1. Construction of a operation theatre
Dr. S. Parthasarathy
MD., DA., DNB, MD (Acu),
Dip. Diab. Dip. Software based statistics
PhD (physio), IDRA ,FICA

2. Why we need to know ? It’s the heart of any hospital construction
Civil, electrical, mechanical biomedical, electronic, biopure
Combo effort

3. Purpose of operation theatre complex--- what should be in the mind ??
Therapeutic, investigative and palliative procedures, of varying degrees of invasiveness--
Cater the needs – present and future
Quality and quantity

4. Location Big crowd access ?? Not in ground floor – preferably !!
First floor
Access to post operative wards
Through OT Cant cross to other wards !
Maximal benefit with minimal space !!

5. Four zones
Protective zone:
Clean zone:
Sterile zone:
Disposal zone:

6. Protective zone !! This consists of the change rooms, preop area
transfer bay,
staffrooms,
stores and records,
recovery beds
I.C.U. and P.A.C.U.

7. Pre op maintaining privacy, For changing from street clothes to gown
to provide lockers and lavatories for staff
IV line
Ryle’s tube
Oxygen, suction , CPR

8. Induction Room Sterile Link to OT complex fast Power , gas outlets
Emergency equipment
Machine
Separate staff

9. Staff facilities !!
One wash basin and one western closet (WC) should be provided for 8-10 persons.
Showers ??
Toilet inclusion in changing room ?
Lockers
TV – OK

10. Clean zone
This intermediate zone is located between the protective and the sterile zone.
This houses the sterilization area,
sterile disposables storing area
Closed circuit TV
Kitchenette
Lab with pathologist place..
Seminar room --

11. Sterile zone
The main operating area along with the scrub zones forms the sterile area

12. Disposal zone
All unsterile items from the OR should come out through a separate exit which leads to the disposal area directly.
Sterile and unsterile items should not use the same entrance.

13. Washing area is different from scrubbing area
The problem is disposal
is back again here

14. Sterile zone
Elbow operated or infrared sensor operated taps / water source is ideal.
It is essential to have non slippery flooring in this area.

15. Theatre size 6.5 metres * 6.5 metres * 3.5 metres
Approx 21 feet *21 feet * 10 feet
5 feet sliding doors – No air currents
Surface – slip resistant , flush – no big grooves
Epoxy paint walls
Flush outlets - protruding trays from walls - NO
Soothing Blue paint

16. Floor Smooth but non slippery
jointless conductive tiles/ terrazzo, linoleum
The recommended minimum conductivity is 1m ohm and maximum 10m Ohms.
Presently the need for antistatic flooring has diminished as flammable anaesthetic agents are no longer in common use

17. Sometimes we need such big

18. Needy One table / OT X ray illumination
Electric – around 5 feet above floor
Pendants – preferably two – reserve – for all
Corridors - - minimum 9 feet

19. What is a pendant ?? oxygen, nitrous oxide,
four bar pressure medical compressed air
For what ??
medical vacuum,
Scavenging terminal outlets
At least four electric sockets
Electric safety – separate topic

20. How may OTs 750 bedded hospital 375 is surgical – 375/10
Approx 38 surgeries / day
For each 150 – one OT complex
2 OT complexes with 10 each is ideal !!
Endoscopy , mini and septic may be different

21. General lighting – 500 lux
On table – centre – lux
Shadow less – cold
Halogen better
UPS adequate for OT lights, anesthesia machine - monitors

22. Air handling in the OT including air Quality:
Air is supplied through Terminal HEPA (High-efficiency particulate air) filters in the ceiling .
The minimum size of the filtration area should extend one feet on each side of the OT table to cover the entire OT table and surgical team

23. laminar air flow (LAF) plenum
20 air changes / hour
21 degrees AC
20 – 60 % humidity
Positive pressure inside – 2.5 pascals

24. Plenum system !!

26. Traffic routes

27. Why do we need AC?
Cool temperature – less growth of bacteria and viruses .
Less condensation
Less sweat of staff.
It decreases the heat effects of OT lights

28. HVAC
Heating
Ventilation AC

29. Eye OT
Cardiac OT
Neuro OT
Special

30. Laminar flow – orthopedics
Laminar flow ventilation comprises a continuous flow of highly filtered ultraclean air (UCA) of less than 10 colony-forming units per metre - uniform velocity - single direction - - parallel flow
300 flow changes
Particles are also less
Horizontal or vertical

31. The AHU has three chambers
first chamber has provision or fresh air inlet and returns air inlet.
The air passes through a set of 5 μ filters into the second chamber
it is cooled by the condenser coils and blown by an air blower at a desired pressure through a set of 3 μ filters into the third chamber.
The cooled, filtered air now passes through a thermo insulated aluminum air ducts into the terminal LAF plenum inside the OR, which houses a 0.3 μ filter.

32. We should remember Air take from outside
First filter – may be upto 10 mic
Passes through air conditioner – upto 5 mic.
HEPA filter – 0.3 mic.
O separate AC and hepa

33. Post anaesthetic care units (PACU)
Recovery room adjacent
medication station,
hand washing station, nurse station,
storage space for stretchers,
monitors
equipment
gas, suction outlets and ventilator.
80 sq. feet for each patient
5 feet between beds
4 feet between wall

34. PACU

35. Miscellaneous Fire alarms and equipment Phone Code blue Intercom
Reception area
Catering
Data management
OT equipment

36. basically divide Engineering based Ergonomics based Finance based
blend all for safety, comfort and manpower
Esthetics ??

37. Think about MGMCRI Almost fulfils all the criteria
Disposal area coming again
Plan for the lift
? Execution

38. Some of the images are taken from the internet for academic use only
Summary
Four zones
Number of OT s
How many OTs
Size of OTs
Air flow
PACU
Thank you all
Some of the images are taken from the internet for academic use only
Non commercial