FGI Emergency Department Requirements: Room Sizes, Trauma Clearances, and Decontamination (2010 Edition)

250 square feet. That is the minimum clear floor area of a trauma/resuscitation room in a hospital emergency department under the FGI 2010 Guidelines §2.2-3.1.3.6(6)(a)(i), with a minimum clear dimension of 5 ft to any permanently fixed object around all sides of the stretcher. This article states the room sizes, clearances, decontamination room and ventilation rates of the 2010 edition, and nothing from the earlier 2006 edition.

Which FGI edition applies to your project?

Every value here is from the 2010 FGI Guidelines for Design and Construction of Health Care Facilities, including the ASHRAE/ASHE 170-2008 ventilation table printed in it as Part 6. That is not the current edition. The FGI 2026 edition has been released (fgicodes.org: “2026 Edition is Here!”), and states adopt different editions (2014, 2018, 2022, 2026). Areas, clearances and ventilation tables can change between editions; the 2010 edition itself changed several 2006 values. Ask the authority having jurisdiction (AHJ) which edition and which ASHRAE 170 version is adopted and check every number below against it before submitting drawings.

What do the FGI 2010 ED room size minimums look like at a glance?

Areas are clear floor areas. All values are in binding text (“shall”).

What are the minimum treatment room sizes for a hospital ED?

Single-bed treatment rooms follow §2.1-3.2.1, so each has a minimum clear floor area of 120 sq ft (11.15 m²) (§2.1-3.2.1.1), and in renovation every effort is made to meet it, with 100 sq ft (9.29 m²) permitted where that is not possible (§2.2-3.1.3.6(2)(a)). Each treatment room contains an examination light, a hand-washing station, storage for supplies, and writing space (§2.1-3.2.1.3), plus a work counter, a cabinet, space for medical equipment, and a vision panel designed for patient visual privacy adjacent to or in the door (§2.2-3.1.3.6(2)(b)). Rooms used for pelvic exams allow the foot of the table to face away from the door (§2.2-3.1.3.6(1)(b)).

In multiple-bed areas cubicles are at least 80 sq ft (7.43 m²) each and are separated by curtains (§2.1-3.2.2.1; §2.2-3.1.3.6(3)(a)). A hand-washing station is provided for each three or fewer treatment cubicles and each major fraction thereof (§2.2-3.1.3.6(3)(c); §2.1-3.2.2.3). Combining cubicles to accommodate bariatric patients is permitted ((3)(b)). Patient toilet rooms: at least one per eight treatment rooms or fewer and each fraction thereof, with hand-washing stations (§2.2-3.1.3.7). At least one AII room is included in each initial and each definitive emergency care service, with more or protective environment rooms set by an ICRA (§2.2-3.1.4.2).

How much space does a trauma room require, and what about bariatric patients?

Each trauma/resuscitation room has a minimum clear floor area of 250 sq ft (23.23 m²) and a minimum clear dimension of 5 ft (1.52 m) to any permanently fixed object around all sides of the stretcher (§2.2-3.1.3.6(6)(a)(i)-(ii)). Cubicles added for more than one patient meet the same 5 ft clearance ((6)(a)(iii)). Doorways leading from the ambulance entrance to the trauma/resuscitation room have a minimum clear dimension of 6 ft (1.83 m) to accommodate stretchers, equipment and personnel at the same time, and the size of regional EMS gurneys and equipment is incorporated into the design ((6)(e)). In renovation, if the AHJ approves deviation from the square-foot standard, the doorway may be 4 ft (1.22 m) ((6)(f)).

The room contains cabinets, emergency supply shelves, x-ray film illuminators and/or PACS, examination lights and counter space for writing or electronic documentation ((6)(b)); provisions for patient monitoring ((6)(c)); and supply storage for immediate access to personal protective equipment ((6)(d)). Scrub stations are in or adjacent and convenient to each trauma and/or orthopedic room (§2.2-3.1.6.5).

