How to lay out an ICU from the bed space outwards: clearances that let an arrest team work, services at each bed, isolation provision, sightlines from the nurse station, and where a high dependency list differs.
Most intensive care units in Bangladesh are built inside a building designed for something else. Someone hands you a rectangle that used to be a general ward, a bed count that came from the board rather than the floor plan, and a budget already carved into tender lots. The unit that comes out of that usually fits the promised number of beds and then cannot be worked in, because the geometry was fixed by the bed count and the equipment specified afterwards.
It is worth reversing the order. Draw one bed space properly, with every object that will stand in it, then multiply. If the room will not take the number you promised, that is a finding you want before the tender goes out rather than after the beds arrive.
An ICU bed space is not the footprint of the bed. It is the bed at full extension, plus the equipment around it, plus the people who have to stand somewhere. Measure your own bed with the backrest raised, the side rails up and the headboard fitted, because that is larger than the catalogue footprint.
Rather than copy a clearance figure out of a foreign guidance document and hope it matches your equipment, derive the number from the longest bed you will buy, the widest trolley that has to pass it, and the width of a person carrying something. Quote that figure in the tender alongside the equipment it came from, so the next person can check your working.
Write this list per bed and multiply it, then add the shared items separately. Costing an ICU by bed count alone is how units end up with twelve beds and four IV stands.
| Item | What to specify, and why |
|---|---|
| Electric ICU bed | Backrest, knee, height, Trendelenburg and reverse, and lateral tilt if your clinical lead wants it. Ask for battery backup on at least height and backrest, so a power interruption does not leave a patient stuck in one position. The Saikang C8c, X9x and Z7z sit in this class and the D8d adds a single action CPR release. Confirm the function list on the datasheet of the model you shortlist rather than across a range. |
| Bedside cabinet | One per bed. An ABS and steel unit such as the SKS008 takes daily disinfectant without swelling. Laminated chipboard ward furniture is cheaper on the day and gone within two monsoons. |
| Overbed table and IV stand | In an ICU the SKH042 class table is a working surface for line changes rather than for meals, so height range matters more than top area. Add bed mounted pole sockets plus at least one free standing stand such as the SKH041(15) per bed, counted against your real infusion channels at peak rather than your average. |
| Suction | A wall take off point if the area is piped, plus a mobile unit available to each bay as backup. SK-EX122 and SK-EX123 are the ward mobile class. |
| Monitor and ventilator support | Decide early whether these are trolley mounted, wall mounted or on a pendant. This changes the socket layout and it is expensive to revisit later. |
| Waste and seating | A foot operated waste bin, a sharps container and one wipeable stool, each with a defined position. |
Shared items sit outside that list: emergency trolley, medicine trolley such as the SKR-MT606, transportation trolley such as the SKB041-3, a spare bed and the stores furniture. Shared items are where tender lots most often come up short, because nobody owned them.
Three services arrive at every bed: electrical, medical gas and data. In Bangladesh the electrical part deserves more attention than it usually gets, because the failure modes here are not the failure modes the equipment was designed around.
If the generator changeover gap is longer than the bed control box tolerates, the bed resets and the nursed position is lost. Find that out on commissioning day, not during a real power cut.: Vvon Technologies installation practice
Sightline is a geometry problem and it is testable before anything is built. Stand where the nurse will sit, at seated eye height, and count the patient faces and monitor screens you can see. Repeat with the privacy curtains half drawn, because that is the normal condition, and again at night with the ambient lighting down.
A large number of Bangladeshi units label one side room as isolation and consider the requirement met. The room is the smallest part of it. What makes isolation work is whether the equipment, the waste route and the airflow are dedicated.
High dependency provision is often specified as a diluted ICU, which produces either an expensive HDU or an unsafe one. Agree the split below with your clinical lead before it goes into a tender, because it depends on what your intensivists intend to do in each area.
| Aspect | Intensive care | High dependency |
|---|---|---|
| Bed | Full function electric bed with CPR release and a radiolucent section, since chest films are taken in situ | Electric bed with backrest, knee and height is normally sufficient; the Y8t multifunctional class fits this role |
| Ventilation | Invasive ventilation per bed, plus at least one spare machine per unit | Usually non invasive only; plan oxygen delivery and humidification rather than a ventilator per bed |
| Monitoring | Invasive pressure capable, networked to a central station | Continuous ECG and oximetry with non invasive pressure is the usual baseline |
| Sightline | Direct line of sight to every bed from the nursing position | Sightline still matters, but larger bays and longer sight distances are workable |
| Attendant provision | Restricted, and usually outside the unit | A seat per bed is realistic and should be in the furniture schedule from the start |
Commissioning is the last point at which a supplier will fix something without an argument about who pays. Treat the day as a test schedule with signatures, not a demonstration.