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When provided, the following supplemental surgery and special procedure services shall meet the requirements below:
1224.28.1 Cardiovascular and Other Special Procedures
When provided, the cardiovascular room shall have a minimum clear floor area of 650 square feet (60.39 m2), with a minimum of 20 feet (6096 mm) clear dimension. Orthopedic surgical and other special procedure rooms shall have a minimum clear floor area of 600 square feet (55.74 m2), with a minimum of 20 feet (6096 mm) clear dimension. When open-heart surgery is performed, an additional room in the restricted area of the surgical service space, that is directly accessible to this operating room, shall be designated as a pump room where extra corporeal pump(s), supplies and accessories are stored and serviced. Appropriate plumbing and electrical connections shall be provided in the cardiovascular, pump and storage rooms.
1224.28.1.1 Service Areas
Shall be provided in accordance with Section 1224.15.3.
Exception: Where renovation work is undertaken in facilities built under the 2001 or prior California Building Code, existing rooms for cardiovascular, and other special procedures may have a minimum clear floor area of 500 square feet (46.45 m2). Orthopedic surgical rooms shall have a minimum clear floor area of 360 square feet (33.44 m2) and a minimum dimension of 18 feet (5486 mm).
1224.28.2 Cardiac Catheterization
1224.28.2.1 Procedure Room
A procedure room with a minimum clear floor area of 400 square feet (37.16 m2) for the procedure room in addition to spaces for control, monitoring and recording equipment and imaging equipment power and controls and a minimum of one scrub sink for each catheterization laboratory. This space does not include the control room.
1224.28.2.1.1 Emergency Response Space
Where electrophysiology studies are performed, dedicated space and equipment for emergency resuscitation and stabilization shall be immediately accessible to the procedure room.
1224.28.2.2 Control Room
A control room or area shall be provided. A view window permitting full view of the patient from the control console shall be provided.
1224.28.2.3 Equipment Space
An equipment space or enclosure large enough to contain imaging equipment transformers, power modules and associated electronics and electrical gear shall be provided.
1224.28.2.4 Scrub Facilities
Scrub facilities with hands-free operable controls shall be provided adjacent to the entrance of procedure rooms.
1224.28.2.5 Staff Clothing Change Areas
Appropriate areas shall be provided for male and female staff working within the surgical service space. The areas shall contain lockers, showers, toilets, handwashing stations and space for donning surgical attire. These areas shall be arranged to ensure a traffic pattern so that personnel entering from outside the service space can enter, change their clothing and move directly into the cardiac catheterization service space. The staff change area may be combined with the surgical staff change area.
1224.28.2.6 Patient Holding
A patient preparation, holding, and recovery area or room shall be provided and arranged to provide visual observation before and after the procedure. This may occur in a unit outside of the catheterization service space.
1224.28.2.7 Clean Utility Room
A clean utility room shall be provided. If the room is used for preparing patient care items, it shall contain a work counter and handwashing station. If the room is used only for storage and holding of clean and sterile supply materials, the work counter and handwashing station shall be permitted to be omitted. The clean utility room may be shared with an adjacent surgical unit.
1224.28.2.8 Soiled Utility Room
A soiled utility room shall be provided which shall contain a handwashing station and a clinical sink (or equivalent flushing rim fixtures). When the room is used for temporary holding or soiled materials, the clinical sink and handwashing station shall be permitted to be omitted. The soiled utility may be shared with an adjacent surgical unit.
1224.28.2.9 Housekeeping Room
Shall be a minimum floor area of 15 square feet (1.4 m2). It shall contain a service sink or floor receptor and provisions for storage of supplies and housekeeping equipment. This may be shared with an adjacent surgical unit.
1224.28.3 Freestanding Cardiac Catheterization Laboratory Service Space
A general acute care hospital referenced in Health and Safety Code Section 1255 (d)(3)(E) may provide cardiac catheterization laboratory service in a freestanding nonhospital building in conformance with this section and Section 1226.2.2. In addition, the service space shall comply with Section 1224.28.2 and applicable requirements in Section 1224.15.3 that are not covered by this section.
1224.28.3.1 Outpatient Support Areas
Outpatient support areas shall include outpatient waiting rooms in compliance with Section 1224.4.5. A separate space shall be provided where outpatients change from street clothing and are prepared for a procedure. This space shall include provisions for clothing storage, toilet room(s), sink and an area for clothing change and gowning.