All emergency centers provide a bariatric treatment room of at least 200 sq ft (18.58 m²) with a minimum clear dimension of 12 ft (3.66 m) (§2.2-3.1.3.6(5)(a)). It has a minimum clear dimension of 5 ft on both sides and at the foot of the table or bed ((5)(c)); a lift (overhead or portable) designed for not less than 800 lb ((5)(d)); floor-mounted furniture, fixtures and casework or items designed for 1,000 lb ((5)(e)); and, where a portable lift is used, 35 sq ft of storage per bariatric treatment bed, or 25.2 sq ft with a ceiling lift ((5)(f)). Doorways, corridors and elevators used to reach it have a clear width of at least 3 ft 8 in (1.12 m) ((5)(g)).

What does the decontamination room requirement include?

In new construction FGI 2010 §2.2-3.1.3.6(9) requires a decontamination room with an outside entry door located as far as practical, but no less than 10 ft (3.05 m), from the closest other entrance. The internal door opens into an ED corridor, swings into the room and is lockable against ingress from the corridor. The room has a minimum clear floor area of 80 sq ft (7.43 m²); smooth, nonporous, scrubbable, nonadsorptive, nonperforated surfaces; a floor self-coving to 6 inches (15.24 cm); two hand-held shower heads with temperature controls and a floor drain, with a dedicated holding tank if required by local authorities; acid-resistant fixtures; and portable or hard-piped oxygen, with portable suction available. The section does not preclude decontamination capability at other locations or entrances immediately adjacent to the department ((9)(e)).

Appendix A2.2-3.1.3.6(9) is advisory. For an exterior decontamination area it suggests ideally 150 ft (45.72 m) from the ambulance entrance, no less than 30 ft (9.14 m) where site constraints require; for a decontamination room within the facility it describes a separate secured external entrance adjacent to the ambulance entrance but at least 30 ft away, and spatial requirements and support of a standard emergency area AII room, with air exhausted externally and separately from the hospital system.

How does ventilation work in an emergency department?

These rates are from ASHRAE/ASHE 170-2008 Table 7-1, printed as Part 6 of FGI 2010. Later ASHRAE 170 versions have different tables.

Triage is the point of entry and assessment for patients with undiagnosed and untreated airborne infections; it is designed and ventilated to reduce exposure of staff, patients and families, with requirements in Part 6 (§2.2-3.1.3.3(3)(b)). If the hospital ICRA requires it, the ED waiting area gets special measures against airborne transmission, which may include enhanced general ventilation and air disinfection (§2.2-3.1.3.4(2)).

What does an ED observation unit and secure holding room require?

Where the functional program calls for an observation unit for patients requiring observation up to 23 hours, FGI 2010 §2.2-3.1.4.3 sets: a patient cubicle of at least 100 sq ft, or 120 sq ft if a patient room is used; bedside space for visitors; visual privacy; a centralized nurse station; one hand-washing station per four or fewer observation cubicles and each major fraction; one toilet room per eight or fewer cubicles and each major fraction; one shower room per sixteen treatment cubicles or major fraction (it may be combined with the toilet room); a nourishment area; supply storage; and x-ray illuminators and/or PACS.

A secure holding room, when required by the functional program, is at least 60 sq ft (5.57 m²) with wall lengths of 7 to 11 ft and a ceiling height of at least 9 ft; has tamper-resistant finishes, light fixtures, vents and sprinklers; no electrical outlets, medical gas outlets or similar devices; no sharp corners, edges or protrusions, and walls free of objects; outward-swinging doors with hardware on the exterior side only and a door width of at least 44 inches; and a small impact-resistant view panel in the door (§2.2-3.1.4.4).

Which errors should you check for in ED drawings?

1. Using renovation values on new construction. 100 sq ft treatment rooms and 4 ft trauma doorways apply only where the AHJ accepts renovation relief.
2. Carrying an older trauma doorway or clearance. The 2010 text has a 6 ft doorway from the ambulance entrance and 5 ft clear around the stretcher; check the adopted edition for both.
3. One hand-washing station per four cubicles. The 2010 text in treatment areas is one per three or fewer cubicles and major fraction (observation units are four).
4. Omitting the decontamination room or placing its door too close to another entrance. Outside door at least 10 ft from the closest other entrance.
5. Omitting the bariatric treatment room. 200 sq ft, 12 ft clear dimension, with lift and 5 ft clearances.
6. Setting triage ventilation to positive pressure. Triage is negative with 12 total ACH in ASHRAE 170-2008; the trauma room is the positive-pressure space.
7. Skipping the edition check.