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With the proliferation of electrical and electronic medical equipment in general care or critical care patient bed locations of a hospital, the number of branch circuits necessary to supply the equipment and the number of receptacles on these branch circuits becomes a real dilemma. However, it is important to note that the National Electrical Code (NEC) is not the document responsible for making these determinations.
The responsibility for performance requirements, and the requirements for the minimum number of branch circuits and receptacles, lies with NFPA 99, the Standard for Health Care Facilities. The NEC is responsible for the a hospital’s electrical installation requirements for a hospital’s general care and critical patient bed locations or areas after NFPA 99 has determined the performance requirements.
The 2012 edition of NFPA 99, which was adopted at the June 2011 NFPA annual meeting, undertook a major modification where the former occupancy-based document was changed to a risk-based document. For example, the risk to a patient does not change for a given procedure. If the procedure is performed in a doctor’s office versus a hospital, the risk to the patient remains the same. This new NFPA 99 eliminated all occupancy chapters within the document and has adopted a risk-based approach as far as the patient is concerned.
A new Fundamentals Chapter 4 of NFPA 99 outlines the parameters for this risk-based approach. Ultimately, the NEC will reflect these changes. For example, a new process detailing building systems categories in healthcare facilities has been introduced. Category 1 covers facility systems in which failure of such equipment or system is likely to cause major injury or death of patients or caregivers. Category 2 is facility systems in which failure of such equipment is likely to cause minor injury to patients or caregivers. Category 3 is facility systems in which failure of such equipment is not likely to cause injury to patients or caregivers but can cause patient discomfort. Finally, Category 4 is facility systems in which failure of such equipment would have no impact on patient care. These categories are determined by documenting a defined risk-assessment procedure found in NFPA 99.
Chapter 6 in NFPA 99 covers electrical applications for all patient care rooms and requires a patient bed location to be served by not more than one normal branch-circuit distribution panelboard. When required, branch circuits serving a patient care bed location are permitted to be supplied from more than one critical branch-circuit panelboard. These two installation requirements are consistent with the current requirements in the 2011 NEC in 517.18(A) for general care bed locations and 517.19(A) for critical care bed locations. Based on the performance requirements in NFPA 99 and NEC 517.19(A), Exception No. 2 states critical care areas shall be served by circuits from a critical branch panel(s) served from a single automatic transfer switch and a minimum of one circuit served by the normal power distribution system or by a system originating from a second critical branch automatic transfer switch. Again, this requirement has not changed in either document.
The minimum number of receptacles is determined by the intended use of the patient care rooms in accordance with 220.127.116.11.6.2 in the new NFPA 99. Each patient bed location in general care areas, where considered a Category 2 application, shall be provided with a minimum of eight receptacles; 517.18(B) in the 2011 NEC requires only four receptacles.
Each patient bed location in a Category 1 critical care area shall be provided with a minimum of 14 receptacles; 517.19(B) in the 2011 NEC requires only six receptacles. Category 1 operating rooms shall be provided with a minimum of 36 receptacles; 517.19(B) in the 2011 NEC requires only six receptacles. These receptacles can be installed as wall receptacles; can be part of a listed headboard assembly based on UL Subject 2440, the Outline of Investigation for Prefabricated Medical Headwalls; or can be part of a power boom installed in an operating room.
Receptacles installed as part of a listed headwall for a patient sleeping bed or in power boom in an operating room are not counted differently than other receptacles installed in a regular mounting in a box in the wall of the room. Where they are installed within the patient care bed location and are intended for connection of electrical equipment in a general care or critical care patient location, these receptacles must be counted as the required receptacles. As can be seen by the new requirements for more receptacles in the 2012 edition of NFPA 99, the counting of these receptacles will be extremely important as the NEC is modified for 2014.
ODE is a staff engineering associate at Underwriters Laboratories Inc., based in Peoria, Ariz. He can be reached at 919.949.2576 and [email protected].