EP1931297B1

EP1931297B1 - Movable isolation system, method for temporarily isolating rooms and an assembly of a movable isolation system and a room to be isolated

Info

Publication number: EP1931297B1
Application number: EP06783920.9A
Authority: EP
Inventors: Elizabeth Johanna Jacoba van de Vorle-Houben
Original assignee: Individual
Current assignee: Individual
Priority date: 2005-09-13
Filing date: 2006-09-13
Publication date: 2015-12-02
Anticipated expiration: 2026-09-13
Also published as: EP1931297A2; WO2007032668A2; NL1029937C2; WO2007032668A3

Description

The invention relates to a movable isolation system with which possible infections can be prevented, wherein a temporary anteroom is provided, comprising a regulating device for adjusting the pressure and/or composition, respectively, of the air in the anteroom, while the isolation system is designed for use in an existing room to be isolated.
The invention further relates to a method for temporarily isolating rooms.
The invention furthermore relates to an assembly of a movable isolation system and a room to be isolated.
Known are special isolation rooms for strict isolation or protective isolation of patients in hospitals. See for example GB118145 .
With these, a patient or his environment can be prevented from becoming infected. This is arranged with the aid of pressure differences in different rooms. In case of strict isolation of patients suspected of being infected, the air pressure in an anteroom is to be higher than in the isolation room so that infected particles that may be present in the isolation room cannot escape. With the aid of the anteroom, a treating doctor can enter the isolation room without infected air/particles escaping. In the case of protective isolation, the pressure in the isolation room is higher than the pressure in the anteroom and/or the outside air so that air that may infect the patient will not enter just like that. With these known provisions, the entering and/or issuing air in the entrance is also filtered. This information is also substantially described in the document "Construction and design requirements for isolation department, Construction of Isolation rooms ("Bouw en inrichtingseisen isolatieafdeling, Bouw van isolatiekamers"), dated December 2004, by the Working Party on Infection Prevention, to be found on http://www.wip/nl.
Temporary isolation systems are also known. These are used for temporarily converting a patients' room into an isolation room. This may bring the advantage that it is not necessary to only depend on the special isolation rooms in the hospitals, which are often scarce and may not be equipped with the desired appliances. An inflatable lock for instance, which, basically, creates a lock, is connected to an entrance of a space to be isolated, so that this is converted from patients' room to an isolation room. Such an isolation system is the Barrier 2000, intended to for once-only use in hospitals so that, basically, patients can be isolated in any ward. A comparable system is, for instance, a temporary decontamination lock, also called IDPD-Unit (Inflatable Disposable Portable Decontamination Unit), in which different relative negative pressure and relative positive pressure rooms are arranged and which is also provided with shower installations. These locks are shown on the website www.imgeurope.nl. After use, such locks, or at least a part thereof, are disposed of.
A drawback of such known isolation systems is that with higher isolation requirements, they are no longer adequate, as infectious air might still spread via other openings in the patients' room to be isolated. Infections could be spread via, for instance, the ventilation shaft to neighboring patients' rooms or could escape outside via windows and the like. It is furthermore not simple to provide protective isolation with the existing temporary systems.
An object of the invention is to provide a high-grade movable isolation system for existing patients' rooms which prevents infections from spreading and checks the air flows in an advantageous manner.
This object and other objects are achieved with the movable isolation system according to the invention, as claimed in claim 1, with which possible infections can be prevented, while a temporary anteroom is provided, comprising a regulating device for adjusting the pressure and/or composition, respectively, of the air in the anteroom, while the isolation system is designed for use with an existing room to be isolated, the isolation system being provided with a movable second regulating device, which is provided with feed-through means of air from and/or to an area outside the anteroom and outside said existing room.
The isolation system according to the invention is utilized in a rapid, simple and removable manner, with existing rooms that, until then, had a different function. Preferably, these existing rooms can be patients' rooms in hospitals, as hospitals are pre-eminently equipped for treatment of infected patients. It will however be clear that in principle, many types of rooms can be provided with a system according to the invention, for instance parts of different types of nursing homes, homes for the elderly, sheds, containers, schools, houses, flats, army bases, camps, laboratories, research centers, et cetera. Here, in particular all cases in which isolation rooms are to be arranged ad hoc, as already equipped isolation rooms are not available should be considered.
