the programmed run it met all testing requirements. My bud who works for CAT tells me more than half of the sets he runs tests on won't function long when they are needed because the install was screwed up. In most cases the screwup was connecting the louvers to PoCo power at install. That screwup is also rarely detected in test and loadbanking because the louvers operate.


Bobelectric, DAMN Right! My ego is a product of a life of experience, mine. If you aren't willing to pay for the answer from me get it from somebody else. Sooner or later you'll pay. Life safety, I care about mine. I care as much about anybody's else's as my insurance carrier cares about mine. I stop paying premiums they stop paying claims, and they don't care.
Hospitals can be a great place to work. I spent over 8 years as head electrician in one. It can be a high stress job when there is little support from above.
We had three priority risers off the gen sets. First one up to speed carried life support. I treated the emergency circuits as if my grandkids life depended on it.
My pri-3 riser was mostly machinery and carried an 80% generator load. This allowed me to select which generator was loaded each week for a four hour run.
After many years I was able to talk the facilities management dept into allowing the local Cat shop to come out and load bank us. It brought out some of the hidden generator weaknesses. I also has Asco come out yearly to test & service our transfer switches. We had always done it ourselfs but they were used to verify our findings and allow us to schedule a return trip for repairs.
I always planned for the worst and practiced damage control before anything happened.
Lightly loading a generator for a monthly test is worse then no run at all.
Also check your fuel, bunker diesel is better as it has anti-bacterial additives.
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Old 05-23-2011, 03:51 PM   #13
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Hospitals can be a great place to work. I spent over 8 years as head electrician in one. It can be a high stress job when there is little support from above.
We had three priority risers off the gen sets. First one up to speed carried life support. I treated the emergency circuits as if my grandkids life depended on it.
My pri-3 riser was mostly machinery and carried an 80% generator load. This allowed me to select which generator was loaded each week for a four hour run.
After many years I was able to talk the facilities management dept into allowing the local Cat shop to come out and load bank us. It brought out some of the hidden generator weaknesses. I also has Asco come out yearly to test & service our transfer switches. We had always done it ourselfs but they were used to verify our findings and allow us to schedule a return trip for repairs.
I always planned for the worst and practiced damage control before anything happened.
Lightly loading a generator for a monthly test is worse then no run at all.
Also check your fuel, bunker diesel is better as it has anti-bacterial additives.
You're in an entirely different situation than is found in this part of the country.

Here the norm is to install automated systems and walk away from them based upon reliance on the expert salesman. The secondary reliance is on the Fire Department to ride in on a white horse and make up for the shortcomings in your system. 90% of the gensets here also rely on natural gas for fuel. Oddly NOBODY believes the NG will stop arriving after a few hours of a power outage, because it hasn't happened yet. It'll never happen, and if it does somebody will have an untested halfassed plan, and they'll ride to the rescue. Besides, we spent a lot of Homeland Security money on those lovely red hand lanterns hanging on the walls all over the hospital. Don't dare ask when they were last tested, the Hospital has enough expense replacing batteries in IV pumps. Since nobody from Joint Commission will check any of that on the next certification it doesn't matter anyhow!

When the generator does come into service for a power outage sending an employee to babysit the machine is considered a waste of manpower. When I made that suggestion in the previously mentioned example I was informed by a hospital administrator the machine operated to design, and a babysitter wouldn't have been of any help. My suggestion that a babysitter with a crescent wrench could have kept the machine on line and avoided the destruction of louvers by simply loosening a setscrew and manually opening the louvers I was called a troublemaker. It's the mindset here that some things are just inevitable and pre planning for such events might open someone to litigation in the future.

Load testing is only done when mandated by an Insurance Carrier in order to get or maintain a policy. 15 minutes is considered a sufficient test, after all there is no reason to burn fuel without getting something from it. We'll never really need the generator, and if we do it will probably work.

Bunker fuel is also a virtual unknown here any more, I'd need to make a couple calls to find out if anyone is still burning anything heavier than #2. A knowledge of Bunker oil and steam atomization will result in being told to shut up and being issued a TROUBLEMAKER badge around here. The EXPERTS we rely on don't know what Bunker is and if it's old it is BAD.

Hell, the PSC in NY allowed the local PoCo to demolish the only Generating Station in this part of the State with a house generator 2 years ago, it was obsolete technology, and it didn't fit the Montana Power Model any more. That insured the next restart from a blackout will take days rather than hours even if machines don't overspeed and destruct.

Planning for backup power here is left to Architects with the understanding minimizing the cost of backup power is the primary concern. Do the least possible allowable by law because we'll never really use it is the standard.

