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Construction of a operation theatre
Dr. S. Parthasarathy MD., DA., DNB, MD (Acu), Dip. Diab. Dip. Software based statistics PhD (physio), IDRA ,FICA
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Why we need to know ? It’s the heart of any hospital construction
Civil, electrical, mechanical biomedical, electronic, biopure Combo effort
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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
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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 !!
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Four zones Protective zone: Clean zone: Sterile zone: Disposal zone:
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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.
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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
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Induction Room Sterile Link to OT complex fast Power , gas outlets
Emergency equipment Machine Separate staff
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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
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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 --
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Sterile zone The main operating area along with the scrub zones forms the sterile area
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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.
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Washing area is different from scrubbing area
The problem is disposal is back again here
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Sterile zone Elbow operated or infrared sensor operated taps / water source is ideal. It is essential to have non slippery flooring in this area.
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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
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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
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Sometimes we need such big
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Needy One table / OT X ray illumination
Electric – around 5 feet above floor Pendants – preferably two – reserve – for all Corridors - - minimum 9 feet
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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
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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
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General lighting – 500 lux On table – centre – lux Shadow less – cold Halogen better UPS adequate for OT lights, anesthesia machine - monitors
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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
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laminar air flow (LAF) plenum
20 air changes / hour 21 degrees AC 20 – 60 % humidity Positive pressure inside – 2.5 pascals
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Plenum system !!
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Traffic routes
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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
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HVAC Heating Ventilation AC
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Eye OT Cardiac OT Neuro OT Special
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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
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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.
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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
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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
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PACU
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Miscellaneous Fire alarms and equipment Phone Code blue Intercom
Reception area Catering Data management OT equipment
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basically divide Engineering based Ergonomics based Finance based
blend all for safety, comfort and manpower Esthetics ??
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Think about MGMCRI Almost fulfils all the criteria
Disposal area coming again Plan for the lift ? Execution
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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
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