Biomedical Engineering Reference
In-Depth Information
and the scavenging of waste gases from the anesthesia
machine breathing circuit. A health care facility must
have two suction pumps, each individually capable of
handling the overall demand.
The size of the operating suite should reflect the space
required by the patient, staff, and equipment to carry out
the surgical procedure. The standard surgical suite is at
least 400 square feet. Surgical suites that require spe-
cialized equipment or additional personnel can be sig-
nificantly larger. It is important to provide space so that
sensitive medical equipment is not positioned in high-
traffic areas. The shape of an operating suite can take on
a variety of forms, (e.g., square, rectangular, round, or
oval), depending on design preferences and overall OR
layout.
The surgical table is typically oriented in the center of
the room, with the surgeons positioned along the side of
the patient. The scrub nurse is positioned in an area
where both the instrument table and the surgeon's
outstretched hand are within reach. The anesthesiologist
and anesthesia equipment are generally located at the
head end of the table. This allows the anesthesiologist to
have access to the patient's airway. The anesthesia
equipment also must be positioned near medical gas,
vacuum, and power outlets that can be located on a wall
or column. Other devices, such as defibrillators, elec-
trosurgical units, video towers, and bypass machines, are
located further outside the surgical field. Figure 4.3-3
shows a typical layout of an OR.
The surgical suite also must provide accommodations
for storage. Commonly, cabinets, shelving, and carts will
line the walls of a surgical suite. In addition, surgical
suites are usually equipped with communication equip-
ment. Computer, intercom, and telephone access are
standard in modern surgical suite layouts.
Lighting
Lighting is an essential utility in a health care facility. The
OR requires special attention to lighting because of the
small-scale delicate tasks that must be performed. Al-
though the choice of a surgical light is subjective, several
characteristics must be addressed. The criteria include
light intensity, light color, focusing capability and range,
degree of shadow production, heat production and dissi-
pation, choice of mounting, lamp head maneuverability,
and ease of cleaning (Bronzino, 1992).
Communication
The speed and reliability of communication in the OR is
vitally important. Communications systems are becoming
increasingly complex with the continual advances in net-
working and wireless technology. Fundamental modes of
communication such as telephones, paging systems, and
intercoms are common in ORs.
Advances in computer technology and network sys-
tems have had a profound effect on the communications
systems within the OR environment. E-mail, Internet
access, online scheduling, and patient databases have
vastly improved the quantity and quality of exchanged
information.
Fire protection
Common operating room
technologies
All health care facilities must be equipped with a fire
protection system. The fundamental elements of such
a system include smoke detectors, alarms, a sprinkler
system, and automatically closing doors to contain the fire.
The hospital staff must have an established evacuation
plan for patients and staff. Several OR fires occur each
year. The combination of an oxygen-enriched atmo-
sphere, fuel source (e.g., drapes, endotracheal tubes, and
the patient) and ignition source (e.g., electrosurgical units
and lasers) have produced catastrophic fires (de Rich-
mond and Bruley, 1993).
The following is a list of typical medical technologies
commonly found in the OR. A brief description of each
technology is included.
Furniture
Furniture is utilized extensively in the OR and serves
a wide range of functions. Patient beds are employed for
transporting patients and as an adaptable platform for
performing surgery. Transport beds, or stretchers, are
designed with side rails and large casters to safely trans-
port patients within the hospital.
Surgical beds are valuable tools for patient positioning
during surgery. In order to accommodate various pro-
cedures, surgical beds are more substantial and complex
than transport beds. Modern beds are equipped with
mechanical, electronic, and hydraulic systems that allow
clinicians to position a patient in numerous orientations,
Surgical suite layout
A well-designed surgical suite provides ample space for
staff and equipment. It encourages a smooth flow of
people and materials within the room. While the layout
of an individual surgical suite varies by surgical service,
all suites share some characteristics, as described in
below.
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