1224.28.3.2 Connection to Hospital
The freestanding cardiac catheterization laboratory service space shall be located in the nonhospital building such that the service space has a direct connection to the general acute care hospital providing cardiac surgery by a patient corridor link in compliance with Section 1224.4.7. The corridor link shall have a minimum width of 8 feet (2438 mm) as required under Section 1224.4.7.1. The corridor link shall connect to the hospital corridor system with access to all basic services as required under Section 1224.4.7.5.
1224.28.3.3 Control Station
Control station(s) shall be located to permit visual observation of all traffic into the semi-restricted service space from unrestricted corridors and/or passageways.
1224.28.3.4 Essential Electrical System
Cardiac catheterization laboratories shall meet the provisions for ambulatory surgical clinics required in the California Electrical Code including the requirements of Article 517.45 for an essential electrical system.
1224.28.3.5 Services/Systems and Utilities
Services/systems and utilities that support the catheterization laboratory space include, but are not limited to: normal power; emergency power; nurse call; communication and data systems; space heating systems; cooling systems; domestic hot and cold water systems; building drain and sewer systems; and medical gas systems. When these systems serve other portions of the building, any alteration to the system shall be subject to review by the Office of Statewide Health Planning and Development.
1224.28.4 Interventional Imaging
Image-guided interventional procedures shall be performed in procedure rooms in compliance with this section. Cardiac catheterization operating rooms shall be in compliance with Section 1224.28.2, and hybrid operating rooms shall be in compliance with Section 1224.28.5.
1224.28.4.1 Space Requirements
The procedure room shall meet the space, clearance and storage requirements for the imaging equipment contained in the room and the following:
  1. A minimum clear dimension of 18 feet (5486 mm).
  2. The procedure room shall also be sized to allow a minimum clearance of 4 feet (1219 mm) on all sides of the procedure table.
1224.28.4.2 Pre-Procedure and Recovery
Pre-procedure and recovery areas shall be immediately accessible to procedure rooms and separate from corridors. The pre-procedure and recovery areas shall comply with the requirements of Section 1224.16 Anesthesia/recovery Service Space.
1224.28.4.3 Interventional MRI Facilities
Interventional and intraoperative magnetic resonance imaging (I-MRI) procedure rooms shall comply with Section 1224.28.5 Hybrid Operating Rooms.
1224.28.4.4 Control Room or Area
A control room or area shall be provided.
  1. The control room or area shall be sized to accommodate the image-recording and viewing equipment.
  2. A shielded view window permitting direct observation of the patient from the control console shall be provided.
  3. The shielded control room shall be configured to prevent radiation exposure into occupied areas of the control room when ionizing radiation modalities are used.
  4. Where the procedure room requires positive (or negative) pressure, a door shall be provided between the control room and the procedure room or between the combined control room/procedure room and other adjacent space.
  5. Where control functions for ionizing radiation exposures take place in the procedure room, storage for personal radiation protection devices shall be provided.
1224.28.4.5 Scrub Facilities
Scrub sinks shall be located outside of sterile areas. A minimum of one scrub sink station shall be provided for each interventional imaging procedure room. Scrub sinks shall have water supply controls not requiring direct contact of the hands for operation.
1224.28.4.6 Medication Station
A medication station shall be provided in compliance with the requirements in Section 1224.4.4.4.
1224.28.4.7 Reading Room
A reading room for reviewing images shall be available for use by the interventional imaging suite.
1224.28.4.8 Imaging Equipment Room
Imaging equipment room or enclosures large enough to contain x-ray transformers, power modules and associated electronics and electrical gear shall be provided. Sharing of imaging equipment rooms by multiple procedure rooms is permitted.
1224.28.4.9 Clean Utility Room
A clean utility room shall be provided in accordance with the requirements in Section 1224.4.4.6.
1224.28.4.10 Soiled Workroom
A soiled workroom shall be provided in accordance with Section 1224.4.4.7.
1224.28.4.11 Housekeeping Room
A housekeeping room shall be provided in accordance with the requirements of Section 1224.4.15.
1224.28.4.12 Staff Changing Areas
Male and female staff changing areas shall be provided and arranged to ensure a traffic pattern so that personnel can enter from an unrestricted area, change their clothing and move directly into the interventional imaging suite.
1224.28.5 Hybrid Operating Room(s)
Hybrid operating rooms shall comply with the requirements of Section 1224.15 and comply with the requirements in this section.
