Boston University COVID-19 Response Mechanical Ventilation (HVAC) Systems July 28, 2020
Total Page:16
File Type:pdf, Size:1020Kb
Load more
Recommended publications
-
Assessment Report COVID-19 Vaccine Astrazeneca EMA/94907/2021
29 January 2021 EMA/94907/2021 Committee for Medicinal Products for Human Use (CHMP) Assessment report COVID-19 Vaccine AstraZeneca Common name: COVID-19 Vaccine (ChAdOx1-S [recombinant]) Procedure No. EMEA/H/C/005675/0000 Note Assessment report as adopted by the CHMP with all information of a commercially confidential nature deleted. Official address Domenico Scarlattilaan 6 ● 1083 HS Amsterdam ● The Netherlands Address for visits and deliveries Refer to www.ema.europa.eu/how-to-find-us Send us a question Go to www.ema.europa.eu/contact Telephone +31 (0)88 781 6000 An agency of the European Union © European Medicines Agency, 2021. Reproduction is authorised provided the source is acknowledged. Table of contents 1. Background information on the procedure .............................................. 7 1.1. Submission of the dossier ..................................................................................... 7 1.2. Steps taken for the assessment of the product ........................................................ 9 2. Scientific discussion .............................................................................. 12 2.1. Problem statement ............................................................................................. 12 2.1.1. Disease or condition ........................................................................................ 12 2.1.2. Epidemiology and risk factors ........................................................................... 12 2.1.3. Aetiology and pathogenesis ............................................................................. -
Ventilation Recommendations Table
SURVIVING SEPSIS CAMPAIGN INTERNATIONAL GUIDELINES FOR THE MANAGEMENT OF SEPTIC SHOCK AND SEPSIS-ASSOCIATED ORGAN DYSFUNCTION IN CHILDREN VENTILATION RECOMMENDATIONS TABLE RECOMMENDATION #34 STRENGTH & QUALITY OF EVIDENCE We were unable to issue a recommendation about whether to Insufficient intubate children with fluid-refractory, catecholamine-resistant septic shock. However, in our practice, we commonly intubate children with fluid-refractory, catecholamine-resistant septic shock without respiratory failure. RECOMMENDATION #35 STRENGTH & QUALITY OF EVIDENCE We suggest not to use etomidate when intubating children • Weak with septic shock or other sepsis-associated organ dysfunction. • Low-Quality of Evidence RECOMMENDATION #36 STRENGTH & QUALITY OF EVIDENCE We suggest a trial of noninvasive mechanical ventilation (over • Weak invasive mechanical ventilation) in children with sepsis-induced • Very Low-Quality of pediatric ARDS (PARDS) without a clear indication for intubation Evidence and who are responding to initial resuscitation. © 2020 Society of Critical Care Medicine and European Society of Intensive Care Medicine Care Medicine. RECOMMENDATION #37 STRENGTH & QUALITY OF EVIDENCE We suggest using high positive end-expiratory pressure (PEEP) • Weak in children with sepsis-induced PARDS. Remarks: The exact level • Very Low-Quality of of high PEEP has not been tested or determined in PARDS Evidence patients. Some RCTs and observational studies in PARDS have used and advocated for use of the ARDS-network PEEP to Fio2 grid though adverse hemodynamic effects of high PEEP may be more prominent in children with septic shock. RECOMMENDATION #38 STRENGTH & QUALITY OF EVIDENCE We cannot suggest for or against the use of recruitment Insufficient maneuvers in children with sepsis-induced PARDS and refractory hypoxemia. -
Ventilation Heat Recovery Ventilation Glazing; Equipment Insulation