Nearly all of our our plants including the steam side are NG fired. Where dual fuel boilers exist the oil tanks were removed to take advantage of grant money in the 90s, and not replaced.

We've made tremendous progress since the 80s when CoGen and Peak Shedding machines were in vogue. We're currently bleeding from the ears financially for that progress.
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Old 05-23-2011, 08:32 PM   #14
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Quote:
Originally Posted by Phil DeBlanc

You're in an entirely different situation than is found in this part of the country.

Here the norm is to install automated systems and walk away from them based upon reliance on the expert salesman. The secondary reliance is on the Fire Department to ride in on a white horse and make up for the shortcomings in your system. 90% of the gensets here also rely on natural gas for fuel. Oddly NOBODY believes the NG will stop arriving after a few hours of a power outage, because it hasn't happened yet. It'll never happen, and if it does somebody will have an untested halfassed plan, and they'll ride to the rescue. Besides, we spent a lot of Homeland Security money on those lovely red hand lanterns hanging on the walls all over the hospital. Don't dare ask when they were last tested, the Hospital has enough expense replacing batteries in IV pumps. Since nobody from Joint Commission will check any of that on the next certification it doesn't matter anyhow!

When the generator does come into service for a power outage sending an employee to babysit the machine is considered a waste of manpower. When I made that suggestion in the previously mentioned example I was informed by a hospital administrator the machine operated to design, and a babysitter wouldn't have been of any help. My suggestion that a babysitter with a crescent wrench could have kept the machine on line and avoided the destruction of louvers by simply loosening a setscrew and manually opening the louvers I was called a troublemaker. It's the mindset here that some things are just inevitable and pre planning for such events might open someone to litigation in the future.

Load testing is only done when mandated by an Insurance Carrier in order to get or maintain a policy. 15 minutes is considered a sufficient test, after all there is no reason to burn fuel without getting something from it. We'll never really need the generator, and if we do it will probably work.

Bunker fuel is also a virtual unknown here any more, I'd need to make a couple calls to find out if anyone is still burning anything heavier than #2. A knowledge of Bunker oil and steam atomization will result in being told to shut up and being issued a TROUBLEMAKER badge around here. The EXPERTS we rely on don't know what Bunker is and if it's old it is BAD.

Hell, the PSC in NY allowed the local PoCo to demolish the only Generating Station in this part of the State with a house generator 2 years ago, it was obsolete technology, and it didn't fit the Montana Power Model any more. That insured the next restart from a blackout will take days rather than hours even if machines don't overspeed and destruct.

Planning for backup power here is left to Architects with the understanding minimizing the cost of backup power is the primary concern. Do the least possible allowable by law because we'll never really use it is the standard.

Nearly all of our our plants including the steam side are NG fired. Where dual fuel boilers exist the oil tanks were removed to take advantage of grant money in the 90s, and not replaced.

We've made tremendous progress since the 80s when CoGen and Peak Shedding machines were in vogue. We're currently bleeding from the ears financially for that progress.
I keep failure in mind when I build or design something when a life may be on the line. But sometimes it's the cheap things that management refuse to look at that causes the worst failures.
Boss can we buy a dip stick for the outside tank? I asked many times an the answer was the same. No need, to expensive, not required, ect......
So one day I start the gen test and watch as a water slug passes the fuel sight glass.
I hit the e-stop and go tell the boss.
Hey boss, I know how far off the bottom of the tank the fuel pick up line is for the day tank. It's right at the same level as the water. Can I have a dip stick now?

Like I always say, I'll tell you 3 times your barn is on fire,,,, then I just bring a chair and a bag of marshmallows.
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Old 05-23-2011, 11:20 PM   #15
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The hospital emergency generating systems around here are a joke.

One hospital has 3 350KVA Cummins units for life-safety, and 4 1000KVA Cummins units that'll supposedly power the entire facility. During an actual outage, all 7 gens will start. The smaller units are downstream of the larger ones, so they'll shut down after a while.

There are 3 chillers, 2 of them are 700HP and start with reactors, the 3rd one is 450HP and has an electronic soft-start. The 4 larger gens have load management, and will shut one or more of them down if the load is small. One day when I was working around the gen room, the chief engineer (typical run of the mill idiot) was bragging about how the system worked, and I asked him if this fancy system had enough brains to ensure that enough gens were running to start one of the chillers. It got real quiet for a sec.....

The next day I saw a sign posted 'All Load Management Is Suspended Until Further Notice'. Seriously, if some dumb electrician can come up with that kind of a chink in the armor, how much more is there?

One day I was walking past the smaller gen room, and the Cummins guy was replacing the Woodward governor on one of the units. I talked with him a bit, and he pointed to the starting batteries of one of the other two units. They were about 1/4 full. We both laughed. It very likely would not start.

