Architectural and space-planning solutions

The emergency department is a department of the polyclinic and serves the area assigned to it. The designed building of the ambulance department is adjacent to the eastern wall of the polyclinic, has an L-shaped configuration in plan, in combination with the polyclinic forming a figure in the form of the letter "P" in the plan. The maximum height of the building from ground level to the top of the parapet of the stairwell is 14,775 m. The project documentation takes into account the partial redevelopment of the existing polyclinic building in the area adjacent to the emergency department. The emergency department is a specialized institution for the provision of out-of-hospital and out-of-clinic care. The main tasks of the institution: the provision of emergency medical care at the scene and emergency transportation to hospitals. To provide emergency assistance to patients who applied directly to the station, the design documentation provides for a group of medical facilities. The ambulance department is designed for eight mobile teams. The building is planned to form an integral volume with the existing polyclinic, forming a single healthcare institution with a comprehensive system of public services. The emergency department compositionally consists of two parts, different in height and dimensions in plan. The first part is the main larger three-storey volume with a basement in axes 1-5, A-Zh. The second part serves an auxiliary purpose - it is a one-story volume above the built-in open-type car park for company cars in axes 5-8, A-D. The building of the ambulance department is functionally integrated with the existing polyclinic building on three levels, starting from the ground floor. Basement - no functional connection with the clinic. Planning scheme - corridor. The emergency department includes: premises of the operational unit - first floor; premises of the medical unit - first floor; service, household premises - the second and third floors; premises of the transport part - first floor; auxiliary and storage rooms - basement. This arrangement of premises according to function is due to the technological processes of the emergency department. The conference hall is provided on the third floor. In the building of the ambulance department, two evacuation stairwells of type L1 are provided. In order to communicate the emergency department with the building of the polyclinic, the heights of its floors correspond to the heights of the floors of the polyclinic (3,3 m). The block of premises for the departure of teams is located next to the transport part and is directly connected with the parking lot. The block of premises for the departure of brigades of the ambulance department includes the premises of the control room, the room for filling out documents, the office of the senior shift doctor, the room for completing and storing the property of mobile brigades, the premises for drying clothes and washing stretchers, etc. Departure of ambulances is visually controlled from the control room window. Maintenance of cars is provided at a specialized base of sanitary vehicles. Facade decoration includes artificial stone and facing bricks. The pits are lined with artificial stone. In the area where the ambulance department (an extension) adjoins the polyclinic, the following work is planned: in the basement - dismantling windows with laying window openings; on the first, second and third floors - dismantling windows and laying part of the window openings with the organization of a doorway openings on each floor, dismantling existing partitions and erecting new ones, installing fire doors, decorating the premises of the polyclinic in the adjoining area and replacing the existing windows on the fourth floor of the polyclinic in the extension area of ​​the ambulance department with fire doors. Roll-up roofing is designed in the building of the ambulance department. The cover is flat, combined, with organized external drains. Windows - two-chamber double-glazed windows in a metal-plastic profile. On the ground floor, in all window openings facing the street, the installation of roller blinds with perforated slats is provided from the outside. The basement windows are equipped with bars that open outwards. External doors - metal, insulated. Doors in the technical rooms, pantries, the room for completing the packing of mobile teams and in the storage rooms for medicines and between the polyclinic building and the ambulance department are fireproof. For access to the first floor, to the premises for the temporary stay of sick people with disabilities in wheelchairs, the design documentation provides for: a ramp with a slope of 8% at the entrance area, the installation of a pneumatic lift on the flight of stairs and the device of a special bathroom with standard dimensions for use by people with disabilities in wheelchairs.

