醫院之安全避難手法探討-以建立安全據點與加壓防煙為例

醫院因內部使用型態及使用者的種類與一般建築物不同，所以在防災計畫及避難上有所差異。經由文獻分析得知醫院規劃避難時必須考量「圍城區劃」，又因為避難者無法自行垂直避難，故需要據點來等待救援。除了安全據點的重要性醫療院所內護理站也扮演著重要角色。又藉由日本文獻得知，利用加壓防煙的手法，火災當時除了火災室以外的病患也能實行就地避難，原因是為了避難時需要電子醫療機器的病患能維持生命，在中型走廊1護理單位的病房樓利用加壓防煙達成遮煙達成。本研究將以探討安全據點及加壓手法相關課題，研究目的如下: 一、建立安全據點的空間規模尺寸與鄰接之空間邊界條件。二、瞭解護理站危險因子種類及問題點。三、依文獻分析及現況調查比較安全據點、加壓防煙之間適用性。本研究選定台北市醫學中心與區域醫院共五間醫院做為案例，進行安全據點、護理站危險因子的現況調查分析，並利用日本文獻公式計算加壓防煙時的給氣量。經由歸納分析後得知以下研究成果: 一、透過現況分析歸納出三種安全據點尺寸及邊界條件的重要性 (一)、三種安全據點尺寸分別為甲安全據點: 17m x 3m、乙安全據點: 28m x 3m 、丙安全據點: 6m x 10m。 (二)、邊界條件依安全性能影響由差至優順序分別為：護理站、設施空間、管道空間、走道、廁所、外氣。二、透過現況分析發現護理站危險因子及問題點多護理站與走廊均未區劃且部分醫院醫療車隨意放置阻擋逃生動線，護理站內部均有木製上下櫃、電器設備及可燃物多，其型態類似小型辦公室發熱量以辦公室560 MJ/m2作為表示。三、安全據點與加壓防煙適合情況經由歸納分析後得知安全據點適合一般病房可自行避難者使用，可快速明確到達據點進行避難；加壓防煙適合特殊病房，因無法自行避難並且需使用呼吸系統無法移動，使用加壓防煙進行就地避難。

關鍵字

避難；安全據點；加壓防煙；醫院；避難弱者

並列摘要

The interior ultalization and user types between hospital and the normal buildings are different,so they will have different disaster prevention plan and evacuation. According to the analysis of literature, when organize the evacuation,it is “the besieged zone plan”that needs to put into consideration.Moreover,because the refugees in hospital cannot evacuate verhically on their own, they need a safety stronghold to wait for the rescue.Other than the importance of safety stronghold, the interior nursing station also plays an important role in it. In the Japanese literatures, we also found that using the method of positive pressure and anti-smoke system while on fire can help not only patients out of the fire zone refuge in where they are, but the patients who are kept alive by machines can survive by creating the smoke to cover the ward buidling located in the nuring units on the medium-sized hallway one. The research will investigate the texts relate to safety stronghold and the method of positive pressure and anti-smoke system and has the following purposes: I. Establish the size of space scale and boundary condition of adjacency space for safety stronghold. II. Find out the problems and the type of dangerous factor of nursing station. III. Compare and Contrast the safety stronghold based on the literature analysis, survey, the applicability between positive pressure and anti-smoke systems. We take five hospitals such as Medical Center in Taipei and regional hospitals as the case studies to conduct the survey of dangerous factors of safety stronghold and nursing station and to apply the equation in the Japanese literature to calculate the air input of positive pressure. After the integration and analysis, we have the following results: I. Through the analysis, we conclude three significances in the size and boundary condition of safety stronghold. (A) Three kinds of safety stronghold sizes, which are A safety stronghold size: 17m x 3m, B safety stronghold size: 28m x 3m, C safety stronghold size: 6m x 10m (B) The sequences of boundary condition in accordance with the impact of safety performance from worst to best are nursing station, facility space, channel space, hallway, restroom and external air. II. Through the analysis, we found that there are many dangerous factors and problems in the nursing station. We have no division in the nursing station, and most medical service cars block the escape route because they place at random. There are wood high and low cabinets and many electrical device and combustible material in the nursing station. The heating value of this type is similar to that of small office, that is to say, office fire load 560 MJ/m2. III. The suitable condition of safety stronghold and a positive pressure and anti-smoke System After the integration and analysis, we conclude that a safety stronghold is used for patients in the patient room that can go to stronghold on their own, while a positive pressure and anti-smoke system is used for the patients in the special room who keep alive by machine and can’t escape on their own so need to refuge in where they are by a positive pressure and anti-smoke system.