Town of Warner Building Energy Performance Reports Social Services Government Roads Police Fire Waste Material Waste Water Garage 1 2008 Town Building Energy Use 2 4 5 Oil: 4567 gallons Oil: 4057 gallons LP: 5,122 gallons Elec: 20,160KWH Elec: 19,428KWH Elec: 21,120KWH 72KBtu/ft2 57.4KBtu/ft2 48.4KBtu/ft2 3 8 6* LP: 2,033 gallons Oil: 817 gallons Kerosene: 934 gallons Elec: 19,750KWH Elec: 7,290KWH Elec: 18,731KWH 59.6KBtu/ft2 29.4KBtu ft2 45KBtu/ft2 1 Gallons Btu’s Dollars 7 Oil 10,706 1,483MM $32,118 LP: 2200 gallons LP 9,455 861MM $11,555 Oil: 152 gallons Elec: 130,968KWH Elec 237,906 812MM $37,332 Elec: 459KWH *289KBtu/ft2 TOTALS 2,946MM $81,000 33.8KBtu/ft2 2 Town Building 2008 Utility Costs 3 4 2 $17,615 $15,413 $19,081 5 7 6 $7,005 $9,217 $3,869 8 1 $24,500 $658 3 Town Building 2008 Greenhouse Emissions 2 3 4 120,054lbs 104,184lbs 78,508lbs 5 7 6 34,109lbs 39,232lbs 23,379lbs 8 1 121,507lbs 3,712lbs 4 Town Building Air Leakage Rates 6ACH50 8ACH50 .79cfm/ft2shell 1.21cfm/ft2shell Not tested 2 16ACH50 9ACH50 Not tested 1.3cfm/ft2shell .99cfm/ft2shell ACH50 – Air changes per hour at - 50Pa; relative to building volume 1 6ACH50 33 ACH50 .45cfm/ft2shell Cfm/ft2 shell – cubic feet of air per minute relative to surface area of shell 2.22cfm/ft2shell 5 Summary of Prominent De-ficiencies Insulation Heat Recovery Insulation Ventilation Heat Recovery Ventilation Glazing; Equipment insulation Air Sealing Air Sealing Air Sealing Insulation insulation Equipment Insulation Air Sealing Electric Loads glazing AS / HRV insulation 6 Prioritize by -
Mechanical Ventilation Bronchodilators
A Neurosurgeon’s Guide to Pulmonary Critical Care for COVID-19 Alan Hoffer, M.D. Chair, Critical Care Committee AANS/CNS Joint Section on Neurotrauma and Critical Care Co-Director, Neurocritical Care Center Associate Professor of Neurosurgery and Neurology Rana Hejal, M.D. Medical Director, Medical Intensive Care Unit Associate Professor of Medicine University Hospitals of Cleveland Case Western Reserve University To learn more, visit our website at: www.neurotraumasection.org Introduction As the number of people infected with the novel coronavirus rapidly increases, some neurosurgeons are being asked to participate in the care of critically ill patients, even those without neurological involvement. This presentation is meant to be a basic guide to help neurosurgeons achieve this mission. Disclaimer • The protocols discussed in this presentation are from the Mission: Possible program at University Hospitals of Cleveland, based on guidelines and recommendations from several medical societies and the Centers for Disease Control (CDC). • Please check with your own hospital or institution to see if there is any variation from these protocols before implementing them in your own practice. Disclaimer The content provided on the AANS, CNS website, including any affiliated AANS/CNS section website (collectively, the “AANS/CNS Sites”), regarding or in any way related to COVID-19 is offered as an educational service. Any educational content published on the AANS/CNS Sites regarding COVID-19 does not constitute or imply its approval, endorsement, sponsorship or recommendation by the AANS/CNS. The content should not be considered inclusive of all proper treatments, methods of care, or as statements of the standard of care and is not continually updated and may not reflect the most current evidence. -
Tracheotomy in Ventilated Patients with COVID19
Tracheotomy in ventilated patients with COVID-19 Guidelines from the COVID-19 Tracheotomy Task Force, a Working Group of the Airway Safety Committee of the University of Pennsylvania Health System Tiffany N. Chao, MD1; Benjamin M. Braslow, MD2; Niels D. Martin, MD2; Ara A. Chalian, MD1; Joshua H. Atkins, MD PhD3; Andrew R. Haas, MD PhD4; Christopher H. Rassekh, MD1 1. Department of Otorhinolaryngology – Head and Neck Surgery, University of Pennsylvania, Philadelphia 2. Department of Surgery, University of Pennsylvania, Philadelphia 3. Department of Anesthesiology, University of Pennsylvania, Philadelphia 4. Division of Pulmonary, Allergy, and Critical Care, University of Pennsylvania, Philadelphia Background The novel coronavirus (COVID-19) global pandemic is characterized by rapid respiratory decompensation and subsequent need for endotracheal intubation and mechanical ventilation in severe cases1,2. Approximately 3-17% of hospitalized patients require invasive mechanical ventilation3-6. Current recommendations advocate for early intubation, with many also advocating the avoidance of non-invasive positive pressure ventilation such as high-flow nasal cannula, BiPAP, and bag-masking as they increase the risk of transmission through generation of aerosols7-9. Purpose Here we seek to determine whether there is a subset of ventilated COVID-19 patients for which tracheotomy may be indicated, while considering patient prognosis and the risks of transmission. Recommendations may not be appropriate for every institution and may change as the current situation evolves. The goal of these guidelines is to highlight specific considerations for patients with COVID-19 on an individual and population level. Any airway procedure increases the risk of exposure and transmission from patient to provider. -
