Most hospitals ignore safety filters for ICU

KOLKATA: Many patients trapped in the noxious fumes in the intensive care and high-dependency units of AMRI Hospital at Dhakuria could have been saved if it had a separate air handling unit - a standard procedure in super speciality hospitals. The stand-alone system could have easily staved off the killer carbon monoxide fumes that suffocated these patients on life support by entering critical care units and operation theatres via the common air ducts.
"Critical care units and operation theatres are prescribed to have separate air handling units fitted with air dampers that ensure the flow of 100% fresh air. The purpose is to monitor the air flow and ensure that infections don't come from outside, leave aside fumes. Most city hospitals do not have this system in place," said Ranajit Dasgupta of the mechanical department, Jadavpur University. An associate professor with specialisation in air-conditioning systems, he has visited many super-speciality hospitals in Kolkata.
Hospitals often put off the 'High Efficiency Particulate Air' (HEPA) filters "out of ignorance" or lack of expertise, Dasgupta said. "These are a must in high-capacity hospitals. I had been to the intensive care unit of AMRI Hospital Dhakuria to see one of my relatives a month ago. It has only one exit used by visitors. There is always a risk of contamination," the JU teacher said. "The air handling unit needs to be placed in an isolated zone with free passage to avoid dirt and filth. But in most cases these passages are used as mini stores that can affect the unit."
Even without HEPA filters, there are other auto-mechanisms to snap the air flow. "I wonder how these fumes could enter the air ducts and spread all over the hospital. Under standard procedure there is a control panel that cuts off the compressor in the event of an abnormal rise in temperature," Dasgupta said.
City architects also insist on a specially constructed "fire lift" to evacuate people on life support. "I do not know if AMRI has any such lift, but it is normal practice to have one because of the potential dangers of smoke ingress into the lift. This is a must for patient evacuation. The lift has to run on a stand-alone basis with power connection from a generator so that a glitch in the usual power supply does not affect the functioning of the lift in any case," a city architect engaged in hospital architecture said.
The worst part is that the hospital management did not have an equipped disaster management team on duty in the dead of the night with the minimum technical knowledge to handle the situation. "First of all there is an intelligent building management system in many hospitals that start working automatically. Even if the hospital banked on the archaic fire control panels, the men on duty were incapable of handling the situation without access to the mother drawing of the electrical gadgets. More important they were at a loss to tackle the air handling units that have built in shafts to restrict fumes," the city architect said.