es, so will the pressure required. The inverse of this is the same as patients coming off the ventilators and Airvos - they will need to reduce the pressure back down to normal usage. It becomes a balanc- ing act as bed counts climb and fall along with specific treatments. Architects also got into the mix by developing different scenarios to handle the increased demand for bed space. One of the latest con- cepts - converting one room into an anteroom - works well for treating multiple patients without going in and out of each patient room. This concept is geared more for larger intensive care unit patient rooms. With patient bathrooms in ICUs being considered nonessential in the future, it leaves room for doorways from room to room. When the layout in Figure 2 shows up on your drawing board (computer screen) in the future, your medi- cal gas requirements will likely be handled through a medical gas boom or an articulating arm. We need to make sure we request the architect or health-care planner to require larger medical gas hoses inside these booms to handle an increased flow rate. Yes, your restriction will now be down to the pigtail for the med gas outlet/inlet. As design guides are modified and updated with pandemics in mind, the tables provided here will help in the short term. Part II will dive deeper into how we can retrofit existing facilities and design new facilities from now on. We will also walk through other possibilities, such as emergency pre- paredness with portables. % John Gregory has nearly 35 years of experience in medical gas system design and inspection, process pip- ing, plumbing and fire protection system design for multiple business classes. He is a certified medical gas inspector, NITC 6020. John serves on the NFPA 99 Technical Committee for piping and instal- lation, and he is a co-chair of the P.I.P.E. Medical Gas Committee in Arizona. Email John at john.grego- ry@hendersonengineers.com.

32/Plumbing Engineer March 2021

Figure 1. The Airvo 2 humidified nasal high flow system. Photo credit: Fisher & Paykel Healthcare

Collaborative Health Care Design