Mechanical Ventilation Page 1 of 5
UTMB RESPIRATORY CARE SERVICES Policy 7.3.53 PROCEDURE - Mechanical Ventilation Page 1 of 5 Mechanical Ventilation Effective: 10/26/95 Formulated: 11/78 Revised: 04/11/18 Mechanical Ventilation Purpose Mechanical Artificial Ventilation refers to any methods to deliver volumes of gas into a patient's lungs over an extended period of time to remove metabolically produced carbon dioxide. It is used to provide the pulmonary system with the mechanical power to maintain physiologic ventilation, to manipulate the ventilatory pattern and airway pressures for purposes of improving the efficiency of ventilation and/or oxygenation, and to decrease myocardial work by decreasing the work of breathing. Scope Outlines the procedure of instituting mechanical ventilation and monitoring. Accountability • Mechanical Ventilation may be instituted by a qualified licensed Respirator Care Practitioner (RCP). • To be qualified the practitioner must complete a competency based check off on the ventilator to be used. • The RCP will have an understanding of the age specific requirements of the patient. Physician's Initial orders for therapy must include a mode (i.e. mandatory Order Ventilation/Assist/Control, pressure control etc., a Rate, a Tidal Volume, and an Oxygen concentration and should include a desired level of Positive End Expiratory Pressure, and Pressure Support if applicable. Pressure modes will include inspiratory time and level of pressure control. In the absence of a complete follow up order reflecting new ventilator changes, the original ventilator settings will be maintained in compliance with last order until physician is contacted and the order is clarified. Indications Mechanical Ventilation is generally indicated in cases of acute alveolar hypoventilation due to any cause, acute respiratory failure due to any cause, and as a prophylactic post-op in certain patients. -
Colorcoat Renew SC Design Guide
Uniclass L5141:P41 CI/SfB (41) Nh2 January 2016 Colorcoat Renew SC® Design guide 2 +44 (0) 1244 892199 | www.tatasteelconstruction.com Contents 1. Colorcoat Renew SC® system overview 4 3.4 Other physical solar collector design considerations 15 1.1 Introduction 4 3.4.1 Perforation diameter and pitch 15 1.2 Working principles of Colorcoat Renew SC® 4 3.4.2 Profile options 16 1.3 Benefits of a Colorcoat Renew SC® system 5 3.4.3 Cavity (plenum) 16 1.4 Colorcoat Renew SC® integration 6 3.4.4 Solar collector integration 17 1.4.1 Suitable building types 6 4. Construction 17 2. System performance factors 7 4.1 Requirements and regulations 17 2.1 General design factors 7 4.2 Collector components 17 2.1.1 Solar collector orientation 7 4.3 Typical construction details 18 2.1.2 Collector angle (Tilt) 8 4.4 Fasteners 21 2.1.3 Shading 8 4.5 Maintenance recommendations 21 2.2 Colour selection and influence on performance 9 5. Mechanical and electrical design considerations 22 2.2.1 Guarantee Colorcoat Renew SC® 10 5.1 Building heating and ventilation 3. Collector design and sizing 11 requirements 22 3.1 Building geometry, occupancy and function 11 5.1.1 Intake air quality 22 3.2 Solar collector sizing - description 12 5.2 Relationship between airflow, temperature increase and efficiency 23 3.2.1 Choosing the wall 5.2.1 Temperature rise 23 3.2.2 Determining the volume of the building space to be heated 5.2.2 Wind considerations 24 3.2.3 Determining the volume of air 5.2.3 Transition duct sizing 24 required by the building ventilation system 5.2.4 Pressure drop 24 3.2.4 Determining the optimum balance 5.3 Operating modes 25 of heating and ventilation requirement 5.4 System control and metering 25 3.2.5 Collector sizing guidelines 6. -
Program and Abstracts CONFERENCE COMMITTEE
