2 What are the requirements of the O.T. TABLE?
The modern operation table is a mechanical apparatus capable of
Adjustment to give a variety of positions for a patient
undergoing surgery.
- Most tables are designed to provide suitable positions for a
wide range of general surgical operations.
- It can be adapted for specialised procedures by the addition
Of accessories (neurosurgery, orthopedics).
- The introduction of complex operative procedures has required
The manufacture of more sophisticated operation with the table
Base unit positioned in the centre of the theatre on to which
Is fitted a removable top.
- This facilitates the transport of the operated patient.
An operation table which offers power operation,
Interchangeability of table top for ease of patient transport is
Illustrated. Fig. 1A, and 1B
The table must have the following functions:
* Can be tilted downwards at the head and foot ends.
* Can be tilted from side to side.
* Can be elevated or lowered as a whole.
* Can be broken at hip level for gynaecological operation (e.g.
vaginal hysterectomy), renal surgery, and certain orthopaedic
operations.
* Can have the head and foot ends of the table removed to allow
for other attachments, eg. the application of a neurosurgical
frame.
What are the Accessory Equipments?
Most operating tables should have the following accessory
equipment or attachments:
* A rubber mattress placed on top of the table to prevent the
patient's body touching any metal part of the table in all
positions.
- The mattress is divided into head, body and leg sections,
which may be attached together to prevent slipping.
* A non-slip mattress designed to prevent movement of the patient
in tilted positions.
* An anaesthetic screen - a metal frame, the base of which slides
under the mattress.The top of the frame allows for the
operative drape to be placed over it, thus separating the
sterile operative area from the anaesthetic area.
* A head rest frame - a horseshoe shaped metal frame which is rubber
padded. It attaches to the operating table to stabilize the
patient's head during neurosurgical operations.
* Acrylic plates - transparent plastic bridges which may be placed
on the operating table under the mattress. X-rays can be taken
during an operation by slipping a X-ray plate under the plastic bridge.
* A kidney bridge - a bridge under the mattress at waist level which,
when elevated, arches the middle of the body for easy exposure
of the right or left kidney.
* An arm rest - used to support the patient's arm for intravenous
therapy,blood pressure monitoring or hand operations.It may
also be used to extend the arm for a radical mastectomy,thus
exposing the axilla for access to the axillary lymph nodes.
* An armslide supports the unused arm and preventing it from
falling over the edge of the table.
* Leg stirrups are usually marked left and right.They are used to
stabilise the patient's legs in the lithotomy position,eg.for
a dilation and curettage operation.
* The laminectomy bridge is an arched frame over which the patient
is placed face down.It allows for extension of the
vertabrae and exposure of the lamina.
* A hand table may be attached to the operating table to allow for
a wide working field during operations on the hand or arm.
* Sandbags assist in stabilizing a limb, eg. they may be placed
under a patient's knee for support during a menisectomy
operation.
In a thyroidectomy, the neck may be extended slightly backwards and the head stabilized in a round rubber ring.
A sandbag may be placed on either side of the head for
stability.
* Pillows to provide cushioning and protection for a patient's body
and limbs.
Any questions may be sent to drmmkapur@gmail.com
Tuesday, May 4, 2010
Saturday, May 1, 2010
CRITICAL LOCUS REQUIRMENTS
THE OT COMPLEX MANAGEMENT
THE OT PLAN AND DESIGN
Where should it be located?
All operating theatres should be centralized in one operating
Area rather than spread in the hospital.
this has been shown to be the most economic approach;
-For good engineering and
-Focused nurse’s services,
-Use of equipment and
-Training of staff.
How is it designed?
Present trends in hospital design favor the low-rise building,
Two/three floors high.
With an internal courtyard. This enables maximum use of natural light and ventilation.
The operating department should be constructed separate from general traffic and air movement in the rest of the hospital.
How to plan?
Movement of patients is made easier if at the time of planning
The requirement of the operating department surgical wards and
Intensive care unit (ICU)
Accidents and emergency departments (AED)
Radio diagnostic (X-ray) departments are all considered.
The laboratory facilities should also be close by.
