Operation theater DEMC

Operation Theatre

Prepared by:Muhammad Affandi b Yusof

Supervisor:En. Mohd Razali b Zulkiply

Introduction Also known as an operating

theatre, operating room (OR) or operating suite.

It is a facility within a hospital where surgical operations are carried out in a sterile environment.

Historically, the term "operating theatre" referred to a non-sterile which students and other spectators could watch surgeons perform surgery.

General RequirementOrganization

Consulting surgeon Consulting anesthetist Supporting staff

Attire:

A protective cap covering their hair Masks over their lower face, covering their mouths and noses Shades or glasses over their eyes Vinyl gloves on their hands Long gowns Protective covers on their shoes The surgeon may also wear special glasses that help him/her to

see more clearly.

In DEMC OT There are about 4 operation rooms Handle by:1. Medical Directors:

Surgeon: Dr Mohd Mahmud Musman Anesthesist: Dr Jaseemuddeen Abu Bakar Obstetrics & Gynaecology: Dr Zamri

2. OT department: Nurse : Norbiyusaini Abd Hamid Technician OT assistant Clerk

Organization Chart

Dimension of Operation TheatreMajor operation theatre: Minimum size : 38.0 square meters Minimum ceiling height : 2.7 meters Minimum clear area : 33.0 square

meters (not included cabinet and shelves)

Minor operation theatre: Minimum size : 4.6 meters Minimum ceiling height : 2.7 meters Minimum clear area : 25.0 square

meters (not included cabinet and shelves)

Plan view

Area/partition Patient transfer area Scrub up area Clean up room Instrument and supply storage Anesthesia storage Janitor facilities Stretcher space Staff facilities Preparation area Substerilizing facilities

General view

Room Requirement

Generally windowless and feature controlled temperature and humidity.

Special air handlers filter the air and maintain a slightly elevated pressure.

Electricity support has backup systems in case of a black-out.

Rooms are supplied with wall suction, oxygen, and possibly other, anesthetic gases.

Easy to clean. Any addition facilities should be place

outside the operation room. Operation suite must have own corridor

to avoid traffic when transfer the patient.

The combined surgical suite or combined surgical-obstetrical suite shall be arranged and in one area to prevent traffic.

Ideal Room Condition Temperature : 18-20 degree Celsius Humidity : 50% - 58% Pressure : 70 pascal Wind flow : more than 20 times

Why need to control the temperature? The humidity level will affect the growth of

bacteria and fungus The humidity level will be control between 50%-

58%, if it higher or lower than the range the bacteria and fungus will be able to growth rapidly.

The most important is to control the temperature below 20 degree Celsius, and it is needed to be checking at least 3 times per day.

The bacteria level should be maintain low than 35 CFU (colony forming unit).

The High Efficiency Particulate Air (HEPA) filter:

HEPA standards: an air filter must remove (from the air that passes through) 99.97% of particles that have a size of 0.3 micrometers.

Apply at operating theaters, outpatient surgery suites, labor and delivery departments, isolation rooms, critical care, intensive care, and several other areas.

Put on the return air circulation system together or near the air conditioner.

The air will be filtered by HEPA before it being release through the air flow.

Result

Air changer formula

Types of Power supply: Essential power supply Uninterruptible power supply Normal power supply

Essential power supply Supply power by generator. Known as Genset Function when the power by TNB(normal

power) is stop functioning. It take 7 second on standby. Every plug in the building which

connected to Genset is label with red color.

GENSET

Uninterruptible power supply (UPS) This kind of power supply is mainly known

as backup power from the battery. The battery is use as power supply. UPS is critically use in the operation

theatre to avoid the power break down during the case.

It is label with the yellow plug. UPS will continue supply the power even

the power is off.

UPS System

Normal power supply

This kind of power supply is the normal power supply from TNB to hospital.

It used 3 phase. 415/240v , normal commercial building. The power break down in the normal

power supply will be support by EPS and UPS immediately.

Equipment for Surgery

Basic 1. Overhead surgery light2. 2 x-ray illuminators3. Electric clock with sweep second hand4. Storage for surgical supplies5. Suction outlets6. Oxygen outlets7. Operating table

Overhead surgery light: To provide bright light, without shadows, during surgery.

Specs of lighting Homogenous light: The light should offer a good illumination on a

flat, narrow or deep surface in a cavity, despite obstacles such as surgeons' heads or hands.

Lux: The central illuminance can not exceed 160 000 lux and should not be lower than 40 000 lux

Light field diameter: The D50 should not exceed 50% of d10 diameter

Colour rendition: For the purpose of distinguishing true tissue colour in a cavity, the colour rendering index (Ra) should be between 85 and 100.

Backup possibility: In case of interruption of the power supply, the light should be restored within 5 seconds with at least 50% of the previous lux intensity, but not less than 40 000 lux. Within 40 seconds the light should be completely restored to the original amount of lux.

Electric clock:Accurate, synchronized time

Suction outlets

Oxygen outlets

x-ray illuminators

Supply Cabinet

• This cabinet is the place to store the apparatus that being use during surgery.

Operating Table• It is place on the center of

operation room.• Can be raised, lowered,

and tilted in any direction.• Able to support heavy

load.

Addition A portable x-ray General Anesthetic Machine Anesthetic cart Surgeon Pendant

General Anesthetic Machine

• GA machine help anesthetist to supply oxygen, medical air and nitrous gas to the patient.

• GA machine also assist the patient to breath easily.

• The gas is directly supply from pendant and have backup from the tank behind the machine.

Front Back

• Monitoring the patient's heart rate, ECG, blood pressure and oxygen saturation.

• The PPM of this machine is twice a year.

• Class 1,type B.

Anesthetic machine diagram

Electrical specification

Anesthetic cart Easy access to all anesthesia

tools, in one simple, portable location.

Allows for easy transportation between rooms and could potentially be used in multiple operating rooms.

Keep anesthesia tools safe and in the hands of authorized users.

Surgeon Pendant • Attached to ceiling.• Provide faster, safer and

more efficient access to medical gases, AGSS and electrical services in the operating room

• Provided the access of sockets red/yellow plug to be use.

• Flexible to movement.

Gas supply to OT

Oxygen Nitrous oxide Entonox Medical gas

Anesthetic Gas Scavenging Systems (AGSS) Transport exhaled and waste anesthetic gases

from the exhaust valve of an anesthetic ventilator or anesthetic breathing system into the atmosphere at a safe location away from the operating theatre.

‘Active’ AGSS incorporate a mechanical pump to assist with the disposal of the waste gases.

AGSS consist of transfer, receiving and disposal components.

The transfer hose conveys waste gases from the breathing system to the AGSS receiving reservoir.

The receiving reservoir incorporates an air break to allow entrainment of room air and prevent negative pressure being applied to the breathing system.

The receiving system hose conveys the mixture of waste anesthetic gas and room air from the receiving reservoir to the terminal unit placed at the entry to the disposal system. 

• This inlet connection should also incorporate a means of pressure relief to prevent the pressure within the transfer hose at this point rising above 2 kPa (20 cm H2O) under any condition (for instance, should the transfer hose become blocked or kinked).

The EndThank You