Layout & contents of

anaesthetics room and theater

Operating room (OR) is a functional space in hospitals, designated
for performing surgical intervention to treat, remove or add an
element inside the patient's body, and this requires providing an
appropriate environment completely free of bacteria and
pollutants of various kinds and sterilizing it tight for all parts and
components in the room.

It is preferable to choose the location of the operating room suite

on the ground floor of the hospital, or the first at the maximum,
due to the presence of some equipment for operations, such as x-
ray machines, etc., in which the weight of the device may exceed
5000 kg, which requires ease of movement and special
construction security, such as modern spinal and open-heart
surgery rooms. The operating rooms are connected directly
connected to a mechanical vertical means of communication
(elevator) with hospitalization rooms and intensive care rooms of
all types, and these elevators it must be for the use of patients
only, unaccompanied, doctors, and nurses, to prevent the
presence of contaminants in the elevator.

The operating suite must also be directly connected to the central

sterilization department or contain an independent, connected
sterilization department, the blood bank and the laboratory to
perform medical analyzes that may be required in some
operations, and the operating suite is directly connected to the
operating suite.
Anesthesia room and preparation for patients, and a recovery
suite for patients after a procedure surgery. It is also connected to
the Blood Bank, medical equipment sterilization rooms, and
doctors and nursing rooms a rest area and a storeroom for sterile
equipment. The operating rooms are separated from these parts
by a red line, which is the dividing line between the sterile part
and the semi-sterile part, where it is not allowed to go beyond it
except by using sterile clothes and special sterile equipment with
operations.

The operating suite includes:

1) Protected area (semi-sterile): Protective zone: includes

 Changing rooms for all medical and paramedic staff with

amenities
 Waiting for a transfer bed for the patient from his room to
the operating suite, materials and equipment
 Rooms for administrative staff
 Stores and records
 Preparation and recovery rooms
 Intensive care rooms I.C.U
 Sterile stores

2) Clean zone:

 Stores and cleanliness room

 Equipment storage room
 Maintenance workshop
 Small kitchen (pantry)
 Fire fighting systems room
  Emergency exits
 Service room for employees
 Closed circuit television surveillance

3) Sterile zone - includes operating rooms. Sterile zone: The

protective zone is connected to the clean zone by a red line that
prevents bypassing people and materials that are not completely
sterile:

4) Contaminated waste disposal area - areas where all

contaminated waste is disposed of using a corridor leading to a
waste warehouse contaminated waste is connected directly to the
outside of the hospital so that contaminated waste can be
transported safely.

Type of operation room:

1 - Minor operating rooms (one-day surgeries): They are used to

make bandages and minor operations such as tonsils and some
eye surgeries and similar operations in which the surgical
procedure does not exceed 20 minutes and the average room
area is 16 square metres, and does not contain bulky equipment
or supplies.

2 - Medium operating rooms: which serve small hospitals and can

perform two operations at the same time and are well equipped
medium in terms of complexity of operations and devices used in
operations. The average room area is 30 square metres.

3 - Major operating rooms: These are operations that require a

part of the patient’s body to be medically open for surgery
necessary operations such as heart, bone, and digestive system
operations, organ transplantation, and tumor removal.

General references rely on this division being common, but it is

due to the great development in the field of medical equipment
and devices some rooms contain special equipment that is not
available in regular major operating rooms, which are called
(Hybrid Room) used in open-heart surgeries and cardiac
catheterization. The room size varies depending on the type of
devices required, as the room area sometimes reaches 72 square
meters due to the size of the medical staff and devices used such
as spinal cord, spine and brain surgeries. Operating rooms may
require special specifications, such as transport operating rooms
organs, especially transportation from a live party, as the process
usually requires the presence of two separate rooms through
which they can be moved without exiting the operating room. The
Egyptian code stipulates that the area of the major operating
room should not be less than 50 square meters or less side length
of 6 metres.

The doors:

The main door of the operating room must be of an appropriate

width (from 1.2 to 1.5 metres). It must consist of one or two
leaves. Equipped with a self-closing door, it is preferable to use
sliding doors to reduce the occurrence of drafts. All doors and
openings must be closed of the type that is manufactured from
stainless steel, washable and cleanable, and is completely smooth
and can be supplied the operating room door has a small, non-
openable glass opening (such as stainless steel). It is preferable to
open the door by sensor or foot to prevent touching the door.

