Operating Room

Prep: Mr. Muhammad Usman

INU Peshawar

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 Operating Room

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 Operating Room
• An operating theater (also known as an operating room,
operating suite, operation theatre or operation suite) is a
facility within a hospital where surgical operations are carried
out in a sterile environment.

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 Operating Room (OR)
• The operating room or operating theater is a room specifically
used by surgical and anesthesia team
to carry out surgeries.
• Operating room must not be used for other purposes.
• Every operating room must have following characteristics:
 Proper lightening
 Good ventilation
 Proper equipment for procedures
 Equipment to monitor patients as needed for the procedure
 Drugs and other consumables required for routine and
emergency use

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 Categories of Operating Rooms
• The American College of Surgeons (ACS) defines three
categories or classes of surgical facilities based on the types of
procedures performed in them.
• The criteria include minimal floor space, types of anesthetics
used, and circumferential clearance around the OR bed.

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The classes of ORs with minimal floor space are as follows:

• Class A: 150 ft2 floor area with 12 ft minimum clear dimensions at

the head, sides, and foot of the operating bed
• Class B: 250 ft2 floor area with 15 ft minimum clear dimensions at
the head, sides, and foot of the operating bed.
• Class C: 400 ft2 floor area with 18 ft minimum clear dimensions at
the head, sides, and foot of the operating bed.

• Other ORs not designated by class range in size from 600 to 650 ft2
with a 24- to 25-foot width and accommodate multiple ceiling-
mounted booms, monitors, and high-technology equipment such as
robotics and controlling consoles.
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 Size Determinations
Class A
• smaller procedures performed with topical, local, or limited
regional blocks that have minimal equipment needs.
• Many ambulatory centers have this type of room.
Class B
• procedures under sedation and physiologically supported with IV
medication.
• General anesthesia and spinal or epidural blocks can be used.
• Intermediate to complex procedures are performed in these rooms.
• Additional space is required for larger equipment and longer
procedures.

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 Size Determinations
Class C
• provide adequate space for typical multipurpose procedures.
• A specialized room, for cardiopulmonary bypass or trauma,
may require as much as 600 ft2 of useful space.
• The room must accommodate equipment, such as lasers,
microscopes, or video equipment, either fixed (permanently
installed) or portable (movable).
• Portable equipment requires more floor space.

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 Operating Room Humidity
• A.C .system controls humidity.
• High relative humidity (weight of water vapor present) should
be maintained between 30% and 60%.
• Moisture provides a conductive medium and allows a static
charge to flow to ground as fast as a spark is generated.
• The need of humidity is based on previous decades when the
use of flammable anesthetics posed the risk of explosion after
a spark.
• After 2012 because flammable anesthetics are no longer
used. (cyclopropane, ethyl chloride, ethyl ethel', and
ethylene).

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 Operating Room Temperature
• OR temperature is maintained within a range of 68° F to 73° F
(20° C to 23° C).
• A thermostat to prevent hypothermia in pediatric, geriatric,
and burn patients.
• Only the maintenance department can regulate temperature
in some surgical suites
• this department should be called early enough to reset the
temperature for patients at risk for hypothermia.

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• Substerile Room
A group of two, three, or four ORs may be clustered around a
central scrub area, work area, and a small substerile room.
• It is immediately adjacent to the OR and separated from the
scrub area is it considered the substerile room throughout
this text.
• It contains enclosed storage cupboards, a sink, steam
sterilizer, and a warming cabinet.
• Although cleaning and sterilizing facilities are centralized,
either inside or outside of the surgical suite,

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Advantages:
• It saves time and steps.The circulating nurse, or scrub person
if necessary, can lift sterile articles directly from the sterilizer
onto the sterile instrument table without transporting them
through a corridor or another area.
• It reduces the need for other personnel to obtain sterile
instruments and allows the circulating nurse to stay within the
room.
• Better care of instruments and equipment that require
special handling. Certain delicate or sensitive instruments or
surgeon’s personally owned set usually
are not sent out of the surgical suite.
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 Doors
• Doors should be 4 ft wide for ease in moving patients on carts
and in beds.
• Ideally, sliding doors should be used exclusively in the OR for
the main corridor.
• They eliminate the air currents caused by swinging doors.
• Microorganism that have previously settled in the room are
disturbed with each swing of the door.
• The microbial count is usually at its peak at the time of the skin
incision because this follows disturbance of air from gowning,
draping, movement of personnel, and opening and closing of
doors.

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 Doors

• Doors do not remain open either during or between surgical

procedures.
• Closed doors decrease the mixing of air within the OR with
that in the corridors, which may contain higher microbial
counts.
• Air pressure in the room also is disrupted if the doors remain
open.

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 Doors
• When construction or renovation is in process, always keeping
the doors closed when not transporting patients is important
because the ORs are ventilated with positive pressure.
• The door to the substerile area is usually a swinging style door
with a small window.
• These doors are not used for moving patients in and out of
the OR and should remain closed.

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 Doors

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