Lighting Engineering Journal Design and Application of Hospital Lighting Chen Dahua (Fudan University Institute of Electric Light Sources Shanghai, 200433) A complex of complex institutions such as nursing homes. Therefore, this paper elaborates on the design and correct application of hospital lighting.
1 Introduction With the development of the national economy and the popularization of scientific and technological knowledge, the importance of light source and lighting has been recognized by more and more people, and it has become an indispensable comprehensive subject related to the daily life and work of modern people. Especially in some special applications, it is not simply illuminating to meet the expectations that people expect. For example, hospital lighting must aim at the medical function directly and indirectly in order to fully utilize the functions of the hospital to meet the physiological and psychological requirements of the patient. In general, hospital lighting design should take into account its special features: (1) According to the different functions and uses of the hospital, the corresponding contrast light and dark requirements are absolutely different. For example, in a strictly sterilized clean operating room, a place where a fine surgery is performed requires 100,000 lx of illumination, while in a nighttime patrol or nursing observation area, only 10 lx of low-light illumination is required (2) in the hospital, both considerations are required. The lighting requirements for the work of medical staff must also take into account the lighting desires of many patients for comfort and tranquility in life and leisure. (3) Hospital lighting should also consider the time frame used by its various departments. The ward and emergency department are required for 24 hours. The place where work and life are kept, and most of the clinics and management offices are no longer used after the evening. That is to say, the latter's illumination is mainly daylight, so its illumination only needs to be equipped with the necessary auxiliary illumination under sunlight, while the former is the place where medical and sick people live, and there are many kinds of workers in the same place. For different jobs and life, lighting must meet their special requirements. Based on the above analysis, this paper tries to put forward some rough views from the design and application of hospital lighting for everyone to exchange and reference.
2 Hospital lighting requirements for light and darkness and color rendering According to the recommendations of the International Commission on Illumination CIE recommended hospital lighting standards, Table 1 lists the corresponding data for hospital lighting in the United States, France, Germany, the United Kingdom and Japan. This can be used as a reference for the design of hospital lighting in China.
Country name France Germany United Kingdom United States Japan ward general bedside late night reading 150 surgery general surgery vision special inspection general local 1000 or more intensive care room general local examination and treatment general local corridor (ward) day and night late at night, when the hospital doctor diagnoses the patient, It is necessary to observe and identify the true color of the patient's skin. The same requirements exist in the hospital's examination room and diagnosis. Therefore, the color rendering of the light source used in hospital lighting and the color of the surrounding environment are necessary for hospital lighting to be considered in addition to light and dark. The second major factor. The actual situation is that the light source used in the ward and the examination room prefers to use a lighter specification with a slightly lower light efficiency, and also must ensure a light source with a color rendering of 80 or more. Of course, for almost all departments of the hospital, we must make the hospital atmosphere as soft as possible in the choice of color for lighting design and wall decoration, giving all patients a comfortable impression. From the basic principle of color adjustment, color depends not only on the feeling, but also on the physiological and psychological requirements of human beings. Of course, this is not fixed. Recently, people often use BG instead of GY, and YR replaces the color system. This is because most people's skin tissue or body fluids are closer to the new color system.
3 The public part of the hospital's public parts is the entrance hall, which includes the lighting of the waiting room, the reception room and the pre-examination office. From a medical point of view, it is mainly to relieve the patients who are in a state of anxiety and anxiety. The entrance hall is the center of the hospital, so it is necessary to give full play to its functional role in a comfortable environment. Since most of the use time of this part is during the day, the balance of the illumination of natural light from the gate should be considered for the room on the first floor that is only illuminated by artificial light. The lighting of the entrance hall, in order to make the patient have a stable mood, should be a hotel-like feeling, the hall should not use lighting that is too bright or too gorgeous. Hospital channel lighting should consider the balance of natural irradiance from the entrance gate.
For example, the first floor passage is brighter than the second floor even during the day. The public access areas of hospitals and clinics often pass through labyrinthine corridors and stairs, so the lighting design should first pay attention to the full illumination of the direction indication, followed by general lighting. It is usually better to arrange a series of lamps continuously on one side of the corridor than at the top in the middle of the corridor. Lamps should not be installed laterally in any corridor, as this would cause visual interference when moving under high brightness and low brightness, causing the patient to feel a sense of being carried on the rails. When transporting a patient with a transport bed, the patient should be covered with a cover to avoid glare because the patient faces the ceiling. Emergency lighting is required in all public areas.
