Post-op, they studied patient outcomes to see what worked best. And they tried a variety of approaches that they hoped would allow them to accommodate infected patients while mitigating risk to staff and those in recovery. They made some ORs negative pressure and some ORs positive pressure.
In 2015, hospitals in South Korea did several things differently to adjust to the new infection risk presented by the MERS outbreak. We can learn from previous global outbreaks by looking at the ways surgeons around the world faced similar issues. These are difficult questions with no easy answers. Keep the OR positive, bring in the patient and risk the release of viral particles into the OR and potentially to the other suites, racetrack, and to other patients in this area? Or make the OR negative pressure to protect patients in adjacent areas, which would also allow microbes and bacteria into the surgical suite? For instance, surgeons performing surgery on COVID-positive patients faced a conundrum regarding infection control. In the early months of the pandemic, we began to see the limitations of the positive air pressure OR. Positively pressured rooms prevent particles from adjacent areas from entering the operating rooms. With the body so vulnerable, conventionally we circulate huge amounts of clean air though the operating suite with a cascade of transferred air from the sterile core into the OR and from the OR into the surrounding racetrack. Surgery means breaking the body’s protective barrier to infection, bacteria, and fungi. Due to the pandemic, requests are now coming in from clinicians for alternative configurations for ORs so that they can treat COVID-positive patients and not risk spreading the infection to adjacent operating rooms.įrom an engineering and design perspective, I wonder if there is a better approach that can help reduce HAIs and save lives? Do we need, for example, both positive and negative-pressure ORs? Why we use positive pressure in ORsįirst, let us remember why we use positive air pressure in surgery. Prior to the pandemic, the CDC recorded the US making progress in reducing HAIs. In Canada, a 2013 study indicated that more than 200,000 patients get infections every year while receiving healthcare and 8,000 die as a result. In 2018, the US Centers for Disease Control and Prevention (CDC) identified that nearly 1.7 million hospitalized patients in the US annually acquire HAIs while being treated for other health issues and that roughly 99,000 infected patients die due to these issues. And the air that systems push into the OR is typically HEPA-filtered and extremely clean.Īs I’ve previously written, HAIs are a major issue. They are designed to shield the surgical site from infection from outside. Typically, ORs have been protected with positive air pressure. And the pandemic experience has shed new light on what's been a constant challenge, the engineering and design of operating rooms (ORs) that reduce hospital-acquired (or healthcare-acquired) infections (HAIs). This will reduce the risk of contaminated air finding its way back into non-contaminated areas through a back-draught situation.People are at their most vulnerable in the operating room. The exhaust air ducts for isolation rooms should be independent from the building’s air exhaust system. To maintain negative pressure, the exhaust system needs to remove more air than what is being supplied into the room. Magnehelic gages should be installed to ensure negative pressure relationships are held.Ī dedicated exhaust system should be provided from the isolation room. It is imperative that the isolation room keeps negative pressure to the anteroom, and the anteroom keeps negative pressure to the surrounding area, to ensure infectious particles do not escape from either room into the surrounding areas when any of the doors are open. For Class N isolation rooms, due to the negative pressure relationship between the isolation room and the surrounding area, separate doors can be provided for the ingress and egress of the patient’s bed directly in and out of the isolation room. The anteroom provides access to the isolation room for staff and visitors. The door into the anteroom from the isolation room should be self-closing, and should swing into the anteroom. When designing an isolation room, make sure the anteroom has enough space for storage and application of PPE.
0 kommentar(er)