In this description, the terms infection, infectious, contamination and the like relate to transmission by means of airflows of, basically, undesired particles. Somewhat more specifically, it relates to the transmissibility of microorganisms to humans and/or animals. Viruses, bacteria and/or contamination et cetera can be involved here, this should, however, not be understood to be limitative in any manner.
In this description, movable and/or removable is understood to mean that the movable isolation system can be dismantled and assembled relatively simply, so that, in principle, the isolated room can, once again, have the function it previously had. Needless to say, this initially holds for normal use of the interior and the room. It might be so that an isolation system according to the invention is primarily arranged for temporary use but is not removed/disassembled for a long period of time. This type of use is also understood to fall within the framework of the invention.
A system according to the invention provides a temporary anteroom with a regulating device for pressure and filtering, as described hereinabove. Such a temporary anteroom is, for instance, the Barrier 2000, both movable and disposable, but also, an already existing intermediate space can be designed as pressure or filtering space, while this is provided with, for instance, a movable regulating device. The anteroom can also comprise a decontamination zone, and several rooms for relative negative and relative positive pressure with, for instance, several regulating devices such as, for instance, the IDPD-Unit. It will be clear that many types of temporary anterooms are suitable within the framework of the invention.
It has appeared that with known devices, undesired air flows carrying possibly infectious microorganisms still spread via ventilation holes or passages such as windows, single glazing, porous walls, cracks, slits and the like into neighboring rooms or the outside air. That is why the system according to the invention provides a movable second regulating device which, in a controlled manner, reroutes air that may carry infectious particles. To this end, feed-through means conduct the air between the room to be isolated, for instance an existing patients' room, and an outside area, for instance the outside air, thereby decreasing the risk of infection. The outside area can comprise, for instance, the outside air, a corridor, a different room in a building, a filter compartment, via which compartment the air is conducted through to, for instance, the ventilation system, etc. The second regulating device can be mounted and disassembled in a simple manner, so that it is movable and may be suitable for reuse, for instance with other rooms to be temporarily set up as isolation room. With the aid of such a regulating device according to the invention, infection of a patient to be isolated in case of protective isolation, or infection of his surroundings in case of strict isolation is prevented, and many types of already existing rooms, originally having a different function, can be configured to isolation rooms.
By providing the movable second regulating device, which is placed in or near the room to be isolated, also with a pressure regulation, the pressure in the room to be isolated can be regulated independently of the pressure of the outside environment. Thus, the desired pressure difference between the room to be isolated and the outside areas can be realized more precisely and efficiently. For protective isolation for instance, the pressure in the anteroom is increased with respect to the outside areas, while the pressure in the room to be isolated is increased even further by the second regulating device. In addition, desired negative pressure in the room to be isolated can be created for strict isolation, whereby the anteroom is also held at a negative pressure that is less than the negative pressure in the room to be isolated. Also, with the regulating devices, the desired isolation conditions can be effected without a partition wall, for instance a tarpaulin or a door or the like, being specifically needed thereto. In such a case, the anteroom and the room to be isolated are defined by the pressure differences. With the ad hoc measures mentioned, controlled isolation is effected in a previously 'conventional' patients' room or other room whose previous function was different from isolation room.
It is also advantageous to provide the second regulating device with second filters, so that the air that is conducted out of, or into the isolation room is suitably freed of undesirable, transmittable components. With strict isolation for instance, in a favorable manner, infectious air can be conducted via the second filter to the outside air.