Structural and space-planning solutions

The level of responsibility of the building is II, normal. The building was designed according to a mixed structural scheme, divided by a sedimentary joint into two parts and separated from the existing polyclinic building by a sedimentary joint. Part of the building with a basement is designed according to the longitudinal-wall design scheme. The basement walls are designed from prefabricated concrete blocks. The thickness of the outer walls of the basement is 600 mm, the inner 500 mm and 300 mm. External load-bearing walls are two-layer, made of large-format stones M100, F 35 510 mm thick and facing bricks M100, F 35 120 mm thick on mortar M50. Internal load-bearing walls - from solid ceramic bricks M100, F35 on a solution of M 50, 380 and 250 mm thick. Floor slabs are prefabricated reinforced concrete with a thickness of 220 mm, monolithic reinforced concrete sections made of concrete of B25 strength class. Coating slabs - prefabricated multi-hollow pre-stressed bench formless molding with a thickness of 400 mm, according to the catalog of OAO PO Barrikada. Flights of stairs are designed from prefabricated reinforced concrete steps on metal stringers, landings - from monolithic reinforced concrete. The spatial rigidity and stability of the building is ensured by the closed configuration of the building, a system of longitudinal and transverse walls connected by floor disks. The structural scheme of the part of the building without a basement is combined. The first floor is designed according to the frame scheme, the second floor - according to the longitudinal-wall structural scheme. The frame is a single spatial system consisting of columns with a section of 400 x 400 mm, beams with a section of 400 x 600 (H) mm and ceilings with a thickness of 200 mm, designed from monolithic reinforced concrete of class B25, F50. Second floor walls: external load-bearing walls - two-layer, from large-format stones M 100, F 35 510 mm thick and facing bricks M 100, F 35 120 mm thick on mortar M 50; internal load-bearing walls - from solid ceramic bricks M100, F35 on mortar M 50, 380 mm thick. Cover slabs - prefabricated reinforced concrete with a thickness of 220 mm, monolithic sections - from concrete of B25 strength class. The spatial rigidity and stability of the building is ensured by the joint work of the vertical load-bearing elements of the building with floor and roof disks. The load-bearing structures were calculated using the SCAD 11.1 software package, taking into account the joint work of the building with the foundation. The relative mark of 0,000 corresponds to the absolute mark of 14.19. Foundations - pile. Piles - bored monolithic reinforced concrete with a diameter of 400 mm, a length of 14,7 m, concrete B25, W4, F50, arranged using retrievable casing pipes or using the technology of piling with short through augers. The design load on the pile is assumed to be 44 tf on the basis of the calculation and will be verified by static tests before mass production of piles. Grillages for walls are taken as strip grillages, for columns - columnar grillages 600 mm high, united by a foundation slab 250 mm thick made of monolithic reinforced concrete of class B25, W4, F50. Pairing of piles and grillage is rigid. Under the grillages, concrete preparation is provided from concrete of class B7,5 with a thickness of 100 mm. In accordance with the report on engineering and geological surveys, the bottom of the pile is immersed in the EGE-5 soil - light silty hard clays with semi-hard interlayers, E=130 kg/cm2, IL=-0,02, e=0,662. The expected settlement of the building is 2,0 cm. The existing buildings of a polyclinic, a residential building, a transformer substation, a workshop and a private garage fall into the 30-meter zone of influence of the construction. Visual inspection, photographic fixation of defects, examination of the foundations of adjacent buildings were completed. All buildings are assigned to the second category of technical condition of structures. In the adjoining area in the existing building of the polyclinic, it is provided: repair and restoration work to eliminate defects in load-bearing and enclosing structures in accordance with the recommendations set out in the technical report on the inspection of structures; laying openings with bricks and arranging doorways instead of window openings in the boundary wall; the device of partitions from a brick 120 mm thick. The assessment of the impact of construction on the existing polyclinic building was carried out using the Plaxis software package. Additional precipitation of the adjoining building and buildings of the surrounding buildings do not exceed the maximum allowable values. To reduce the negative impact of construction, it is planned to install a non-removable sheet pile wall made of secant bored piles with a diameter of 300 mm and a length of 9,3 m, made of concrete B25, F50, W4 with EGE 4 immersion in the ground and a 5 m high Larsen L-IV sheet pile fencing. The design documentation provides for geotechnical control of the surrounding buildings during construction and installation works.