Provision of both protective and source isolation facilities adds cost and leads to difficulties with utilization of these specialized rooms. Two solutions are available.
1. The isolation unit can be a single room without an antechamber but with a reversible air flow. This will allow the room to be used for either protective or source isolation. The problems are (a) that patients requiring simultaneous source and protective isolation will have to be nursed under negative pressure, and (b) that great care is necessary to ensure that the air flow has been switched in the correct direction for the particular clinical need. A firm operating policy must be available, otherwise inevitably a source-isolated patient will be positive-pressure ventilated with possible dire consequences for the rest of the ICU.
2. The preferred solution is to have a single room separated from the rest of the ICU by an antechamber that acts as an air lock. Pressurized air can be delivered directly to the room. Exhaust ventilation from the lobby will allow simultaneous protective and source isolation to be carried out without further adjustment ( NHS Estates ...1993).
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