c. Size of Individual Operating Room. In addition to plans for the number of
ORs required, the size of each room must also be considered. Certain types of surgery
require the use of much bulky equipment. This is especially true of open-heart surgery,
during which large machines are required to pump and oxygenate the blood outside of
the body and to monitor the functioning of the heart. Factors such as this must be
planned for and sufficient floor space provided so that breaks in aseptic technique due
to overcrowding will be avoided. On the other hand, rooms should be no larger than
necessary, thus reducing the amount of unnecessary times spent walking. The Army
criteria for square footage per room are sufficiently flexible to provide for the needs of its
hospitals. (See figure 1-3, "Type" floor plan for an Army hospital-operating suite.)
d. Four Areas. The designations listed in the Four Zone Concept (1) thru (4)
are not necessarily used for all hospitals, but whenever feasible the surgical suite is
segregated into four areas for traffic control. The purpose of such control is to assure
maximum protection against infections. In analyzing the traffic and commerce system
of the OR system, specific traffic patterns must be determined. These are
dependent on the entrances and exits for both personnel and materials. Renovation
planning of existing facilities should consider renovation of central supply and storage
areas to bring these as close to the point of utilization as possible. Where entirely new
wings, buildings, or entire hospital complexes are being considered, there is opportunity
to design traffic, materials-handling, and storage systems around the requirements of
the surgical suite. Traffic control design is aided by designation of the four-zone
concept (as shown below): the interchange area, semirestricted area, restricted area,
and dirty area.
Four-zone concept.
(1) Interchange area. The interchange area is provided to enable persons
from outside the surgical suite to meet with personnel within the suite when necessary.
Examples of such rooms are the offices--one for the OR supervisor and one for the
chief of anesthesiology (see figure 1-3 (18) and (19))--whenever the offices for these
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