Theatre design

Operating theatres should be sited near surgical wards and the main lifts, and they should be within easy access of the accident and emergency department and X-ray department; ideally the intensive therapy unit (ITU) and anaesthetic office should be close by.

Principles in design

The operating suite should include the following areas.

1.       An outer reception area including:

    the reception office;

  the reception bay for patients to wait after checking in, for which there should be soft lighting and gentle music;

  an area for storage of trolleys;

  an area for hanging of clean gowns and overshoes for parents to wear when accompanying children to the anaesthetic room.

  2.       A ‘clean zone’ including a wide, clean corridor which allows access to and from the following:

    the anaesthetic rooms;

  the recovery bay;

  the clean storage area;

  the emergency autoclave;

  staff relaxation rooms/changing rooms;

  a storage area for large equipment including X-ray image intensifiers, etc.

  3.       The operating theatres.

    There should be a dirty or ‘back’ corridor where there are adequate disposal areas for soiled linen, soiled dis­posable drapes, disposable instruments and cleaning of used instruments prior to their delivery by direct lift shaft to the Central Sterile Supplies Department (CSSD)

  Laminar airflow is important in maintaining theatre asepsis; most theatres have between 20 and 40 air changes per hour, with the air being pumped in through filters in the ceiling and exiting through ventilation

flaps adjacent to the floor. Humidity and air control are important both for patient safety and for staff comfort (a hot humid atmosphere leads to a reduction in con­centration and performance by the operating surgeons).

  The operating theatres, recovery rooms and anaesthetic rooms must always be designed to have adequate power points, emergency electricity; piped gases, anaesthetic scavenging systems, ancillary lighting and wall suction. Cardiac resuscitation equipment must be readily available.

  Of considerable importance are the proper location of telephones and the use of internal vacuum tubes for the transportation of samples and specimens.