THEATRE DESIGN BY

DR JIMOH
NOH-DALA

OUTLINE
INTRODUCTION THEATRE DESIGN TEAM DETERMINANT FACTORS PRINCIPLES OF MODERN THEATRE DESIGN CONSTRUCTION OF OPERATION THEATRE COMPLEX FUTURE TRENDS CONCLUSION

INTRODUCTION
Operation theatre complex is designed and built to carry out investigative, diagnostic, therapeutic and palliative procedures of varying degree of invasiveness

The heart of the surgical hospital

Most complex & challenging area of hospital construction Modern theatre is no longer a scene from science fiction, but a complex with most advanced technology

HISTORICAL PERSPECTIVE
Early surgeries were done in convenient rooms In 18th century, theatres were built in the form of amphitheatres Late 19th century, rooms were designated as operating theatres with large windows 20th century marked the beginning of the modern operation theatre complex

EARLY OP ROOM .

19TH CENTURY OPERATING ROOM

THEATRE DESIGN TEAM

Health care professionals Surgeons,Anaesthetists,Nurses Architects Engineers Information technology specialists Interior designers Environmental specialists

DETERMINANT FACTORS
Type of hospital GH--- single theatre suite Specialist hosp. twins theatre suites Teaching hosp. multiple theatre suites Type of surgical departments Current surgical techniques Anticipated surgical techniques

Available resources
Information & communication systems

PRINCIPLES OF MODERN THEATRE DESIGN

LOCATION: In cul-de-sac & not a thoroughfare 1st floor of a multi-storey building Close to:

Location:

surgical wards
A&E

ICU

Operating Theatre

SSSD

Radiology

Day Case Ward

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PRINCIPLES OF MODERN THEATRE DESIGN CONT.

COMPARTMENTALIZATION: Based on the degree of cleanliness & bacteriological count OUTER ZONE (general access areas):
Patient reception Changing room Stores & record Conference rooms

PRINCIPLES CONT.
CLEAN ZONE (limited access area):
Recovery room Emergency autoclave area Staff resting room Emergency exits Equipment store room Fire fighting device room

PRINCIPLES CONT.
RESTRICTED ACCESS ZONE:
Anaesthetic room Induction room Scrub room

ASEPTIC ZONE:
Operating suites Sterile instruments preparation room

PRINCIPLES OF MODERN DESIGN CONT.

ADEQUATE & APPROPRIATE SPACE ALLOCATION PROVISION FOR VENTILLATION & TEMPERATURE CONTROL PROVISION FOR EMERGENCY EXIT CONSIDERATION FOR FUTURE EXPANSION

CONSTRUCTION OF OPERATION THEATRE

OP. SUITE LOCATION:
Aseptic zone

SIZE:
7m x 7m(24 x 24ft) max 6m x 6m(20ft x 20ft) min

SHAPE:
Circular is ideal, but inefficient.

Most OP. rooms are square or nearly so

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CONSTRUCTION CONT.
HEIGHT:
3m (10ft) Addition of 1- 2ft Made of impervious material Laminated surface with plastic sheath or vinyl sheet Smooth surface without interstices

WALL:

IDEAL OP THEATRE . WALL & FLOOR

CONSTRUCTION CONT.
COLOUR:
Recommended colour is pale blue, green or grey Allow reflection of light and yet soothing to eyes 45sq m Impervious continuous smooth surface covering without interstices

FLOOR:

CONSTRUCTION CONT.
Antislippery Antistatic Main door = 1.2 - 1.5m wide Room doors: o Single or double o Spring loaded o Manual (hand operated) or o Automatic (foot or sensor operated)

DOORS:

CONSTRUCTION CONT.
WINDOWS:
Small size Made of glass Preferable on one side of the theatre room Supply heated/cooled humidified ultraclean air to the op.room & adjacent clean areas Comfort of the staff & patients

VENTILLATION:

CONSTRUCTION CONT.
Removal of the anaesthetic pollutants Removal of contaminated air system:
Ceiling mounted air condition supply filtered air

Patterns:
Vertical parallel laminar flow , Horizontal parallel laminar flow or Op box ventilation system