For supplying air to and/or discharging air from the room to be isolated, the feed-through means are provided with hoses, tubes and/or ducts et cetera, which can conduct the air along the filters and pressure systems in the direction of, for instance, the outside air. It is advantageous that, to this end, flexible hoses and/or intermediate parts and/or tube bends are provided so that air can be conducted via the desired passage. In a preferred embodiment, with strict isolation for instance, the air is fed with a hose system towards, for instance, a ventilation hole or passage or the like, to which end the hose system is coupled to an airtight connection, to be arranged on the respective ventilation hole. In this description, a ventilation hole can, in principle, be any air passage such as a ventilation grate towards the outside, a window or a crack et cetera. In many cases, when utilizing the present invention in an existing patients' room in a hospital for instance, the ventilation hole will comprise a window.
To prevent rain or wind from exerting an influence from the outside on the second regulating device, in a preferred embodiment, the connection is provided with a valve. This valve stops gusts of wind and/or rain or the like that threaten to enter the connection from the outside.
The connection to a ventilation hole can be arranged with the aid of a flexible fixation frame designed to that end. This fixation frame is designed for airtight connection to several types of undergrounds and/or ventilation holes. Also, in one embodiment, a substantially airtight coupling piece is provided, with which the hose system, the tubes or ducts et cetera, is coupled to the connection in a simple and airtight manner. The coupling piece may be designed in the form of a flange pack. In this manner, an isolation system for existing rooms, which can be built up very rapidly is achieved, limiting the risks of infection to a large extent. The feed-through means too can be mounted in a simple manner.
As spaces are often provided with several ventilation holes such as, for instance, entrances, windows or connections to ventilation systems, an isolation system according to the invention is also provided with coverings. If an opening of a ventilation system ends up in a patients' room to be isolated, it can be advantageously covered with a system according to the invention, with which possible infectious particles that may be present in the air do not end up in the ventilation system. This prevents possible risk of infection for other patients present as, generally, the ventilation system connects several patients' rooms or is at least not separated for each individual room or space. Other 'holes' or 'cracks' too can be covered so that infectious particles will not find a passage to neighboring spaces. In the case of protective isolation, it evidently holds that with the coverings, passage of infectious particles to the isolation room is prevented. It is also advantageous to utilize the coverings on ventilation holes for controlling pressure difference within the room to be isolated.
In one embodiment according to the invention, also, second feed-through means are provided for circulating or supplying air, while the air pressure, or the air pressure difference, is maintained. Thus, the air in the patients' room to be isolated is freshened in an advantageous manner. To this end, also, a third filter can be provided. Furthermore, the second feed-through means can optionally be combined with the first feed-through means.
In one embodiment, the invention according to the invention is controlled by electronic means, while the operating panel can be advantageously positioned outside the room to be isolated. With it, a specialist can regulate and/or read the condition of the air (pressure, composition of the air, et cetera), in the room to be isolated in a favorable manner without having to enter the room to be isolated. To this end, the operating panel could be provided with wireless connecting means to the electronic control system. Naturally, the operating panel can also provide information about the complete condition of the isolation system, both of the anteroom and the isolation room.
In an advantageous embodiment according to the invention, the anteroom comprises an already existing movable and/or disposable lock.
This object and/or other objects are also achieved with a method according to the invention for temporarily isolating rooms, while the pressure in a temporary anteroom is regulated with respect to a room to be isolated, which anteroom gives access to the or a room to be isolated, while also, air is fed through between the room to be isolated and an outside area with the aid of a movable second regulating device.
This object and/or other objects are further achieved with an assembly of an isolation system according to any one of claims 1-14 and a room to be isolated according to the invention.
In clarification of the invention, embodiments will be described on the basis of the drawing. In the drawing:

Fig. 1 shows a schematic top plan view of a use of a movable isolation system according to the invention;
Fig. 2 shows an outline of a movable lock according to the invention;
Fig. 3 shows a schematic top plan view with pressure differences indicated therein in a case of strict isolation;
Fig. 4 shows a schematic top plan view with pressure differences indicated therein in a case of protective isolation; and
Fig. 5 shows a perspective rough representation of a temporary isolation room according to the invention.

These embodiments shown are not to be construed to be limitative in any manner. In this description, identical or corresponding parts have identical or corresponding reference numerals.
