Environment in the Operating Theatre (OT) – Exam Notes

Definition

• Operating Theatre (OT) is a specially designed sterile environment for performing surgical procedures safely and efficiently.

• Main objectives:

  • Prevent infection

  • Ensure patient safety

  • Facilitate smooth surgical workflow

  • Provide optimal conditions for surgical team

Components of OT

1. Anaesthesia Room

Functions

• Preoperative patient preparation

• Induction and administration of anaesthesia

• Monitoring patient before surgery

Equipment

• Anaesthesia machine

• Oxygen supply

• ECG monitor

• Pulse oximeter

• Blood pressure monitor

• IV fluid lines

Design Features

• Spacious and near OT

• Bright lighting

• Sterile and clean environment

• Wall-mounted gas pipelines

Role of Anaesthesiologist

• Administers anaesthesia

• Monitors vital signs during surgery

2. Sterilizer Room

Functions

• Cleaning, sterilization, and storage of instruments

• Prevention of surgical site infections

Design Features

• Separate dirty and sterile zones

• Adequate ventilation

• Storage for sterile instruments

• Equipped with sterilization devices

Sterilization Methods

1. Autoclaving (steam under pressure)

2. Dry heat sterilization

3. Chemical sterilization (ethylene oxide, hydrogen peroxide)

3. Recovery Room (PACU)

Functions

• Post-operative monitoring

• Observation until patient regains consciousness

Equipment

• ECG

• Pulse oximeter

• BP apparatus

• Capnography

• Ventilation equipment

Monitoring Includes

• Respiratory status

• Pain management

• Hemodynamic stability

Emergency Equipment

• Defibrillator

• Airway management tools

• Emergency drugs

4. Store Room

Functions

• Storage of surgical instruments, medicines, and supplies

Design Features

• Located near OT

• Separate sterile and non-sterile storage

• Shelves and cabinets

• Inventory control system

5. Changing Room

Functions

• Staff change into sterile attire before entering OT

Features

• Lockers for personal belongings

• Handwashing facilities

• Separate clean and dirty areas

• Maintains hygiene and prevents contamination

6. Scrub Room

Functions

• Surgical hand and arm scrubbing before surgery

• Reduces infection risk

Features

• Elbow-operated sinks

• Antiseptic solutions

• Sterile brushes and towels

• Proper ventilation

• Waste disposal area

Infection Control in OT

Importance

• Prevents surgical site infections

• Protects patients and healthcare workers

• Maintains sterile environment

Theatre Dress, Cap and Mask

Surgical Scrubs

Purpose

• Protect patient and staff from infection

Characteristics

• Lightweight and breathable

• Easy to clean

• Loose fitting

• Usually pocket-free

• Sometimes color-coded

Surgical Cap

Purpose

• Prevent hair and dandruff contamination

Types

1. Bouffant cap

2. Surgical skull cap

Face Mask

Functions

• Prevent droplet transmission

• Maintain sterile field

Types

1. Surgical mask

2. N95 respirator

Scrubbing Technique

Indications

• Before sterile procedures

• After touching contaminated objects

Steps

1. Wash hands and forearms

2. Clean nails

3. Apply antiseptic soap (chlorhexidine/povidone iodine)

4. Scrub fingers → wrists → forearms

5. Rinse thoroughly

6. Dry with sterile towel

Duration

• Usually 3–5 minutes

Donning a Sterile Gown

Steps

1. Check sterility of gown

2. Open package carefully

3. Insert arms into sleeves

4. Secure/tie gown

5. Adjust for full coverage

Important Points

• Covers torso and arms

• Acts as sterile barrier

• Usually made of fluid-resistant material

Gloving Technique

Steps

1. Perform hand hygiene

2. Select correct size sterile gloves

3. Wear without touching outer surface

4. Use double gloves in high-risk surgeries

Precautions

• Check for tears

• Remove gloves without contamination

• Dispose in designated waste container

Theatre Cleaning and Maintenance

Daily Cleaning

• Disinfect surgical tables

• Clean instrument trays

• Mop floors with disinfectants

• Maintain HEPA filtration system

Terminal Cleaning

• Done after each surgery

• Deep cleaning of all surfaces

• Sterilization of reusable equipment

• Linen replacement

• Prepares OT for next procedure

Frequently Asked Viva Questions

1. What are the main functional areas of an OT?

   • Anaesthesia Room, Sterilizer Room, Recovery Room, Store Room, Changing Room, Scrub Room.

2. What is PACU?

   • Post Anaesthesia Care Unit (Recovery Room).

3. Name three sterilization methods.

   • Autoclaving, Dry Heat Sterilization, Chemical Sterilization.

4. What is the recommended scrub duration?

   • 3–5 minutes.

5. Why is a surgical mask used?

   • To prevent droplet transmission and maintain sterility.

6. What is terminal cleaning?

   • Deep cleaning and disinfection of OT after surgery.

7. What is the function of a scrub room?

   • Surgical hand and arm preparation before entering OT.