What are the key considerations for setting up a new operation theatre?

Key Considerations for Setting Up a New Operation Theatre

When setting up a new operation theatre, prioritize safety features including well-marked fire manual call points, fire extinguishers, oxygen shut-off valves, multiple exit routes, and sufficient ventilation to ensure patient and staff safety. 1

Design and Layout Considerations

Space and Positioning

• The operating theatre should be at least 55 m² to allow adequate space for equipment and staff movement 1
• The theatre should be positioned centrally within the theatre complex with easy access to post-anesthesia care unit (PACU) 1
• Operating theatres should be arranged in zones so that >50% remain unaffected if a fire occurs in one area 1
• Consider separating clinical and non-clinical areas to improve workflow and safety 1

Ventilation and Air Quality

• Operating theatres require 25 air changes per hour to prevent oxygen enrichment and reduce infection risk 1
• Anaesthetic rooms should have 15 air changes per hour 1
• Recovery areas should have 10 air changes per hour 1
• Install override and control systems for smoke control and ventilation 1

Fire Safety Features

• Install well-marked fire manual call points, fire extinguishers, and oxygen shut-off valves (AVSUs) 1
• Position AVSUs to allow isolation of individual areas without shutting off oxygen to the entire theatre suite 1
• Include multiple exit routes with at least three separate exits, two allowing horizontal evacuation 1
• Consider modern sprinkler and misting systems for fire suppression 1
• Install a fire alarm system with both audible and visual alerts 1

Recovery Area (PACU)

• The ratio of PACU beds to operating theatres should not be less than 2:1 1
• PACU should be open-plan to allow observation of all bays, with curtains for privacy 1
• Each PACU bay should have 12 electrical socket outlets, oxygen and medical air outlets, vacuum outlets, and monitoring equipment 1
• Include an emergency call system with alarms and telephone/intercom links to operating theatres 1

Equipment and Technical Requirements

Electrical and Medical Gas Supply

• Each PACU bed space should have 12 electrical socket outlets (six on each side) 1
• Provide one oxygen pipeline outlet, one medical air outlet, and two vacuum outlets per bay 1
• Consider ICU pendants which improve electrical safety and reduce fire risk 1
• Include an exhaled gas scavenging system for anaesthetic machine use 1

Monitoring and Communication

• Install physiological monitors with display screens and recording systems 1
• Ensure compatibility between operating theatre, PACU, and ward monitoring equipment 1
• Implement good communication systems linking staff with operating theatres, wards, and other clinical facilities 1
• Include at least two separate landline telephones for emergency communications 1

Patient Transfer and Positioning

• Ensure door widths are sufficient to allow bariatric beds to pass through without adjustment 1
• Provide lateral transfer devices for safe patient movement between surfaces 1
• Consider the space needed for different surgical positions (supine, prone, lateral, lithotomy) 1

Staff Considerations

Ergonomics

• Design workspaces with ergonomic principles to prevent musculoskeletal injuries 1, 2
• Provide adjustable seating and work surfaces for anaesthetists 1
• Ensure proper positioning of equipment to maintain ideal work postures 1, 2

Staff Facilities

• Include access to a staff rest area near but outside the immediate operating area 1
• Provide toilets, showers, clean duty clothes storage, and secure storage for personal possessions 1
• Ensure appropriate security systems, especially at night 1

Safety Protocols

Emergency Preparedness

• Install computerized fire alarm handler systems to expedite emergency response 1
• Ensure staff are trained in fire safety procedures and evacuation protocols 1
• Test emergency call systems at least weekly 1
• Have all drugs, equipment, fluids, and algorithms required for resuscitation immediately available 1

Infection Control

• Design the theatre to facilitate proper cleaning and sterilization procedures 3, 4
• Ensure appropriate temperature control (18.5-22°C is preferred by most surgeons) 5
• Consider the flow of staff, patients, and instruments to maintain sterility 3, 4

By addressing these key considerations when setting up a new operating theatre, you can create a safe, efficient, and ergonomic environment that optimizes patient care and staff workflow while minimizing risks.