In cases wherein specific microorganisms should be prevented from ending up by means of airflows, inside or outside a specific room, isolation rooms are used, such as described and schematically shown in, for instance, the document already cited herein: "Construction and design requirements for isolation department, Construction of Isolation rooms ("Bouw en inrichtingseisen isolatieafdeling, Bouw van isolatiekamers"), dated December 2004, by the Working Party on Infection Prevention, which is understood to be incorporated herein by reference.
Different forms of isolation are used with the present invention. In this description of the Figures, strict isolation and protective isolation will be discussed. In the case of strict isolation, the pressure in a patients' room will be lower than the ambient pressure in the surrounding outside area. Thus, airflows carrying possibly infectious organisms are, in principle, prevented from flowing from the patients' room to the outside area.
In case of protective isolation, the patient will be protected from the environment. Here, airflows are prevented from entering from the outside area into the patients' room due to relatively high pressure in the patients' room.
In both cases, the transmission of infectious microorganisms by means of airflows 5, 6, 7 is prevented by effecting a pressure difference between a patients' room 2 and an outside area 9, 10, 11 and/or between a patients' room 2 and a movable lock 8. These elements are schematically shown in Fig. 1. In the following, mostly, an isolation room 2 will be mentioned, which means the patients' room 2 to be temporarily set up as isolation room 2.
With strict isolation as well as with protective isolation, a doctor must be able to visit the isolated patient in the temporary isolation room 2 while the isolating conditions are maintained. In the case shown, a doctor will step into the isolation chamber 2 by clearing entrance 12, for instance by opening door 13. Here, the risk could arise that an exchange of airflows 5, 6, 7 occurs. To counteract this risk, with an embodiment according to the invention, a movable lock 8 is provided. One embodiment of such a lock 8 is shown in Fig. 2. Examples of pressure differences that can occur between corridor 11, lock 8, isolation room 2 and outside air 10 are indicated in Figs. 3 and 4.
As described hereinabove, despite the pressure difference between lock 8 and isolation room 2, an airflow exchange could occur when the entrance 12 is opened. To prevent infectious particles from flowing between corridor 11 and lock 8, in the lock 8, a pressure difference relative to the corridor 11 is applied with the aid of the first regulating device 14. The first regulating device 14 is provided with pressure means 15 and first filter system 16, with the pressure means 15 enabling a positive or negative pressure in the lock 8, and the first filter system 16 can purify the air in the lock 8. Hence, undesirable airflows are prevented as much as possible, and the air in the lock 8 can be kept clean. If an airflow exchange between the lock 8 and the isolation room 2 and/or between the lock 8 and corridor 11 were to occur, the airflows will be relatively clean. The lock 8 and the first regulating device 14 are movable, so that, in principle, any patients' room 2, 9 can be equipped with them. The lock 8 can also comprise a decontamination lock or any other type of lock that can be movably connected to the isolation room 2.
The movable lock 8 can be designed in several manners. Two examples of such locks are the Barrier 2000 and the IDPD-Unit of IMG Europe. It is also possible that a lock 8 is created by providing the first regulating device 14 in an already present intermediate space, not shown, between, for instance, a corridor 11 and isolation room 2. Several ad hoc locks 8 are possible within the framework of the invention.
As shown in Fig. 5, the movable isolation system 1 is provided at the patients' room 2 with a movable second regulating device 17. This second regulating device 17 is provided with a pressure regulation 18, a second filter system 19 and feed-through means 20 - 24. The pressure in the isolation room 2 can be regulated with the pressure regulation. To this end, the pressure regulation 18 is connected to feed-through means 20 -24 that conduct the air between the regulating device and the window. If the pressure in the isolation room 2 is to be increased, outside air 10 is drawn in via the feed-through means 20 - 24 and if the pressure is to be reduced, air can be discharged from the room 2 via feed-through means 20 - 24. To prevent infectious air from being conducted inside or outside via the second regulating device 17, this is provided with a second filter system 19. Thus, relatively clean air can be supplied and/or discharged.
