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Who determines "self-preservation"?

Sleepy

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The four person limit isn't a concern. They will be classified as an ambulatory care facility by IBC definition even if they only have one at a time. The provision for separated construction kicks in after four people, but even if under four the classification remains. There are several issues with the proposed design, but they all fall in line behind the requirement for fire suppression in IBC 422.6.

Note that 422.6 (IBC 2012) refers to 903.2.2 which only requires the sprinklers if there are four or more incapable of self-preservation, or one or more on any floor other than the level of exit discharge. And the sprinkler system is not required throughout the whole building.
 

cda

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Not near NFPA 101

It may give some guidance


If they cannot get up readily and walk out,,


You might be sedated
 

Sifu

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Note that 422.6 (IBC 2012) refers to 903.2.2 which only requires the sprinklers if there are four or more incapable of self-preservation, or one or more on any floor other than the level of exit discharge. And the sprinkler system is not required throughout the whole building.

The proposed design is on the second floor of the 2 story building. That would require sprinklers no matter the number of care recipients, and include the floor below. So the entire building will end up being suppressed.

As for the rhetorical question about doing the architects job. It was rhetorical since I know if they can't get there themselves I have to help them. I guess I naively believe they should be able to get there themselves.
 

ADAguy

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"never" assume Sifu; your license is similar to a noose, the court is the gallows (smiling).
Did you ever ask your E & O carrier for an opinion?
 

ADAguy

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The code does not cover every contingency.
Never has, never will.
Not intended to.
That's where the debate comes in on Knowledge vs Wisdom
Knowledge
is about facts and ideas that we acquire through study, research, investigation, observation, or experience. Wisdom is the ability to discern and judge which aspects of that knowledge are true, right, lasting, and applicable.

Nice comment MH, gets into the realm of Best Practice.
 

Sifu

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Boss got the call from the lawyer today. They (plastic surgeon) now want to say they don't sedate people. If boss wants to accept a revised letter, that contradicts the first letter, it is on him.
 

sergoodo

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The general consensus is that the threshold for a patient who is "incapable of self preservation" is the patient that cannot breath without assistance.
 

cda

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The general consensus is that the threshold for a patient who is "incapable of self preservation" is the patient that cannot breath without assistance.


a person can be sedated, but still breath on their own, but not be able to move
 

Sifu

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The issue here is I have a DP and owner/operator who initially used words like sedated, 30-minute recovery and who use terms like under the direct care of while sedated, that after I said they sounded like they were incapable of self-preservation are disputing the finding. Out of my hands now, bosses and lawyers can hash it out. I made my observation, erred on the side of caution.
 

sergoodo

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The Joint Commission/NFPA® Life Safety Book for Health Care Organizations
http://www.jcrinc.com/assets/1/14/LSG13_Sample_Pages.pdf
“Incapable of self-preservation” means that the individual would not be able to get out of a building by him- or herself in case of fire.

NOT just "...cannot breath without assistance....?

Yes, of course 'NOT'. Should of clarified the consensus is general for patients undergoing 'in office' procedure sedated by anesthesiologist . The same anesthesiologist who in a moment can un-sedate the individual to wide awake state to get out of the building. Anesthesiologist can also 'amp up' the said individual enough to run out of the building...then around the block a few times.

This type sedation is typical for plastic, colorectal, etc surgeons with procedure rooms in their offices, just not the prettiest ambulatory self preservation everyone envisions.
 

Mark K

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This is a situation where the criteria and terminology in the code should be established by the medical experts.
 

tmurray

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Yes, of course 'NOT'. Should of clarified the consensus is general for patients undergoing 'in office' procedure sedated by anesthesiologist . The same anesthesiologist who in a moment can un-sedate the individual to wide awake state to get out of the building. Anesthesiologist can also 'amp up' the said individual enough to run out of the building...then around the block a few times.

This type sedation is typical for plastic, colorectal, etc surgeons with procedure rooms in their offices, just not the prettiest ambulatory self preservation everyone envisions.
That sure sounds like that person is incapable of self-preservation and needs assistance to me.
 

mtlogcabin

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This is a situation where the criteria and terminology in the code should be established by the medical experts.
I disagree and believe the definition is clear enough for the building code application and purposes. A simpler solution might be to require ambulatory care facilities to provide a list and description of the medical treatments provided similar to a fire suppression systems requirement for a list of commodities within a building so a proper design can be done. Then if the TV cameras ever show up at your office after an event asking how come you allowed this you will have a documented answer.
We need to be diligent and thorough when doing plan reviews, however we can't just call them liars when we believe we are being mislead down a certain path because an owner/designer wants follow their vision or path.

[BG] INCAPABLE OF SELF-PRESERVATION. Persons who, because of age, physical limitations, mental limitations, chemical dependency or medical treatment, cannot respond as an individual to an emergency situation.
 

Tim Mailloux

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as someone who recently had his wisdom teeth removed and was under some form of mild sedation during the procedure, there is no way in hell I was capable of self preservation. Even after I was awake and walking under my own power I had no clue what was going on or where I was.

You should ask the doctor if he requires his patients under going a procedure to have someone there with them to drive them home. That will tell you a lot.
 

my250r11

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as someone who recently had his wisdom teeth removed and was under some form of mild sedation during the procedure, there is no way in hell I was capable of self preservation. Even after I was awake and walking under my own power I had no clue what was going on or where I was.

You should ask the doctor if he requires his patients under going a procedure to have someone there with them to drive them home. That will tell you a lot.

ALWAYS SEEMS THEY MAKE THEM GO OUT THE BACK SO OTHER PATIENTS DON'T SEE THEM ALL DRUGGED UP!!
 

ADAguy

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Good discussion, IN CA clinics are not required to be reviewed by OSHPD (local BD can do so), an arch can submit plans but they better know what they are doing.
 
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