Operating Room Health Article

Definition

An operating room (OR), also called surgery center, is the unit of a hospital where surgical procedures are performed.

Purpose

An operating room may be designed and equipped to provide care to patients with a range of conditions, or it may be designed and equipped to provide specialized care to patients with specific conditions.

OR environment

Operating rooms are sterile environments; all personnel wear protective clothing called scrubs. They also wear shoe covers, masks, caps, eye shields, and other coverings to prevent the spread of germs. The operating room is brightly lit and the temperature is very cool; operating rooms are air-conditioned to help prevent infection.

The patient is brought to the operating room on a wheelchair or bed with wheels (called a gurney). The patient is transferred from the gurney to the operating table, which is narrow and has safety straps to keep him or her positioned correctly.

The monitoring equipment and anesthesia used during surgery are usually kept at the head of the bed. The anesthesiologist sits here to monitor the patient's condition during surgery.

Depending on the nature of the surgery, various forms of anesthesia or sedation are administered. The surgical site is cleansed and surrounded by a sterile drape.

The instruments used during a surgical procedure are different for external and internal treatment; the same tools are not used on the outside and inside of the body. Once internal surgery is started, the surgeon uses smaller, more delicate devices.

Operating room equipment

An operating room has special equipment such as respiratory and cardiac support, emergency resuscitative devices, patient monitors, and diagnostic tools.

Life support and emergency resuscitative equipment

Equipment for life support and emergency resuscitation includes the following:

• Heart-lung bypass machine, also called a cardiopulmonary bypass pump—takes over for the heart and lungs during some surgeries, especially heart or lung procedures. The heart-lung machine removes carbon dioxide from the blood and replaces it with oxygen. A tube is inserted into the aorta to carry the oxygenated blood from the bypass machine to the aorta for circulation to the body. The heart-lung machine allows the heart's beating to be stopped during surgery.
• Ventilator (also called a respirator)—assists with or controls pulmonary ventilation. Ventilators consist of a flexible breathing circuit, gas supply, heating/humidification mechanism, monitors, and alarms. They are
  microprocessor-controlled and programmable, and regulate the volume, pressure, and flow of respiration.
• Infusion pump—device that delivers fluids intravenously or epidurally through a catheter. Infusion pumps employ automatic, programmable pumping mechanisms to deliver continuous anesthesia, drugs, and blood infusions to the patient. The pump hangs from an intravenous pole that is located next to the patient's bed.
• Crash cart—also called resuscitation cart or code cart. A crash cart is a portable cart containing emergency resuscitation equipment for patients who are "coding" (i.e., vital signs are in a dangerous range). The emergency equipment includes a defibrillator, airway intubation devices, resuscitation bag/mask, and medication box. Crash carts are strategically located in the operating room for immediate accessibility if a patient experiences cardiorespiratory failure.
• Intra-aortic balloon pump—a device that helps reduce the heart's workload and helps blood flow to the coronary arteries for patients with unstable angina, myocardial infarction, or those awaiting organ transplants. Intra-aortic balloon pumps use a balloon placed in the patient's aorta. The balloon is on the end of a catheter that is connected to the pump's console, which displays heart rate, pressure, and electrocardiogram (ECG) readings. The patient's ECG is used to time the inflation and deflation of the balloon.