The Flooring:

The flooring surface must be slip-resistant, strong, and not

contain joints between its parts, in order to reduce the possibility
of scuffs forming. Bacteria between the joints, non-static
conductivity, minimum recommended conductivity is 1 M ohm
and limit maximum 10M ohm. The floor should be of light colors,
especially in the work area, to make it easier to see stains and
objects on it. It is preferable that it be semi-glossy, cleanable, and
resistant to heat and shocks. The floor can be made of vinyl or
special epoxy.

The Walls:

The walls are designed so that the internal angles are reduced as
much as possible and that the angles inside the room are not less
than 90 degrees. It is preferable to use turns in the corners to
facilitate cleaning. The walls are covered with cleanable and
chemical-resistant materials. Using special paints or epoxy, and
currently a set of panels made of metal or polyethylene is being
installed. Or other shock-resistant materials that can be modified
later when adding more future equipment such as systems air
conditioning, screens, wall cabinets, and various electrical
connections, (currently using stainless steel walls) without
dividers or stained glass that is resistant to shocks and breakage.

Roof:
The ceiling is considered the area for technical operations and
hanging devices, where it is preferable to reduce moving devices
on the floor to facilitate movement medical staff during
operations and reduce lighting connections in the operating room.
In general, the ceiling must be solid and sealed completely
composed of one unit or a group of solid units without visible
joints, which prevents bacteria and leakage the air from the room
can be cleaned, and the medical gas arms and device shelves are
suspended the heart and respiratory system, the monitors for
imaging and monitoring the patient, and the moving lighting units
for operations which does not allow shadows to form on the
patient’s body during the operation, and also helps in seeing the
tissues clearly, in addition for fixed units whose lighting intensity
can be controlled during the process, the ceiling contains ceiling
air conditioning outlets, and a system fire alarm.

Note: that it is strictly prohibited to install any pipes for

transporting water (drainage, supply, or cooling) of any kind
above a room operation to avoid leakage during the operation.

Ideal anaesthetic room:

1. It must be not less than 3X2m2.
2. Multi source of Power supply UPS facilities, light source, air
conditioner system.
3. Piped gas supply (piped medical gas and vacuum) with spare
oxygen cylinders.
4. Moveable bed with giving set carrier.

5. Anaesthetic machine.
 6. Suction unit.

7. Monitors.
8. Ventilator.
9. Trolley for anaesthetic drugs and tools.

Ideal theater room:

1. It must be not less than 4X5 m2 with corner less and
antistatic flour.
2. Multi source of Power supply UPS facilities, light source, air
conditioner system.
3. Piped gas supply (piped medical gas and vacuum) with spare
oxygen cylinders.
4. Fixed or Moveable bed.

5. Anaesthetic machine.
6. Suction unit.
7. Monitors.
8. Ventilator.
9. Trolley for anaesthetic drugs and tools.
 10. With giving set carrier.
11. Scavenging outlet.
12. Surgical tools and device (surgical trolley, X-ray light, …..
etc).

Theater table (surgical bed):

The bed should be able to change as it need in the operation and
patient position. The support tools like: feet support or hand rest
help to make this.
The main advantages of the anaesthetic room are:
1. The patient’s anxiety may be reduced by avoiding the sights
and sounds of the operating theater. This is of special
importance in children.
2. The equipment which may be necessary during induction of
anaesthesia may be stored in a readily accessible from.
3. Time is saved by inducing anaesthesia while surgery is being
completed on another patient. This is useful particularly if
preparation is prolonged, e.g. performance of local
anaesthetic blocks or establishment of invasive
cardiovascular monitoring.

The disadvantages:
1. Anaesthetic and monitoring equipment must be duplicated,
or moved to the operating theatre with the patient; this
usually necessitates temporary disconnection from electrical
or gas supplies.
2. Hazared are involved in transferring an unconscious patient
from a trolley to the operating table.
3. Construction and maintenance of anaesthetic room are
expensive.