And this is a life-safety generator at a hospital!!

Another hospital had an actual outage. Both gens started as planned. They ran for about 10 minutes, then shut themselves down. There was coolant all over the floor........

The entire hospital was completely dark. They were moving patients to the other hospitals as quickly as possible.

And these incidents are the few that I know about. How many more are there that I haven't heard about!!

Makes ya wonder......

Rob
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Old 05-23-2011, 11:32 PM   #16
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You're far more generous than I with the Suit Set. My RULE is I say something 1 time. If you have a Certificate of Hearing Imparement on file I will repeat myself, maybe, when I'm damn good and ready.

On the tank rod, best rod is a set of the screw together fiberglass chimney cleaning rods. They're 3 feet long, and you can stuff 50 feet of them in a piece of 3" PVC with a cap on each end. You even get to use the PVC container with dishwashing soap to soak the rods clean when necessary. Works well when you work from a truck. You can also use them for pushrods when shoving wire above a suspended ceiling.

I have an antique tank thief with a 20 foot chain that was invented around 1900. I have many times hauled it along to explain how even in ancient times people knew water accumulates in underground tanks, and they also knew the benefit of sampling for water. Usually about that point I strongly advise I will shoot any SOB who touches it, and boil in oil anybody dipping it into a tank.

We've made some good money from Permangenate paste and knowing how to remove the water without disturbing the oil. Sorry sir, I don't care who you are, only our people are permitted inside of the tent when we're removing water. It's dangerous in there and very noisy.
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Old 05-23-2011, 11:44 PM   #17
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The hospital emergency generating systems around here are a joke....
Been there, seen that.

When I was doing contracting we had an overnight planned outage in a hospital do some work on their gear.

Three standby diesels were supposed to pick up the life-safety.

Time came to fire up the generators and when we got about two hours into the project one died. They did some load-shedding and gave us the okay to continue. Got another hour in and the second one died. We were too far along to go backwards, working like mad men to try and get everything back up and running in case the third one crapped out.

We made it, but it was definitely high pucker. Come to find out their "PM" program consisted of starting each generator once a week and running it unloaded for about ten minutes. Totally different ballpark from when the thing is suddenly carrying 75% load for hours on end.

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Old 05-24-2011, 07:11 AM   #18
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When I was first assigned to a hospital to replace the older man who was going deaf & close to retirement, the boss was a man I work for several years earlier. He had asked for me and you can't refuse.
I sat down with him the first day and asked what hospital regulations and requirements he had for me to follow. He scratched his head and he told he had the NEC.
I knew then I was in deep.
I built a strong maintenance program from scratch after that day.
We had our problems but it worked well and the inspectors were impressed enough to mention me by name after their next visit.
An in house hospital maintenance staff brings alot of experience with them when things go wrong.

The motor generator institute has a great web site. It lists many disasters and how they could be avoided.

An EPSS cert is a must for anyone that works at a hospital.
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Old 05-24-2011, 06:39 PM   #19
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In Canada we need at least 3 documents to determine the receptacle requirments in a hospital and the general electrical requirements.
Building code determines what are the life safety systems and whether the building has special requirments for fire alarm and other emergency systems. Most hospitals are under the building code for high buildings regardless of them being tall. High buildings have the most stringent emergency system requirments such as smoke handling, firefighter controls and phones. elevators, lighting etc.
there is the Canadian Electrical code which addresses how the required systems may need to be wired and there is the Z32 Standard for patient care electrical systems.

A full blown hopital has 3 required electrical systems, Vital, delayed vital, and conditional. Vital loads must be served within 11 seconds of a power failure, so at least 1 generator must be up to speed and connected to load within that time.
Delayed vital has another 20 seconds or so until it must be on line and conditional is optional loads which usually require manual reconnection to the generators especially if they are not large enough to take all the hopital load. Essential building loads are typically connected to the vital supply and each patient care location has presribed the location and number of Vital outlets. Some essential systems can be connected to the delayed vital as most of these systems are required to come on line within the normal time a delayed vital panel must be re-energised.

It is the hospital administrator in cooperation with the design engineer to determine their basic needs and wire to the standard as they have designed.

The big hopital in our jurisdiction just underwent 2 major buildings upgrades and the servicing substation had to be upgraded. The new generators also destroyed a couple of plenums and louvers on first start up from the vacuum they created on start up. The two 12,500 volt, 4 mva generators started and paralleled in 7 to 9 seconds every try with full load to the entire campus within 30 seconds.
Pretty impressive when it works.
So as to the red outlet in the emergency room? at the patient bed location and not anywhere in the room unless it is above the minimum required. Sorry I don't want to look that up right now.

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