The public parts of the hospital also include offices, laundry, kitchens, etc. These visual operations departments are not designed for medical careers. However, hospitals work 24 hours a day, so the lighting of these auxiliary departments may have to be extended, so it is necessary to use efficient lighting and appropriate switching methods, combined with manual or building centralized management mode.
The public part of another hospital includes a treatment room, a pharmacy, and an emergency department. In general, most clinics rely on natural daylighting or consider the combination of lighting and natural light. Especially for applications where the patient is facing up, attention should be paid to the position and brightness of the lighting fixture. Screen spacing is often used in the treatment room, so this should be fully considered in the illumination distribution.
For the auditory room of the ear and nose department, the ballast should be placed outdoors when using fluorescent lighting. The darkroom and X-ray room of the ophthalmology are suitable for not using fluorescent lamps. This is because the residual fluorescence after turning off the light can hinder the work. The dental treatment room lighting should consider the requirements of the operating room lighting regulations. Its ceiling should be white, the reflection ratio is above 70, the wall Chen Dahua: the design and application wall of hospital lighting is light, the gloss is not, the reflection ratio is 60. Above, the reflection ratio of the floor is preferably 20 to 40. Although the color discrimination of the dental room is most suitable for natural light illumination, natural light is not always available. Therefore, the general lighting tone should be noted to effectively determine the color coordination of the filling material and the teeth.
The illumination of the oral cavity is high, but the light cannot be allowed to enter the patient's field of vision. The dental doctor relies on artificial lighting to determine whether the color of the filling material and the teeth are coordinated, observe the anastomosis of the denture, and correctly determine the drilling depth to see if the filling material is strong. In order to have illuminance of 10,000 lx in the lower part of the patient, and no shadow is generated in the oral cavity, the lighting fixture can refer to a shadowless lamp using a similar operating room.
The pharmacy lighting should focus on improving the vertical illumination of the drug rack. Generally, the lighting should be properly selected and arranged. For places where balances are used, local lighting should be provided as needed, but avoiding the use of desk lamps that interfere with the work, it is advisable to use the upper part.
As for emergency room lighting, since most patients are treated without relying on other departments of the hospital, they are directly in the emergency room. Therefore, its lighting should be considered to meet the requirements of simple surgery and even various inspections. In this way, emergency room lighting should be considered in the lighting requirements of the following operating room or examination room.
4 The examination room of the hospital and the operating room are the departments for examining the body and the disease. It is also a physiological examination room for patients. Checking the illumination of the body part can be considered as in a general chemical laboratory. However, when considering the color rendering of the light source, even if the efficiency is lower, the requirements of the light color should be satisfied. For the physiological examination room for patients, it is important to consider how to make the patient feel safe and relaxed due to the oppression of the place.
In terms of specific analysis, the radiation examination room illumination generally does not require too high illumination, but requires a dimming function. The X-ray room requires 200 lx illumination for mechanical maintenance and adjustment. In the perspective stage, 50lx is required to enter and exit the room. The foot switch can be used to adjust the red light from 20lx to zero. Cobalt, electronic induction accelerators and other machines have a feeling of heavy pressure, and at least the lighting should be considered so that the patient does not feel pressure. Flushing equipment should be provided for the scope of radiation pollution, and dimming is sometimes considered.
In the room where radiation and radioactivity are treated, in order to avoid direct radiation, the partition wall is often provided. Therefore, attention should be paid to the arrangement of the lighting fixtures. The position of the lighting fixtures on the ceiling is often restricted by the radiation machinery.
The ophthalmic examination room lighting must have a bright room and a dark room. The illuminance can be changed from 10000lx to 50lx. From the inspection content, it is also possible to eliminate the need for continuous dimming, and some of the lights can be turned off. However, when the illuminance is low, the dimmer should be set. The darkroom can be changed from 50lx to zero, but the dimming of the low illumination of the fluorescent lamp is caused by the flashing, so the sliding resistance regulator is used.
