| (ii) In a multiple-bed holding/observation room/area, the clearance between the side of the bed/gurney and a wall/partition shall be a minimum of 3 feet. The clearance between sides of the beds/gurneys shall be a minimum of 6 feet. The minimum distance at the foot of the bed/gurney shall not be less than 7 feet for single load area/room or 10 feet for double load area/room. Four feet of the passage space at the foot of the bed may be shared between 2 beds/gurneys. The multiple-bed holding/observation room/area shall contain cabinets, work counters, and a hand washing fixture with hands-free operable controls. One hand washing fixture shall be provided for every 4 holding/observation beds or fraction thereof. Fixtures shall be uniformly distributed. The fixed and moveable cabinets and shelves shall not encroach upon the bed/gurney clear floor space/area. The requirements of this clause are illustrated in Table 5, Diagram (B) of §131.148(e) of this title. (iii) In a multiple-bed holding/observation room/area, a patient toilet room with a hand washing fixture with hands-free operable controls shall be provided within the room or area. (C) When a multiple-bed gurney holding or observation room is not within or adjacent to the emergency suite, the following additional spaces shall be provided: (i) A stretcher and wheelchair storage alcove/room shall be provided. The alcove/room for stretcher and wheelchair storage shall be located out of the line of traffic. (ii) A clean storage room shall be provided within or adjacent to the holding or observation room. The clean storage room shall be provided for clean supplies and linen as needed. A hand washing fixture shall be provided with hands-free operable controls. (iii) Soiled workroom. A soiled workroom shall be provided within or adjacent to the holding or observation room. The workroom shall contain a work counter, a clinical sink or equivalent flushing type fixture, hand washing fixture with hands-free operable controls, waste receptacles, and soiled linen receptacles. The soiled workroom required in support of a treatment/exam room may be combined with the holding or observation room/area if confidently located between the 2 areas. (6) Medication work room or alcove. A medication work room or alcove shall be provided and located separate from patient and public areas and under the direct supervision of staff. A work counter, refrigerator, medication storage, and locked storage for biologicals and drugs shall be provided. A hand washing fixture with hands-free operable controls shall be located in the medication work room or alcove. Water spouts used at lavatories and sinks shall have clearances adequate to avoid contaminating utensils and the contents of carafes, etc. (A) Functional space shall be provided and areas required for records, reports, and accounting activities. (B) Space for the poison control center shall be provided with storage facilities for reaction data and drug information centers. (7) Diagnostic radiographic (X-ray). A diagnostic radiographic (X-ray) room shall be provided and be readily available to the emergency suite. The diagnostic radiographic (X-ray) room size shall be in compliance with the manufacturer's recommendations. Clearance and unobstructed space shall not be less than three feet around the diagnostic equipment. Dressing room(s) shall be provided and located near the X-ray room. (8) Computed tomography (CT) scanning. A CT room shall be provided and be readily available to the emergency suite. Clearance and unobstructed space shall not be less than three feet on each side of the diagnostic equipment. The CT room(s) size shall be in compliance with the manufacturer's recommendations and shall contain the following. (A) A control room shall be provided with a view window permitting view of the patient. The control room shall be located to allow convenient film processing. (B) A patient toilet room shall be provided conveniently to the procedure room. When directly accessible to the scan room, the toilet room shall be arranged so that a patient may leave the toilet room without having to reenter the scan room. The toilet room shall have a hand washing fixture with hands-free operable controls. (9) Laboratory services. Laboratory suite shall be provided with the following minimum facilities. (A) The laboratory work room(s) shall include counter(s), space appropriately designed for laboratory equipment, and sink(s) with hands-free operable controls. (B) Each laboratory room or work area shall be provided with a hand washing fixture(s) with hands-free operable controls. (C) General storage, including refrigeration for reagents, standards, supplies, and stained specimen microscope slides, etc. shall be provided. Separate facilities shall be provided for such incompatible materials as acids and bases, and vented storage shall be provided for volatile solvents. (D) A refrigerator or other similar equipment shall be provided for specimen storage waiting for transfer to off-site testing. (E) Specimen room/area for blood collection shall be provided with a counter, space for seating, and hand washing fixture with hands-free operable controls. A toilet and lavatory with hands-free operable controls shall be provided for specimen collection. This facility may be outside the laboratory suite if conveniently located. (F) When chemical safety is a requirement, an emergency shower and eye flushing devices shall be provided. (G) Flammable or combustible liquids, when used, shall be stored in approved containers, in accordance with National Fire Protection Association 30, Flammable and Combustible Liquids Code, 2003 edition. (H) When radioactive materials are employed, safe storage facilities shall be provided. (I) Each laboratory unit shall meet the requirements of Chapter 11 of NFPA 99 (relating to Laboratories), and Chapter 20 of NFPA 101 (relating to New Ambulatory Health Care Occupancies). (10) Isolation room. The need for an airborne infection isolation room in the emergency suite shall be determined by the governing body and the infection risk assessment. (A) When the facility provides treatment rooms to perform procedures on persons who are known or suspected of having an airborne infectious disease, these procedures shall be performed in a designated emergency airborne infection isolation treatment rooms and meeting airborne infection isolation ventilation requirements. The isolation room shall meet the ventilation requirements contained in Table 1 of §131.148(a) of this title. (B) The emergency airborne infection isolation treatment room for a single patient shall have a minimum clear area of 120 square feet clear floor area exclusive of fixed and movable cabinets and shelves. The minimum clear room dimension exclusive of fixed cabinets and built-in shelves shall be 10 feet. The emergency treatment room shall contain cabinets, medication storage, work counter, examination light, and a hand washing fixture with hands-free operable controls. (C) The emergency airborne infection isolation room shall be provided with an enclosed anteroom. The enclosed anteroom shall open to directly into the emergency airborne infection isolation treatment room. The enclosed anteroom shall have facilities for hand washing, gowning, and storage of clean and soiled materials. One enclosed anteroom may serve multiple isolation rooms. (D) The door from the enclosed anteroom to the emergency airborne infection isolation room shall be provided with a self-closing device. (E) Pressure differential monitors or air flow devices shall be installed outside the isolation room and anteroom. Devices shall be installed in corridors, passageways, etc. (11) Secured holding room. When provided, this room shall be constructed to allow for security, patient and staff safety, patient observation, and sound mitigation. The secure holding room shall have a minimum clear area of 100 square feet clear floor area exclusive of fixed cabinets. The minimum clear room dimension exclusive of fixed cabinets shall be 10 feet. (12) Orthopedic and cast room. When provided, the room(s) may be in separate room(s) or in the trauma room. The room(s) shall contain a work counter, storage for splints and orthopedic supplies, traction hooks, medication storage, examination light, and a hand washing fixture with hands-free operable controls. When a cast room is provided it shall be equipped with hand washing facilities, storage, and other provisions required for cast procedures. (13) Film processing room. When a radiographic (X-ray) room is provided, a darkroom for processing film shall be provided unless the processing equipment does not require a darkroom for loading and transfer. When daylight processing is used, the darkroom may be minimal for emergency and special uses. Film processing shall be located convenient to the darkroom. Cont'd... |