ICC 19 San Diego, CA · June 20-23, 2016 P Program and Abstracts CONFERENCE COMMITTEE Conference Chairman Program Committee Dean Johnson Carl Kirkconnell, West Coast Solutions, Jet Propulsion Laboratory, USA USA - Chair Email: [email protected] Mark Zagarola, Creare, USA, - Deputy Chair Conference Co-Chairmen Tonny Benchop, Thales Cryogenics BV, Netherlands Jose Rodriguez Peter Bradley, NIST, USA Jet Propulsion Laboratory, USA Ted Conrad, Raytheon, USA Email: [email protected] Gershon Grossman, Technion, Israel Elaine Lim, Aerospace Corporation, USA Sidney Yuan Jennifer Marquardt, Ball Aerospace, Aerospace Corporation, USA USA Jeff Olson, Lockheed Martin, USA Email : [email protected] John Pfotenhauer, University of Wisconsin – Madison, USA Treasurer Alex Veprik, SCD, Israel Ray Radebaugh Sonny Yi, Aerospace Corporation, USA National Institute of Standards and Technology (NIST), USA ICC Board Email: [email protected] Dean Johnson, JPL, USA-Chairman Ray Radebaugh, NIST, USA – Treasurer Proceedings Co-editors Ron Ross, JPL, USA – Co-Editor Saul Miller Jeff Raab, Retired, USA – Past Chairman Retired Rich Dausman, Cryomech, Inc., USA - Email: icc [email protected] Past Chairman Paul Bailey, University of Oxford, UK Peter Bradley, NIST, USA Ron Ross Martin Crook, RAL, UK Jet Propulsion Laboratory, USA Lionel Duband, CEA, France Email: [email protected] Zhihua Gan, Zhejiang University, China Ali Kashani, Atlas Scientific, USA Takenori Numezawa, National Institute for Program Chair Material Science, Japan Carl Kirkconnell Jeff Olson, Lockheed Martin Space System West Coast Solutions, USA Co., USA Email: [email protected] Limin Qiu, Zhejiang University, China Thierry Trollier, Absolut System SAS, Deputy Program Chair France Mark Zagarola, Creare, USA Mark V. -
Mechanical Ventilation
Fundamentals of MMeecchhaanniiccaall VVeennttiillaattiioonn A short course on the theory and application of mechanical ventilators Robert L. Chatburn, BS, RRT-NPS, FAARC Director Respiratory Care Department University Hospitals of Cleveland Associate Professor Department of Pediatrics Case Western Reserve University Cleveland, Ohio Mandu Press Ltd. Cleveland Heights, Ohio Published by: Mandu Press Ltd. PO Box 18284 Cleveland Heights, OH 44118-0284 All rights reserved. This book, or any parts thereof, may not be used or reproduced by any means, electronic or mechanical, including photocopying, recording or by any information storage and retrieval system, without written permission from the publisher, except for the inclusion of brief quotations in a review. First Edition Copyright 2003 by Robert L. Chatburn Library of Congress Control Number: 2003103281 ISBN, printed edition: 0-9729438-2-X ISBN, PDF edition: 0-9729438-3-8 First printing: 2003 Care has been taken to confirm the accuracy of the information presented and to describe generally accepted practices. However, the author and publisher are not responsible for errors or omissions or for any consequences from application of the information in this book and make no warranty, express or implied, with respect to the contents of the publication. Table of Contents 1. INTRODUCTION TO VENTILATION..............................1 Self Assessment Questions.......................................................... 4 Definitions................................................................................ -
Covid-19 Ventilation Faqs
COVID-19 VENTILATION FAQS Updated July 9, 2021 Limiting COVID-19 transmission in the workplace involves critical elements outlined in the University’s COVID-19 Prevention Plan for the Workplace. Maintaining building systems, including central heating, ventilation, and air conditioning (HVAC) systems, to support safe occupancy is a supplemental effort to the University’s COVID-19 prevention measures. This document contains responses to frequently asked questions from occupants in University facilities. Building coordinators and facility managers may share the responses with occupants as appropriate. Which standards and guidelines does the University follow for maintaining HVAC systems? • American Society of Heating, Refrigerating and Air-Conditioning Engineers (ASHRAE) o Coronavirus (COVID-19) Response Resources from ASHRAE and Others • Centers for Disease Control and Prevention (CDC) – Ventilation in Buildings • Seattle Mechanical Code / International Mechanical Code • Washington State Department of Labor & Industries o General Coronavirus Prevention Under Stay Home-Stay Healthy Order o COVID-19 Guidance on Ventilation in the Workplace What do I need to know about ventilation in University buildings? UW