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Operating Room Equipment

Operating Room Equipment

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Published by gatordawg
An overview the the medical devices typically found in a hospital operating room.
An overview the the medical devices typically found in a hospital operating room.

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Published by: gatordawg on May 28, 2011
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Operating Room Equipment

An operating room may be designed and equipped to provide care to patients with a variety of conditions, or it may be designed and equipped to provide specialized care to patients with specific conditions. An operating room includes equipment such as operating table; operating room lights over the table; patient monitors; diagnostic devices; respiratory and cardiac support; anesthesia; and emergency resuscitative devices. Each operating room varies depending on the type of surgery being performed. Following is a more detailed description of many of the equipment categories typically found in an operating room. Operating Table Operating tables are available in numerous configurations to fit specific requirements. Tables are offered in different sizes, electromechanical, hydraulic, remote controlled, programmable, with radiolucent composite tabletops, slidable table tops, interchangeable sections and adjustments for operating position. Operating Room Lights Lighting is considered by many to be the most important element in the operating room. Without the right lighting it may be possible to miss an important factor that can dramatically increase the chance of a mistreatment or misdiagnosis. Traditional halogen lighting is in common use but many hospitals are transitioning to LED lighting, especially for major in-patient procedures. LED lighting offers several advantages; brighter, better-color light; longer life (some LEDs are rated at 20,000 hours); about 70% less energy consumption than halogen; lower operating temperatures
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increase comfort for the doctor and patient and eliminate the drying of tissue that heat causes. Next generation lights incorporate an on/off/intensity control switch in a handle that the surgeon can adjust. Operating room lights can be ceiling mounted with arms located on tracks or trolleys or mobile type lamps on stands depending on the surgical procedure. These lights, typically two to four fixtures, may be extended or retracted as well as slid along a track to provide the specific focus of light required on the patient. Patient monitoring equipment Comprehensive patient monitoring systems can be configured to continuously measure and display various parameters via electrodes and sensors connected to the patient. Parameters monitored may include the electrical activity of the heart via an ECG, respiratory rate, blood pressure (noninvasive and invasive), body temperature, cardiac output, arterial hemoglobin oxygen, mixed venous oxygenation, end-tidal carbon dioxide and BIS. The pulse oximeter monitors the arterial hemoglobin oxygen saturation of the patient's blood with a sensor clipped over the finger or toe. An automated blood pressure device automatically inflates the blood pressure cuff at specified intervals. In cases with head trauma or other conditions affecting the brain, intracranial pressure monitors are connected to sensors inserted into the brain through a cannula or bur hole. These devices measure the pressure of fluid in the brain and record or display pressure trends. Intracranial pressure monitoring may be a capability included in a physiologic patient monitor.

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Diagnostic Devices The use of diagnostic equipment may be required in the operating room. Mobile x-ray units are used for bedside radiography, particularly of the chest. These portable units use a batteryoperated generator that powers an x-ray tube. Handheld portable clinical laboratory devices, called point-ofcare analyzers, are used for blood analysis at bedside. A small amount of whole blood is required, and blood chemistry parameters can be provided much faster than if samples were sent to the laboratory.

Respiratory and Cardiac Support Heart-lung bypass machine, also called a cardiopulmonary bypass pump, operated by a perfusionist, 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.

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The ventilator, also known as a respirator, assists or controls pulmonary ventilation. Ventilators consist of a flexible breathing circuit, gas supply, heating/humidification mechanism, monitors, and alarms. They are microprocessorcontrolled and programmable, and regulate the volume, pressure, and flow of respiration.

Anesthesia The anesthesia machine is at the head of the operating table. This machine has tubes that connect to the patient to assist in breathing during surgery. Built-in monitors help control the mixture of gases in the breathing circuit. Depending on the nature of the surgery, various forms of anesthesia or sedation are administered. The anesthesia cart, next to the anesthesia machine, contains the medications, equipment, and other supplies that the anesthesiologist may need.