Computer and ECG room lighting design should be considered, although due to the development of electronic machinery, the current ECG and EEG measurement, no special equipment protection room, but the protective room lighting is best to use DC power. If the light source uses alternating current, the lamp can be covered with a phosphor bronze wire mesh with a diameter of 0.8 mm and a mesh of 5 to 10 mm, and the copper mesh is connected to the grounding bus of the equipotential.
The lighting design of the operating room should fully recognize that the operating room often requires the most rigorous visual work. The operating room is often a relatively narrow windowless place, requiring medical staff to continue to work for a long time. Therefore, operating room lighting must consider reducing the fatigue of the personnel involved. In the range from the operating room to the preparation room passage, the general illumination should reach a high level, and the lighting fixtures are required to have good diffusibility, a cover, a firm structure and no dust. General lighting is usually a fully embedded enclosed fluorescent fixture that prevents dust from entering the ceiling cavity, is easy to clean, and uses high color rendering lamps that meet clinical observation requirements. The local illumination on the operating table is provided by a set of specialized luminaires that utilize a multi-lamp and facet combination reflex system that provides shadowless illumination of the operating table. The illumination level of the general illumination of the local operating range is very high, and the horizontal illumination is usually 1000lx. In order to make the brightness distribution good, the vertical illumination should not be lower than the horizontal illumination 50. When the illumination on the operating table can be between 10,000 and 50000lx When selecting and changing between, it is usually necessary to provide a background illumination of 400 to 500 lx. This illuminance standard is suitable for the medical staff to perform auxiliary operations, for example, to operate emergency equipment.
The high color rendering of clinically required illumination is not only required in the operating room, but also in the anesthesia room and rehabilitation room. In the operating room, as in transitional wards and intensive care units, emergency lighting should be equal to or similar to the quality provided by normal lighting.
In addition, an exhaust device of an X-ray device and an aseptic device is provided on the ceiling of the operating room. These devices occupy more than half of the ceiling surface, and the position is on the upper part of the operating table. Therefore, the lighting fixtures of the operating room are generally easy to contradict with the air conditioning equipment, so the lighting design should be considered comprehensively. Operating room lighting in ophthalmology and otolaryngology also requires the ability to install step-by-step dimming devices.
The shadowless lamp used in the operating room should generally meet the following requirements. First, the illumination requirement is 20,000 to 100,000 lx, and in principle, dimming is required. The illumination beam range is controlled at Υ10~ and the beam size can be adjusted within a certain range. There should be no light spots on the light distribution, and the color rendering should be as good as possible to eliminate the heat contained in the illumination light. The wound surface of the surgery is required. The higher the lighting engineering requirements, the lighting equipment should also have The depth of focus of a certain degree of illumination is usually more than 15cm, and the position and direction of illumination should be easily adjusted by medical personnel. As the development trend of modern shadowless lamps, the illumination of the chest surgery table has reached the light source using multi-phantom tungsten halogen lamps. As for the illumination of the aseptic operating room, in order not to disturb the airflow passage of ventilation, some fixed shadowless lamps embedded in the ceiling Or a ceiling-mounted transmission shadowless lamp. Most of the anesthetics used in the operating room are flammable. Recently, due to advances in anesthetics, explosion-proof problems have generally been resolved. However, the issue of explosion-proof lighting should also be considered from the entire operating room.
The intensive care unit (ICU), which is closely related to the operating room and generally managed by an anesthesiologist, is not the surgical department, but the design of the lighting should be considered by the surgical department. In terms of patient life, the intensive care unit can also be said to be a ward. Because this is the room for treating seriously ill patients who need to be supervised, the lighting cannot be treated as a normal ward. In order to carry out complex medical work, a tester and various devices are placed around the hospital bed, and local illumination lamps are required to produce 1000 lx illumination on the bed surface. In nursing care, because most of the large rooms are more than two beds side by side, the ceiling lighting needs to consider the influence of adjacent beds. General illumination can be used with diffused and color-developing hooded fluorescent lamps with an illumination of 300 lx and is expected to be dimmable.