buildings are typically supplied with a percentage of outside air either via mechanical fans (a mechanical HVAC system), or natural ventilation (e.g., operable windows), dependent on each building and system. Those systems are maintained to provide ventilation and thermal comfort as designed through the following activities: • In most cases, air filters in buildings equipped with central heating, ventilation, and air conditioning (HVAC) systems are rated at MERV-13 or higher as recommended by the CDC and have been inspected and changed per maintenance procedures and schedules. • Building HVAC systems have continued to operate normally during all phases of the pandemic, even while buildings were unoccupied or at reduced occupancy. -
Ventilation for Acceptable Indoor Air Quality
ANSI/ASHRAE Addendum n to ANSI/ASHRAE Standard 62-2001 Ventilation for Acceptable Indoor Air Quality Approved by the ASHRAE Standards Committee on June 28, 2003; by the ASHRAE Board of Directors on July 3, 2003; and by the American National Standards Institute on January 8, 2004. This standard is under continuous maintenance by a Standing Standard Project Committee (SSPC) for which the Standards Committee has established a documented program for regular publication of addenda or revisions, including procedures for timely, documented, consensus action on requests for change to any part of the standard. The change submittal form, instruc- tions, and deadlines may be obtained in electronic form from the ASHRAE web site, http://www.ashrae.org, or in paper form from the Manager of Standards. The latest edition of an ASHRAE Stan- dard and printed copies of a public review draft may be pur- chased from ASHRAE Customer Service, 1791 Tullie Circle, NE, Atlanta, GA 30329-2305. E-mail: [email protected]. Fax: 404-321- 5478. Telephone: 404-636-8400 (worldwide), or toll free 1-800-527- 4723 (for orders in U.S. and Canada). ©Copyright 2003 American Society of Heating, Refrigerating and Air-Conditioning Engineers, Inc. ISSN 1041-2336 ASHRAE Standard Project Committee 62.1 Cognizant TC: TC 4.3, Ventilation Requirements and Infiltration SPLS Liaison: Fredrick H. Kohloss Andrew K. Persily, Chair* Roger L. Hedrick Walter L. Raynaud* David S. Bulter, Sr., Vice-Chair* Thomas P. Houston* Lisa J. Rogers Leon E. Alevantis* Eli P. Howard, III* Robert S. Rushing* Michael Beaton Ralph T. Joeckel Lawrence J. -
Download-Manager-files/ Manual Italian.Pdf (Accessed on 29 May 2020)
energies Article Dynamic Analysis of the Natural and Mechanical Ventilation of a Solar Greenhouse by Coupling Controlled Mechanical Ventilation (CMV) with an Earth-to-Air Heat Exchanger (EAHX) Sara Bonuso 1, Simone Panico 2, Cristina Baglivo 1,* , Domenico Mazzeo 3 , Nicoletta Matera 3, Paolo Maria Congedo 1 and Giuseppe Oliveti 3 1 Department of Engineering for Innovation, University of Salento, Via per Arnesano, It-73100 Lecce, Italy; [email protected] (S.B.); [email protected] (P.M.C.) 2 Eurac Research, Institute for Renewable Energies, Viale Druso 1, 39100 Bolzano, Italy; [email protected] 3 Department of Mechanical, Energy and Management Engineering (DIMEG), University of Calabria, P. Bucci Cube 46/C, It-87036 Arcavacata of Rende (CS), Italy; [email protected] (D.M.); [email protected] (N.M.); [email protected] (G.O.) * Correspondence: [email protected]; Tel.: +39-0832-297750 Received: 2 July 2020; Accepted: 16 July 2020; Published: 16 July 2020 Abstract: Greenhouse crops represent a significant productive sector of the agricultural system; one of the main problems to be addressed is indoor air conditioning to ensure thermal well-being of crops. This study focuses on the ventilation analysis of solar greenhouse with symmetrical flat pitched roof and single span located in a warm temperate climate. This work proposes the dynamic analysis of the greenhouse modeled in TRNsys, simultaneously considering different thermal phenomena three-dimensional (3D) shortwave and longwave radiative exchange, airflow exchanges, presence of lamps with their exact 3D position, ground and plant evapotranspiration, and convective heat transfer coefficients. Several air conditioning systems were analyzed, automatic window opening, controlled mechanical ventilation systems (CMV) and horizontal Earth-to-Air Heat Exchanger (EAHX) coupled with CMV, for different air volume changes per hour.