In the embodiment shown, the feed-through means 20 - 24 comprise hoses 21, 23, coupling pieces 22, window connection 20 and a valve (not shown). It will be clear that the window connection 20 is to be designed to be as airtight as possible, so that no undesirable airflows are formed at the edge of the connection 20. To this end, in a preferred embodiment, the window connection 20 is designed having a flexible fixation frame 24. With the aid of this flexible fixation frame 24, the connection 20 can be adapted for several types of windows or other types of ventilation holes. Within the framework of the invention, the fixation frame 24 is suitable when the window is taken out or is opened inwards or outwards.
The connection 20 is provided with an outlet or hose 23, having at its end a coupling piece 22a in the form of a flange coupling 22a. With it, the window connection 20 can be coupled in a simple and airtight manner, by means of a second flange coupling 22b and a second hose 32, to the second regulating device 17.
To prevent gusts of wind or rain from influencing the second regulating device 17, in a preferred embodiment, the connection is provided with a valve. This valve is not shown in the Figures, it will be clear to the skilled person that it may be arranged in the hose 23 or, for instance, in the center of the fixation frame 24.
In Fig. 5, a configuration is shown wherein the movable second regulating device 17 is placed more or less within the space of the isolation room 2. It will be clear that it is well possible to arrange at least a part of the second regulating device 17 outside the isolation room 2. Possibly, even, the entire regulating device 17 can be arranged at the outside of the room 2, for instance against the wall.
To prevent undesired inward and outward airflows; the movable isolation system 1 is provided with several coverings 25. These coverings 25 prevent any undesirable airflows without the second regulating device 17 being involved. In a preferred embodiment, a covering 25a is designed for a passage of a ventilation system. In the case of strict isolation, airflows carrying undesired microorganisms could be fed, via this passage, towards other patients' rooms. In the case of protective isolation, an undesired airflow carrying microorganisms could enter here. This is prevented with the covering 25a, and the movable second regulating device 17 enables controlled regulation of airflows without the ventilation system being involved. Also, for instance, coverings 25b, 25c can be provided for windows, ventilation grates to the outside et cetera.
As shown in Fig. 5, in the isolation room 2, second feed-through means 26 are provided for the supply of fresh air. In the case of strict isolation, these can supply fresh air, for instance from a corridor 11. In the case of, for instance, protective isolation, the second feed-through means 26 are provided with a third filter system (not shown) to prevent the supply of air that may be infectious. To regulate this supplied air, the second feed-through means 26 can be connected to or integrated with the first or second regulating device 14, 17. The second feed-through means 26 can also be connected to an outside area 9, 10.
The movable isolation system 1 is provided with an electronic control system 27 and an operating panel 28, with which the system 1 can be controlled and be held in the correct position. All elements of the system 1 can be controlled. Hence, this holds for, for instance, the pressure regulations, the filter systems, the air flows et cetera for, for instance, both the lock 8 and the movable regulating system 17. This is possible via an algorithm whereby for instance also sensors are provided in the system 1, and the system 1 is held in desired, optionally pre-programmed positions, while the different elements are held in the proper position relative to each other and the surroundings. The system can also be manually controlled, by means of an operating panel 28. Here, it is advantageous when the operating panel 28 is arranged outside the isolation room 2 so that, with little effort, a doctor can control and check the condition in the isolation room.
The invention is not limited in any manner to the embodiments shown or described. Many variations and combinations are understood to fall within the framework of the invention.

Claims

A movable isolation system (1) with which possible infections can be prevented, wherein a temporary anteroom (8) is provided, comprising a regulating device (14) for adjusting the pressure and/or composition, respectively, of the air in the anteroom (8), while the isolation system (1) is designed for use with an existing room (2) to be isolated, characterised in that the isolation system (1) is provided with a movable second regulating device (17) which is provided with feed-through means (20-24) for air from and/or to an area (10, 11) outside the anteroom (8) and outside said existing room, wherein the second regulating device (17) is provided with a pressure regulation (18) for regulating the pressure in the room (2) to be isolated independently of the pressure of the outside area (10,11).
The isolation system (1) according to claim 1, wherein the isolation system (1) is provided for increasing the pressure in the anteroom (8) with respect to the outside area (10, 11), while the pressure in the room (2) to be isolated is increased even further by the second regulation device (17).
