Theatre discipline
adil ghauri
SITE
Operation theatre should be sited
near
Surgical wards
Main lifts
Emergency and accident
department
Radiology department
Intensive care office
Clean and Dirty areas
Clean and dirty areas should be well
demarcated with staff traffic to
remain minimum at clean area.
Infection control
Important factors for controlling the
infection are
Appropriate design
Controlled air quality
Quality cleaning
Impermeable clothing
Hand scrubbing
Patient preparation
Principles in design
Outer reception area
Clean zone
Outer reception area
Reception office
Reception area where patients wait for
checking in
Area for storage of trolleys
Area for hanging clean gowns and
overshoes for parents to wear when
accompanying children to anesthetic rooms
Clean zone: It includes
Wide and clean corridor that allows access
to and from
Anesthetic room
Recovery area
Clean storage room
Emergency autoclave
Staff relaxation and changing rooms
Operting theatre
Scrub room
It is designated as
Two doors; one to corridor and one to operating theatre
Sink with taps that can be manipulated with elbows and
soap holders that can be manipulated with foot pedals
or elbows
Good drainage and suitable panels incorporated in sink
to prevent splashing of clothes
Antiseptic floors
Easily cleaned shelves for gown packs and gloves
Adequate facilities for disposal of linen and paper
Brushes for cleaning finger nails
OPERATING ROOM
Should have double door entrance from
anesthetic room and double door exit from
clean corridor
Should have small entrances from clean
store room and opening from scrubbing
room
A single exit door to dirty corridor
All doors should be well cleaned in order to
comply with air ventilation system
Operating theatres, recovery rooms and anesthetic
rooms must be designed to have adequate power
points and emergency electricity, piped gases,
anesthetic scavenging system, lightening and wall
suction
Cardiac resuscitation equipment must be readily
available
Temperature range between 19 degree Celsius and
22 degree Celsius with humidity of 45-50%
Operating table should be adjustable with all
working parts sealed, regularly cleaned to
ensure checked to ensure that it can be
raised and lowered smoothly within
appropriate gears for trendelenburg tilt and
lateral tiltand an adequate breaking system
Lights should be adjustable, sealed and
cleaned with facilities of light handles so
surgeon and scrub team can adjust it
Plaster work and floor should be well sealed
any defect should be repaired as matter of
emergency
Fixed surfaces should be avoided
and reliance placed on steel
trolleys
Radiographic viewers should be
inserted into wall and kept in good
repair
EQUIPMENTS
Trolleys should be cleaned and have safety rails
with well fitting tube and mask, all of which are
regularly checked and empty cylinders replaced
Suction apparatus should be well cleaned and
checked with spare suction tubes and catheters
available
Anesthetic machine should in good working order
All electric equipments should be
regularly checked
Fire policy, regular fire drills and
weekly testing fire doors are
essential safety precautions
Control of Air Quality
An OT should be fitted with controlled
ventilation and filters because non-visceral
bacteriological contamination of wound is
predominantly from air
For general surgical theatres the
maximum benefits are obtained from 20
air changes per hour using 5mm size filter
In orthopedic OT there should be ultra
clean air in which bacterial count is kept
below 10 CFUs per cubic mm
Additional measures include
Minimizing number of individuals
in OT
Avoiding excess movement of
individuals in OT
Ensuring that air vents are not
obstructed and that the doors are
closed
