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1. Isolated air handling Renovated from an existing ward within the Nebraska Medical Center's University Hospital, The Nebraska BPCU is sealed of from the rest of the hospital, and operates on its own dedicated air system. Incom- ing air is channeled via two redundant air handling units with pre-fi lters and HEPA fi lters. The HEPA-fi ltered exhaust air exits via redundant, high-plume dilution exhaust fans mounted on the roof. Light fi xtures, electrical outlets and light switches are sealed, in addition to entrance and patient room doors. Washable sub-ceilings are used for the protection of adjacent non-containment areas. Sheet vinyl fl ooring is installed with welded seams, and an antimicrobial sealant is applied to all wall and wall- to-fl oor seams. Exterior windows in the unit contain impact-resistant glass for protection against violent weather. 2. Negative pressure patient rooms Patient rooms are kept at negative pres- sure by means of specially calibrated airfl ow, which prevents contaminated air from fl owing into adjacent areas. Air is exchanged 15 times per hour. The air fl ows from "clean" to "dirty," entering at the ceiling, and exiting at the room's most infectious point, just above the fl oor at the head of the patient bed. An alarmed pres- sure monitor outside each door sounds if the room's pressure falls below a certain threshold. 3. Unidirectional throughput Staf throughput in the unit follows a clean to dirty path. The secure staf entrance leads to a clean changing room, where personal items are placed in pass-through lockers. Changing booths are provided for privacy. After passing into the vestibule, staf is prevented from returning to the changing room through the absence of a return door knob. After completing shifts, staf exits the unit via a pass-through shower, where they "shower out" into the exit room. There, they have access to the opposite side of the same pass- through lockers used when entering. Left: The staff exit is outfi tted with a pass-through shower, allowing staff to "shower out" into the exit locker room. The patient rooms in the biocontainment unit employ daylighting to provide comfort to patients. Bottom: Pass-through lockers in the biocontainment unit can be accessed from either the entrance or exit side. 15 Number of times per hour air is exchanged in a patient room at the Nebraska Biocontainment Patient Care Unit. 440 gallons Treating one Ebola patient produces eight 55 gallon drums of medical waste each day. Purifi cation of waste takes an average of 12 hours in an autoclave. Photos: Courtesy of LEO A DALY MCDM AG.COM | JA N UA RY/ F EBRUA RY 2015 | Medical Construction & Design 31