How to Design and Control Environmental?
The term operating suite is sometimes used to designate the room used for surgery.
This room is usually 400sq ft with minimum of 20 feet distance from cabinets and wall shelfs.
Special surgery suits cardiac, orthopedic neurosurgery and minimal invasive surgery and requires 600 sq ft. of space.
The support areas (changing rooms, scrub and utility
Rooms) are separate.
All operating suites are similar in design.
They are roomy enough to allow scrubbed staff to move around
Sterile equipment without the risk of contamination.
The design is such that dust is not trapped in areas that would be difficult to clean.
The surface vinyl material is free of joints and crevices.
The operating suite, is designed to insure maximum patient safety
* The floors, ceilings, and other surfaces are smooth, non-
Porous, and made of fireproof materials.
* The smooth surfaces allow thorough cleaning and prevent the
trapping of biologic material that could cause cross
Contamination
* All surface materials are made to withstand frequent washings
And cleaning with strong disinfectants
The ventilation system in the surgical suite has filters to
Prevent the contamination of the clean environment by
Air-borne bacteria.
The entry of air is thru high up vents
* The current requirements is, 15 exchanges of air per
Hour, 3 of which must be fresh air.
• Clean air exchange is possible if there is a positive pressure within the suite.
• This air is derived directly from the outside to avoid circulating air that might be contaminated By passage through other areas of the hospital
* The humidity is also controlled to minimize static
Electricity and consequent ignition of any flammable
Solutions or objects used in the operating room.
* The ideal humidity level to achieve minimal static and also
Reduce bacterial growth is 30% to 55%.
The air temperature
Is maintained at 200C to 240C (680F to 750F).
* Emergency signal. The O.T.Management committee should
Consider installing an alarm system in case of a life
Threatening emergency. The activation of this alarm will
Save valuable time to mobiles. The emergency designate staff
And direct them to the site of the emergency.
THE OT PLAN AND DESIGN
Where should it be located?
All operating theatres should be centralized in one operating
Area rather than spread in the hospital.
this has been shown to be the most economic approach;
-For good engineering and
-Focused nurse’s services,
-Use of equipment and
-Training of staff.
How is it designed?
Present trends in hospital design favor the low-rise building,
Two/three floors high.
With an internal courtyard. This enables maximum use of natural light and ventilation.
The operating department should be constructed separate from general traffic and air movement in the rest of the hospital.
How to plan?
Movement of patients is made easier if at the time of planning
The requirement of the operating department surgical wards and
Intensive care unit (ICU)
Accidents and emergency departments (AED)
Radio diagnostic (X-ray) departments are all considered.
The laboratory facilities should also be close by.
How to Design and Control Environmental?
The term operating suite is sometimes used to designate the room used for surgery.
This room is usually 400sq ft with minimum of 20 feet distance from cabinets and wall shelfs.
Special surgery suits cardiac, orthopedic neurosurgery and minimal invasive surgery and requires 600 sq ft. of space.
The support areas (changing rooms, scrub and utility
Rooms) are separate.
All operating suites are similar in design.
They are roomy enough to allow scrubbed staff to move around
Sterile equipment without the risk of contamination.
The design is such that dust is not trapped in areas that would be difficult to clean.
The surface vinyl material is free of joints and crevices.
The operating suite, is designed to insure maximum patient safety
* The floors, ceilings, and other surfaces are smooth, non-
Porous, and made of fireproof materials.
* The smooth surfaces allow thorough cleaning and prevent the
trapping of biologic material that could cause cross
Contamination
* All surface materials are made to withstand frequent washings
And cleaning with strong disinfectants
The ventilation system in the surgical suite has filters to
Prevent the contamination of the clean environment by
Air-borne bacteria.
The entry of air is thru high up vents
* The current requirements is, 15 exchanges of air per
Hour, 3 of which must be fresh air.
• Clean air exchange is possible if there is a positive pressure within the suite.
• This air is derived directly from the outside to avoid circulating air that might be contaminated By passage through other areas of the hospital
* The humidity is also controlled to minimize static
Electricity and consequent ignition of any flammable
Solutions or objects used in the operating room.
