OT FURNITURE & EQUIPMENT’S

Operating rooms (ORs) are specialized workspaces that require highly functional equipment of the highest quality, which surgeons and other OR personnel use to perform lifesaving procedures. Without this equipment in place, OR professionals may struggle to deliver the care that patients need.

There is a definite number of essential operating room equipment that OR professionals need on a per case basis. Each piece of equipment serves a distinct purpose and makes it easier for OR personnel to get the job done.

Here’s we are discuss some of the most common required OR equipment that serve the needs of OR staff and patients every day.

OPERATION TABLE

• Operating tables, also known as surgical tables, are essential to any operating room. A patient lies on the operating table during a surgical procedure.
• The purpose of the table is to keep the patient in place while the surgical team operates, and may aid in moving parts of the patient’s body using surgical table accessories.
• General operating tables are designed to perform a wide range of procedures while others are designed for specific procedures, for example orthopaedic tables.
• There are several types of operating tables in use and all are rather complicated in construction and manipulation.
• The table is equipped with a hydraulic system. It is mounted on casters that are locked in place during surgery.
• They are designed so that they can be adjusted to the needs of the surgeon for any type of operation he may perform.
• 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, e.g. the application of a neuro­surgical frame.
• The standard operation table is divided into 3 to 5 sections joined.
• This arrangement allows articulations of the different sections of the table top by flexing or by extending the joints which facilitates the position of the patient’s for required surgery.
• The foot end can be lowered & patient’s buttocks can be brought to the lower edge in lithotomy position
• OT table has a single or double armed which can be adjusted with the table top at 90 degree which can be also be locked to prevent their movement.
• Patient’s arms are placed on the arm board to facilitate surgery on any part of the arm, hand, finger, facilitates injection, infusion, monitoring patient’s pulse.
• OT table also consist of shoulder braces, body braces, thigh straps, knee braces used to fix with the OT table. It is used to stabilize patient’s body in various position.
• OT table also has stirrups on which legs are hung & supported in lithotomy position.

ACCESSORY EQUIPMENT’S OF OT TABLE

Most operating tables should have the following accessory equipment’s or attachments:

1) Operation Table Mattress - 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 firm covered with a water proof cover to prevent its damage. The mattress is further covered with conductive rubber to prevent electrical hazards. The mattress can be fixed with OT table top by means of clips or hooks. It can be removed to allow cleaning of the OT table top. The mattress is divided into head, body and leg sections, which may be attached together to prevent slipping.

2) 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.

3) 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 an X-ray plate under the plastic bridge.

4) 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

5) Leg Stirrups - Leg stirrups are usually marked left and right. They are used to stabilize the patient's legs in the lithotomy position, e.g. for a dilation and curettage operation.

6) Arm and Hand Surgery Table - A hand table may be attached to the operating table to allow for a wide working field during operations on the hand or arm.

7) Restraint Straps- We have comfortable, secure patient restraints for general purpose, bariatric and many other surgical/exam purposes.

8) Roller boards: Roller board is a patient transfer device, that is available in a number of different sizes, with special models for OB/GYN, bariatric and other procedures.

ROLE OF NURSE FOR OT TABLE MAINTENANCE

• It is essential that all members of the theater staff familiarize themselves with the operation table and its accessories which must be easily available and ready for immediate use.
• Every day the OT table is carbolised by the nurse.
• The whole apparatus must be maintained in good working order and checked before each operation list.

SURGICAL LIGHTS

• Surgical light also known as an operating light or surgical lighthead – is a medical device intended to assist medical personnel during a surgical procedure by illuminating a local area or cavity of the patient.
• High-quality surgical lighting is essential for performing intricate procedures in the operating room. Surgical lights are designed to provide bright white light to illuminate the surgical site and eliminate shadows, all while keeping the surgical staff cool.
• LED lights or halogen lights are two types of surgical lights.
• Surgical lighting is transitioning away from incandescent technology to LED technology due to the many benefits of LED: pure white colour, less heat in the surgical field, more accurate colour rendition, and improved shadow control.
• Many diverse surgical and exam lights are available in OT, including:
• Ceiling-mounted surgical lights: Ceiling-mounted LED and halogen lights are among the top available to brighten the surgical site.

• Mobile surgical lights: it requires in a temporary OR, or for Mobile OT or for a short-term solution.

• Surgical headlights: Light, bright and comfortable, surgical headlights provide surgeons with extra illumination right at the spot they are investigating. These headlights are lightweight and comfortable and will illuminate just about any space immediately.

OT FURNITURE’s

1) Mayo stand

• It is a frame on which a rectangular stainless-steel top can be fixed.
• The base of this frame can be slides under the operation table & top comes over the sterile field on which instruments ,sutures ,ligatures ,sponges etc. can be laid .
• These can be conveniently used by the scrub surgeon during surgery as it provides easy access.

2) Instrument trolley

• This trolley also serves the same purpose as of mayo stand.
• This may supplement the mayo stand because it provides extra space where more instruments, sutures, ligatures, sponges can be laid.
• This trolley is made of stainless steel.
• After cleaning the trolley with antiseptic lotion, a sterile drape is put on the top shelf to make a sterile surface on which instruments are laid.