The BIS (Bispectral Index) monitor provides depth of consciousness and sedation monitoring for the anesthesiologist. The sensor and monitor measure brain activity and compute a number between 0 and 100. This number corresponds to level of consciousness which is known as the BIS value.

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Emergency Resuscitative Devices Equipment for life support and emergency resuscitation includes the crash cart, also known as the resuscitation cart or code cart. A crash cart is a portable cart containing emergency resuscitation equipment for patients who are "coding", meaning their 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 located in the operating room for immediate accessibility if a patient experiences cardio-respiratory failure. Other operating room equipment Infusion pumps deliver 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 can deliver a wide variety of fluids over a broad range of infusion rates. The pump hangs from an intravenous pole that is located next to the patient's bed. The Intra-aortic balloon pump is 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.
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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. Disposable OR equipment includes urinary catheters to drain urine during surgery, catheters used for arterial and central venous lines to monitor blood pressure during surgery (or withdraw blood samples), Swan-Ganz catheters to measure the amount of fluid in the heart and to determine how well the heart is functioning, chest and endotracheal tubes, and monitoring electrodes. New Surgical Techniques An increasing number and type of procedures are now being performed with minimally invasive techniques resulting in better outcomes, enhanced patient safety, less pain, shorter recovery periods, and (theoretically) reduced costs. Advancements in communication, information technology, digital imaging, and robotics have also aided the development of new surgical techniques, allowing surgeons to perform procedures with greater patient comfort, safety, and accuracy. Robot-assisted surgery allows surgeons to perform certain procedures through small incisions. In robotic surgery, a surgeon sits at a console several feet from the operating table and views a magnified, high-resolution 3D image of the surgical site. The equipment uses wristed instruments through which state-of-the-art robotic and computer technologies scale, filter and seamlessly translate the surgeon's hand movements into precise micromovements. Robotic surgery can decrease incision size and length of hospital stay, while improving patient comfort and lessening recovery time.
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Lasers are another alternative for some surgical procedures. Lasers can be used to cut, burn, or destroy abnormal or diseased tissue; shrink or destroy lesions or tumors; sculpt tissue; and seal blood vessels. Lasers may help surgeons perform some procedures more effectively than other traditional methods. Because lasers cause minimal bleeding, the operative area may be more clearly viewed by the surgeon. Lasers may also provide access to parts of the body that may not have been as easily reached manually. The introduction of brain monitors – like the BIS monitor previously mentioned– has provided anesthesia professionals with another method to help care for their patients. A BIS monitor is a medical device that measures brain wave activity and provides the anesthesia professional with information regarding the patient’s brain during surgery, anesthesia and sedation. The anesthesia professional can use this information to adjust the amount of anesthesia medications administered during the operation. Finding the right amount is very important – patients getting too much anesthesia medication are more likely to have anesthesia side-effects; too little medicine increases risk of the patient being awake during anesthesia. Although rare, anesthesia awareness can be a traumatic, psychologically debilitating experience for the patient.

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Works Cited Anandic Medical Systems AG. Web. 22 Mar. 2011. <http://www.anandic.com>. Baxter U.S. - Homepage. Web. 22 Mar. 2011. <http://baxter.com/>. BERCHTOLD. Web. 22 Mar. 2011. <http://www.berchtoldusa.com/home.aspx>. GE Healthcare. Web. 22 Mar. 2011. <http://www.gehealthcare.com/worldwide.html>. Hillenbrand Industries. Web. 22 Mar. 2011. <http://www.hillenbrand.com/>. MAQUET Cardiac Assist. Web. 22 Mar. 2011. <http://ca.maquet.com/>. Surgical and Operating Room Equipment. Web. 22 Mar. 2011. <http://www.dremed.com/>. Philips Healthcare. Web. 22 Mar. 2011. <http://www.healthcare.philips.com/>. Da Vinci Surgery. Web. 22 Mar. 2011. <http://www.davincisurgery.com/>. Stryker. Web. 22 Mar. 2011. <http://www.stryker.com/en-us/index.htm>.

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