1224.28.5.1 Space Requirements
Each hybrid operating room shall meet the space, clearance and storage requirements for the imaging equipment contained in the room and the following:
  1. A minimum clear floor area of 650 square feet (60.39 m2) is required for a hybrid operating room unless the imaging equipment requires a larger area.
  2. The minimum clear dimension shall be 24 feet (7315 mm) unless the requirements for the specific imaging equipment require a greater distance.
  3. If mobile storage units are used in lieu of fixed cabinets, the minimum clear dimension shall be available between such units when they are parked against a permanent partition.
1224.28.5.2 Control Room
If required, a control room shall be provided that accommodates the imaging system control equipment and the following requirements:
  1. The control room shall have a minimum clear floor area of 120 square feet (11.15 m2), which may include fixed work surfaces.
  2. The room shall be physically separated from the hybrid operating rooms with walls and a door.
  3. The room shall have viewing windows that provide for a full view of the patient and the surgical team. Cameras shall be permitted to provide for full view of patient while positioned inside bore.
  4. If the control room is adjacent to a restricted area, it must be physically separated from the restricted area with walls and a door.
1224.28.5.3 Imaging Equipment Room
An imaging equipment room shall be provided for each hybrid operating room.
1224.28.5.4 Radiation Protection
If the imaging equipment emits ionizing radiation, protection shall be provided in accordance with Section 1224.18.1.1.
1224.28.5.5 Requirements for Specific Types of Hybrid Operating Rooms
1224.28.5.5.1 CT
Hybrid operating rooms with intraoperative computerized tomography (CT) systems shall have control rooms that comply with Section 1224.18.3.1.
1224.28.5.5.2 iMRI
Hybrid operating rooms with intraoperative magnetic resonance imaging (iMRI) systems shall comply with the following:
  1. Space and configuration requirements in Section 1224.18.4, except the clearances shall meet the requirements of 1224.28.5.1.
  2. The control room shall comply with Section 1224.18.4, Item 1.
  3. The anteroom shall comply with Section 1224.18.4, Item 2.
  4. Entry doors to iMRI hybrid rooms shall swing outward from inside the room.
1224.28.5.5.3 Vascular Imaging
Hybrid operating rooms with vascular imaging systems shall comply with Section 1224.28.4.
1224.28.5.6 Pre-Procedure and Recovery
Pre-procedure and recovery areas shall be immediately accessible to procedure rooms and separate from corridors. The pre-procedure and recovery areas shall comply with the requirements of Section 1224.16 (Anesthesia/recovery Service Space).
1224.28.6 Electroconvulsive Therapy
If electroconvulsive therapy (ECT) is provided, the requirements of this section shall be met. Where a psychiatric unit is part of a general acute care hospital (Section 1224.31 Psychiatric Nursing Unit), all the requirements in this section shall be permitted to be accommodated in a procedure suite that complies with the requirements in this section or in an operating room in a surgical suite that meets the requirements in Section 1224.15.
1224.28.6.1 General
The ECT procedure area may be a single procedure room or a suite of procedure rooms.
1224.28.6.2 ECT Procedure Room
  1. Space requirements. Each ECT procedure room shall have a minimum clear floor area of 200 square feet (18.6 m2) with a minimum clear dimension of 14 feet (4267 mm).
  2. Handwashing station. A handwashing station shall be provided.
  3. Documentation area. Accommodation for written or electronic documentation shall be provided.
1224.28.6.3 Pre-Procedure and Recovery Area
When ECT services have a low-volume of procedures, the ECT procedure room may be used for pre-procedure patient care and recovery. If a pre-procedure and recovery areas are provided they shall comply with the requirements of Section 1224.16.
1224.28.6.4 Emergency Equipment Storage
Space shall be provided in the procedure room(s) for storage of emergency equipment such as a CPR cart. A separate emergency equipment storage is permitted to serve more than one ECT procedure room.
1224.28.6.5 Patient Support Areas
A waiting area and changing area shall be provided for outpatient use in perioperative areas in support ECT suites that provide outpatient procedures. The waiting room shall comply with Section 1224.4.5. The changing area shall include space for changing or gowning, provisions for storing patients' belongings during the procedure and access to patient toilet(s).

Related Code Sections

1224.28.4 Interior Environment, Interventional Imaging
corridors. The pre-procedure and recovery areas shall comply with the requirements of Section 1224.16 Anesthesia/recovery Service Space ...