The isolation system (1) according to any one of the preceding claims, wherein the isolation system (1) is provided for providing a negative pressure in the room (2) to be isolated, whereby the anteroom (8) is also held at a negative pressure that is less than the negative pressure in the room (2) to be isolated.
The isolation system (1) according to any one of the preceding claims, wherein the second regulating device is provided with a second filter.
The isolation system (1) according to any one of the preceding claims, wherein the feed-through means are provided with a connection, preferably provided with a valve, to be arranged on a ventilation hole, especially wherein the connection comprises a flexible fixation frame for airtight connection.
The isolation system (1) according to any one of claims 4 -5, wherein the second control device is provided with a coupling piece for coupling the feed-through means to the connection.
The isolation system (1) according to any one of the preceding claims, wherein coverings are provided, preferably corresponding to ventilation holes in the room to be isolated.
The isolation system (1) according to any one of the preceding claims, wherein second feed-through means are provided for feeding through air between the room to be isolated and an outside area.
The isolation system (1) according to claim 8, wherein the second feed- through means are provided with a third filter.
The isolation system (1) according to any one of the preceding claims, provided with an electronic checking system with an operating panel and connecting means for controlling at least the second regulating device.
The isolation system (1) according to claim 10, wherein the connecting means are designed for providing the operating panel outside the room to be isolated.
The isolation system (1) according to any one of the preceding claims, wherein the anteroom comprises a lock.
The isolation system (1) according to any one of the preceding claims, wherein the room to be isolated comprises a patients' room in a hospital.
A method for temporarily isolating rooms (2), wherein the pressure in a temporary anteroom (8) is regulated relative to at least one room (2) to be isolated, which anteroom (8) gives access to the or a room (2) to be isolated, wherein air is also fed-through between the room (2) to be isolated and an outside area (10, 11) with the aid of a movable second regulating device (17), and regulating the pressure in the room (2) to be isolated independently of the pressure of the outside area (10,11), wherein the method further comprises increasing the pressure in the anteroom (8) with respect to the outside area (10, 11), while the pressure in the room (2) to be isolated is increased even further by the second regulation device (17), or providing a negative pressure in the room (2) to be isolated, whereby the anteroom (8) is also held at a negative pressure that is less than the negative pressure in the room (2) to be isolated.
The method according to claim 14, wherein the fed-through air is filtered.
The method according to claim 14 or 15, wherein the temporary anteroom is placed at a room to be isolated.
The method according to any one of claims 14 - 16, wherein the temporary anteroom is placed at a patients' room.
The method according to any one of claims 14 - 17, wherein the pressure of the room to be isolated relative to the outside area and/or the anteroom is regulated.
The method according to any one of claims 14 - 18, wherein ventilation holes which are in connection to the room to be isolated are covered.
The method according to any one of claims 14 - 19, wherein the airflows in the existing room are regulated and at least properties thereof are read at a distance from the room to be isolated, preferably near the anteroom.
An assembly of a movable isolation system according to any one of the claims 1 - 14 and a room to be isolated.
The assembly according to claim 21, wherein the room to be isolated is in connection with the second movable regulating device.
The assembly according to any one of claims 21- 22, wherein the feed- through means are coupled, with the aid of the connection, to at least one ventilation hole, preferably a window.
The assembly according to any one of claims 21 - 23, wherein the temporary anteroom is coupled to an entrance to the room to be isolated.
The assembly according to any one of claims 21- 24, wherein the ventilation holes of the room to be isolated are covered with coverings.
The assembly according to any one of claims 21 - 25, wherein the room to be isolated is provided with movable second feed-through means for feeding through air between the room to be isolated and an outside area.
The assembly according to any one of claims 21 - 26, wherein the operating panel is provided outside the room to be isolated.
The assembly according to any one of claims 21 - 27, wherein the room to be isolated comprises a room that previously functioned as a patients' room in a hospital.
Use of the isolation system according to any one of claim 1-13 or the assembly according to any one of claims 21-28 for strict isolation of a patient thus preventing infection of his surroundings.