3) Ring stand

• There may be one or more ring stand.
• These are circular frames which are covered by sterile drapes to make a sterile surface.
• Then sterile basins containing sterile warm normal saline water are placed on the ring.
• It is used for rinsing blood stained instruments, soaking sponges or washing blood stained gloved hand during surgery.

4) Trolley /table for scrub attire

• The scrub personnel have to wear sterile gown & gloves after scrubbing & drying their hands.
• A separate trolley or a table is set up on which sterile packets containing scrub gowns & gloves packets are kept so that they can be picked up or handed over conveniently.

5) Skin preparation trolley

• A skin preparation trolley with 2 to 3 sponges holding forceps, 2 to 3 large bowls containing antiseptic lotion & lots of sponges is prepared for cleaning the operation site before the operation procedure is started.
• After skin cleaning is over the trolley is removed from OT.

6) Sitting stool

• When the operation is of long duration the surgeon may like to sit & do the operation.
• The sitting stool is stainless steel with adjustable heights.
• The stool top should be spacious enough to allow comfortable sitting.

7) Kick bucket

• These buckets are used for discarding soiled swabs sponges etc. during operation.
• Theses buckets are lined with plastic bags so that the inner side of the bucket does not get stained or rusted.

8) Standing platform

• A scrub personnel who is short heightened may need to stand on a platform to work comfortably on the OT table without stretching his or her back.
• The platform should be made of steel & should be stable & strong enough to bear the person’s weight.

9) IV stands/hooks/poles

• IV hooks or poles are preferably ceiling mounted such a s hanging from the ceiling.
• They should be movable & adjustable to any height. The mounted designs cluttering of OT floor with too many equipments & provide maximum space for the OT personnel to move about freely.
• It also allows free movement of stretcher, trolley etc. in the OT.

10) Racks, shelves, almirah

• OT has a good number of steel racks ,shelves & almirah which provides storing space for clean articles, sterile articles, sterile linens, sterile instruments, others articles, emergency equipments, emergency medicines & injections, infusions fluids, antiseptic lotion etc.

11) Stretchers, trolleys, wheel chairs

• There should be number of stretchers, trolleys, wheel chairs in OT for transportation of patient to OT & also from the OT to the recovery room or to the wards or OPD.

ANAESTHESIA EQUIPMENTS

1) Anaesthesia trolley - The anaesthesia trolley contains anaesthetic drugs, anaesthetic equipment’s, O₂ mask, endotracheal tubes of different sizes, endotracheal connectors, laryngoscopes etc.

2) Cardiac monitor - This is an apparatus which is used in operation theatre for monitoring cardiac functioning of the patient during the surgery.

3) Defibrillator - This is cardiac resuscitative equipment used for cardiac defibrillation.

4) Artificial respirator or ventilator - This apparatus is used for pulmonary resuscitation for maintaining patients pulmonary function.

5) Pulse oximeter - It is a device used for pulse oximetry that is for measuring haemoglobin & O₂ saturation of blood.

6) O₂ cylinder - All modern OT have inbuilt O₂ supply channels from a central source through the O₂ pipeline & O₂ sockets. OT keeps one or two O₂ cylinders for ready use & the cylinders should be complete with regulator, humidifier etc.

MAJOR EQUIPMENT’S

1) Operative microscope - This microscope assists in microscopic surgery such as surgery on hands or blood vessels. This is also ceiling mounted & movable as well as adjustable.

2) X-ray machine - OT has a portable X-ray machine. This also may be ceiling mounted. This X-ray machine is used to take X-ray film during the surgery.

3) Cryosurgery unit - Cryosurgery devices can also be ceiling mounted & can be used in OT as & when needed. The selective exposure of tissues to extreme cold, often by applying a probe containing liquid nitrogen, to bring about the destruction or elimination of abnormal cells.

4) Suction unit - Modern operation theatres are equipped with inbuilt suction unit. Most of the OT have portable suction unit either with one bottle or two bottles. A suction apparatus is used for suctioning of the operation site through a sterile suction catheter.

5) X-Ray Viewer - A device for viewing OPG (Orthopantomogram)/Dental X-Ray and x-ray. X-Ray Viewer with LED back light panel provides uniform light in throughout the viewing area.

6) Sterilizer  - A small sterilizer is kept in OTY in sterilization room for sterilization purposes. Small items in small no: can be sterilized in such sterilizers though major supply of sterilized equipments comes from central sterilization supply department.

7) Electrocautery unit - It can used to burn or cut the tissue and seal blood vessels. This helps reduce or stop bleeding during surgery or after an injury. A small probe with an electric current running through it is used to burn or destroy the tissue.

OTHER’S

1) Closed circuit television - Closed circuit television system with ceiling mounted cameras which will project full & an excellent view of the operation to the central monitor at the nurses desk can also be installed. This will allow the personnel to determine the progress of the operation. These cameras are movable & adjustable so that they can be moved just above the operation site. Even the others OT members as well as the visitors can have full view of the surgery through the video cameras.

2) Fire extinguisher  - It is an essential items in OT which is kept ready for safety purpose to combat the hazards in case there is sudden fire breakout due to electrical short circuit etc. All operation theatre personnel should be able to operate on it.

3) Alarm bell - Operation theatre has a ringing alarm bell for emergency use.

4) Wall clock - This is an essential item which is kept in OT for monitoring timings.

5) Music system - OT should have central music system where soft music can be played throughout which is very soothing to the personnel as well as to patients when they are awake.