5 Hospital ward lighting In recent years, the hospital ward unit has evolved from a multi-bed ward to a current compact ward with fewer beds, but the lighting of any ward unit must meet the day and night needs of patients and nurses. During the day, the duties of the nurse include observing the condition, measuring blood pressure and body temperature, filling out forms and making records, and dispensing medicines. At night, nurses must maintain care throughout the night.
When there is no daylight in the morning and dusk, both the patient and the nurse need general lighting, and the patient needs a bedside lamp to read. The modern ward, with its beds and windows juxtaposed, provides good daylight illumination. In some cases, it may be necessary to consider additional lighting away from the window. When viewed from the bedside, relying on the balance of brightness and color on the main surface of the room, plus the specific control of the brightness of the luminaire, the glare should be minimized, as shown in Figure 1.
The lighting design of the ward should take into account the needs of doctors' treatment and the feeling of no glare in the field of vision when the patient is in bed, so that the patient can feel the warmth in the home room. In addition, you should consider the lighting required at night. The illumination of general illumination in the ward is 100 ~ 200lx, so be careful not to cause glare to the patient who is lying up or down. For single or double wards, there is little problem because lighting fixtures can be installed on the wall of the bed. However, when the beds are arranged in two rows in a multi-bed ward, the lighting fixtures are generally placed in the center of the room, which necessitates careful consideration of the position of the patient's eyes and the light distribution of the lighting fixtures. General lighting fixtures are expected to have two levels of dimming. Luminaires must also meet high standards of safety and hygiene, especially if the luminaire should have a minimum level of dust that can accumulate dust, as dust particles in the air can spread harmful bacteria. Noise considerations are also important because the hospital's ambient noise level is much lower than in commercial buildings and the bedside lamp can be placed close to the patient.
When selecting the light source for the ward lighting, it must be noted that when the color temperature of the selected light source is high and the illumination is not high, it will make people feel dark and low mood, so it is best to use a three-color fluorescent lamp with color rendering greater than 80 and a color temperature of 4000K and compact. Fluorescent lamp. In addition, when indirect lighting device sterilization lamps are used on the roof of the ward, it should be noted that the ultraviolet light of the lamp is damaged by secondary reflection and damages the patient's eyes. The design of the illuminated bedside lamp in the clinical part of the ward should be considered to facilitate the patient to turn on the light by himself. When the lamp is turned on, the surrounding patients, especially the opposite patient, should not be glared, so that the patient can easily change the way of lighting by himself. The selected lighting device should be resistant to damage and easy to repair.
In practical applications, many devices on the patient's bedside, such as bedside lamps, call buttons, power outlets for medical gases or suction devices, monitor connectors, etc., are often assembled together, and general illumination and partial illumination are placed in one On the switchboard. The shape of the device is neat and tidy, which makes the interior decoration of the ward completely integrated, and the decorative effect is pleasant.
Because bedside lamps are difficult to use for medical treatment, mobile vertical lamps are often used, but sometimes standard lighting fixtures are used above the hospital beds: the design and application of hospital lighting on the ceiling. The ward's duty lighting, some with a wall or ceiling night light is better, but the position of the lamp needs to be fully considered, so that the patient does not feel uncomfortable glare caused by too bright. In addition, the location of the corridor lighting fixtures should avoid the corridor lights from entering the room. The care room associated with the ward, because it is mainly a place for transactional work and simple disposal, its lighting should be able to adapt to the requirements of various operations. Bedding storage rooms, catering rooms, washrooms, etc. are all relatively clean places. Its lighting should be based on the use of practical equipment with moderate efficiency.
Finally, ultraviolet radiation in hospitals is the most effective measure for the sterilization of air. In the design of the sterilization intensity of ultraviolet light source, in addition to the convection circulation of air, the eyes will be injured by strong ultraviolet rays, and attention should be paid during installation. Do not let light shine directly into the patient's field of view.
The number of lamps of the device UV source can be selected according to the formula N= 4P. The air sterilization requirement according to the height can be based on the formula N=, N: number of lamps P: number of people in the room H: distance between the lighting fixture and the ceiling (m) V: room volume (m), F: lamp efficiency as far as infectious diseases The examination room, toilet, etc. can only be directly irradiated by germicidal lamps when no one is present, in order to obtain a good sterilization effect, which can be achieved by designing an automatic timing control circuit.
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