Room Pressure Guidelines in Healthcare

Hospitals and outpatient facilities serve a critical need in global communities. They provide emergency
care for the sick, but we also rely on them as a safe zone for treating communicable diseases and
keeping the public safe. Pressurized rooms in these special buildings are designed to contain dangerous
airborne contaminants, such as tuberculosis, aspergillus, and vaporized cough. When properly
pressurized, these rooms protect the most vulnerable patients, and allow healthcare staff to safely treat
highly infectious conditions.

When designing or renovating healthcare facilities, mechanical system designers must adhere to
national codes and standards, plus local guidelines. For hospitals and outpatient facilities, the principle
guideline of reference in HVAC is ASHRAE Standard 170. The rooms that are most commonly thought of
as critical spaces to pressurize are operating rooms (positive pressure) and isolation rooms (negative
pressure). However, Table 7.1 in this ASHRAE standard outlines that there are 60 types of rooms that
require pressurization to meet minimum guidelines for patient and staff safety. Even waiting rooms,
physical therapy, and some clean storage areas are pressurized today. Codes and standards continually
evolve as research reveals new pathways for airborne contaminants.

In most healthcare room pressure applications, the minimum requirement is for directional airflow to be
at ±0.01” WC. The guidelines provide this number to ensure compliance can be met by all. But in best
practices, real-world pressures typically run between ±0.02” WC to ±0.03” WC to compensate for sub-
optimal HVAC system operation. Isolation rooms, operating rooms, and pharmacies that do Compound
Sterile Preparations (CSP) are required to have a room pressure monitor to provide a “visual means” to
verify differential pressure. Other rooms require accurate sensors to reliably and repeatedly measure
space pressure.