* The ideal humidity level to achieve minimal static and also
Reduce bacterial growth is 30% to 55%.
The air temperature
Is maintained at 200C to 240C (680F to 750F).
* Emergency signal. The O.T.Management committee should
Consider installing an alarm system in case of a life
Threatening emergency. The activation of this alarm will
Save valuable time to mobiles. The emergency designate staff
And direct them to the site of the emergency.
A CRITICAL HOSPITAL LOCUS
THE RESOURCE FOR OTMANAGE
Tryseffcare is a Metaphor, with emphasis on self, as a motivator, and care providing the path to good performance and achieving your personal development goals
The hospital scene is fast changing in India, it is
estimated that over 15 thousand hospitals and nursing homes already exist, and this number is fast increasing.
This makes a demand on the training requirement of manpower in position.
This could in part be met by making available self learning hand books, or electronic media, to improve absorption capacity for high technology in use in modern Operating Theatres.
The health care outlet (public private hospital/nursing homes) have needs, for upgrading knowledge and skill of staff in place (Nurses & nurse assistant),.and new entrants to these cadres.
This involves areas of high levels of new technology in use in the OT complex. Advanced technique used by surgeons in the operating room complex need to be accessible.
Nurses and thru them other staff (OR assistants and theatre orderlies) need to acquire a commensurate learning abilities to remain efficient, provide quality service and meet the needs of their personal development goals.
The most cost effective means to improve absorption abilities of nurses and staff in position and new ,staff employed is to provide access to inexpensive self learning handbooks in surgical specialties and to introduce them to new required instruments used in modern procedures in these specialties.@
The instruments are illustrated for ease of recognition for organizing sets for procedures
The procedures are outlined in a standard format including;
• objectives of the procedure
• position of the patient during the procedure
• Anesthesia required for the procedure
• Steps of the procedures
• Instruments required (sets and special instruments)
The hand book also covers the important subject of infection control in the OT. Management of the OT complex,
Information on ligature, and
Suture material.
Defibrillators,
Ultrasonic equipment,
Lasers,
Diathermy,
Cryoprobes
.All this information imparts management and nursing skills to the OT staffThis information can be of use trainers as a training guide.
@A Complete Hospital Manual of Instruments and Procedures 2005 Jaypee ISBN81-8061-546-4
Tryseffcare is a Metaphor, with emphasis on self, as a motivator, and care providing the path to good performance and achieving your personal development goals
The hospital scene is fast changing in India, it is
estimated that over 15 thousand hospitals and nursing homes already exist, and this number is fast increasing.
This makes a demand on the training requirement of manpower in position.
This could in part be met by making available self learning hand books, or electronic media, to improve absorption capacity for high technology in use in modern Operating Theatres.
The health care outlet (public private hospital/nursing homes) have needs, for upgrading knowledge and skill of staff in place (Nurses & nurse assistant),.and new entrants to these cadres.
This involves areas of high levels of new technology in use in the OT complex. Advanced technique used by surgeons in the operating room complex need to be accessible.
Nurses and thru them other staff (OR assistants and theatre orderlies) need to acquire a commensurate learning abilities to remain efficient, provide quality service and meet the needs of their personal development goals.
The most cost effective means to improve absorption abilities of nurses and staff in position and new ,staff employed is to provide access to inexpensive self learning handbooks in surgical specialties and to introduce them to new required instruments used in modern procedures in these specialties.@
The instruments are illustrated for ease of recognition for organizing sets for procedures
The procedures are outlined in a standard format including;
• objectives of the procedure
• position of the patient during the procedure
• Anesthesia required for the procedure
• Steps of the procedures
• Instruments required (sets and special instruments)
The hand book also covers the important subject of infection control in the OT. Management of the OT complex,
Information on ligature, and
Suture material.
Defibrillators,
Ultrasonic equipment,
Lasers,
Diathermy,
Cryoprobes
.All this information imparts management and nursing skills to the OT staffThis information can be of use trainers as a training guide.
@A Complete Hospital Manual of Instruments and Procedures 2005 Jaypee ISBN81-8061-546-4
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