CONSTRUCTION CONT.
Exit root:
Wall mounted air duct outlets

Rate :
20-30 air exchange/hour

Pressure:
Positive air pressure of 5cmH2O

AIR CONDITION

VETILLATION NETWORK

CEILING MOUNTED AC COMPONENT

VERTICAL PARALLEL LAMINAR FLOW PATTERN

HORIZONTAL PARALLEL LAMINAR FLOW PATTERN

OP BOX VETILLATION SYSTEM

Re-circulation Air System

AIR HANDLING UNIT
SECONDARY FILTER COOLING COIL PRIMARY FILTER SUPPLY AIR FAN

HEPA FILTER

OPERATING THEATRE

Exhaust Air Fan

Primary Filter Cooling Coil

HEPA Filter Secondary Filter Primary Filter

Humidifier

CIRCULATION AIR SYSTEM

Supply Air Fan

EXHAUST AIR HANDLING UNIT

OPERATING THEATRE
HEPA Filter

SUPPLY AIR HANDLING UNIT

Secondary Filter

CONSTRUCTION CONT.
HUMIDITY:
50-60% Generated by passing air through steam injection or Fresh soft water from a spinning disc Range = 18-25 degree cent.

TEMPERATURE:

CONSTRUCTION CONT.
THEATRE ELECTRICITY:
Power line of 220volts Use of circuit breakers Locking plugs for suspended ceiling outlets Explosive proof plugs Resilient & flexible insulation around ceiling electrical power sources Wall outlets installed 1.5m above the floor Emergency power source ( Generator, UPS)

CONSTRUCTION CONT.
LIGTHING:
General rooms & corridors: Surface ceiling mounted florescent lamps Even illumination of 500lux Operating rooms: Shadowless overhead ceiling mounted halogen lamps 25,000-125,000lux

CONSTRUCTION CONT.
Produce blue white colour of day light Generate less heat( <250,000mW/cm sq of radiant energy) Installation of dimming device Ratio of intensity of general rooms lighting that of op. room lighting = 1 : 3

COMMUNICATION NETWORK:
Intercoms one phone/suite Code warning signals(emergency state)

 Closed circuit TV:

Indirect visualization Communication Help to keep to the 5-8 people/ op. room

 OP. table
Heavy & stable Adjustable

Equipment booms
Reduce floor clutter

Anaesthetic machine

OTHERS AREAS
SCRUB ROOM: 2.1m wide Washable, antislippery floor Splash limiting basins Elbow or infrared sensor operated taps SLUICE ROOMS: 5m sq floor area Sluice pan Elbow operated tap ,basin

INDUCTION & RECOVERY ROOMS

CONSTRUCTION CONT.
RECEPTION AREA: Colour demarcation
Yellow line Red line

STERILE SUPPLY UNIT: 12m sq floor area Autoclave

FUTURE TRENDS
INTEGRATED HYBRID OPERATING THEATRE: Using box-in-box principle to build a flexible complex that allows:
Easy expansion Incorporation of high-tech scanners Performing both open & minimally invasive surgeries

FUTURE TRENDS

CONCLUSION
Operation theatre design has gone a long way with significant achievement, but a lot is still required to meet up with the advancing technology.

Combination of theatre safety with the integrated technology is a great challenge that required multidisciplinary team approach.
The future is very bright

 THANK YOU FOR LISTENING COMPLIMENT OF THE SEASION

REFERENCES

Indian journal of anaesthsia

Typical Air Pressure Cascade

CLEAN PASSAGE

5 Pa

SCRUB-UP

10 Pa

OPERATIN G THEATRE

INSTUMENT ROOM 20 Pa

WASTE 0 Pa

15 Pa

-5 Pa

DIRTY PASSAGE

AMBIENT = 0 Pa

Types of Airflow in Theatres

AIR HANDLING UNIT
SECONDARY FILTER

F R S

= FRESH AIR = RETURN AIR = SUPPLY AIR

COOLING COIL

PRIMARY FILTER

SUPPLY AIR FAN

RE-HEATER

HEPA FILTER

HEPA Filters R 0,45m/s R R R

THEATRE WITH UNIDIRECTIONAL AIRFLOW

THEATRE WITH TURBULENT FLOW

ROOM B

ROOM C

Vertical Uni-directional flow & Turbulent flow.

The Future Minimally-invasive OR

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