OPERATION THEATRE SES/OT

1. General

Modular OT/General OT/Normal OT

 General OT/Modular OT/Normal OT room should preferably be Square in shape and minimum size-6m x 6m for effectiveness of
Laminar flow system avoiding convenient pockets of stagnant air caused microbial growth and for better asepsis. Height of OT room
shall preferably be > 4.25 m for convenience of setting of Laminar Plenum and HVAC ducting.
 General OT/Modular OT/Normal OT room should preferably be free of beam. The beam inside the OT should be avoided for
convenience of fitting of internal ducting and installation of Laminar Plenum. If beam is there in the OR, it should not be at the centre of
the room. Beam should be either at the wall or at the offset from the centre of the OR. There should not be any projected portion or any
sharp corner of column/wall inside the OT. Double brick wall/wall panel should be made to cover-up projection of column. There should
not be any shaft inside the OT.
 No sewage/drain pipe/Water pipe should be inside the General OT/Modular OT/Normal OT.
 No fire pipe and sprinkler should be inside the General OT/Modular OT/Normal OT.
 The area of the OT for CTVS, Hybrid and Robotic surgery should be ≥70 Sq.m and height 4.5m.
 Each OT must have Scrub station and Anti Room in its adjacent for regulating traffic in General OT/Modular OT/Normal OT.
 Each General OT/Modular OT/Normal OT should have one for patient entry and another for doctor’s entry from Scrubber’s room.
 Location of the door of General OT/Modular OT/Normal OT for patient entry should be in the middle of wall and the door from the
Scrubber side must be at least 1.0m away from one side of the OT Room for placement of Return air ducts at the corners.
 Each General OT/Modular OT/Normal OT should have preferably be one hermetically sealed window (Size-1500 x 1200 Approx) with
double toughened glass and Motorized Venetian blinds sandwiched/toughened Frosted glass with dark film to prevent claustrophobia of
the Surgeon and other OT staff. OT window should be flushed to inside wall of the OT.
 Internal ducting inside OT should be of prefabricated Aluminium insulated with Nitrile Rubber/Polyethylene.
 Door shall be Automatic Hermetically sealed sliding door with PUF sandwiched HPL board and vision panel-300 x 300 mm for General
OT/Modular OT/Normal OT and Double leaf hinge typed flushed door of PCGI/SS-304 material with vision panel-300 x 300 mm for
General OT/Normal OT/Minor OT. Double Leaf
 Every Modular OT should have dedicated AHU of 6000 CFM capacity Super Specialty OT and AHU of 4500 CFM for Normal/General
OT. AHU should be placed in the nearby of OT to prevent energy consumption.
 AHU should be of double skinned PCGI wall with corner coving and VFD. AHU is either for supply of 100% fresh air with 25 ACPH or
25 ACPH with 5 fresh air as per NABH. Ideally, AHU blower should run 24 x7 to keep OT free from bacteria. At the idle condition of
OT, AHU Blower will run without air-conditioning.
 Laminar flow system with two mono filament precisely woven polyester sheet and terminal HEPA filter of 0.3micron should be installed
in the General OT/Modular OT/Normal OT. Laminar plenum with built-in light may be optional.
 Laminar size shall be 2400 x 2400 mm for Super specialty and 2400 x 1800 mm for General OT /Normal OT. Laminar Plenum should be
fitted at the centre of the OT room
 Required condition of air management in the Modular OT (Super specialty OT)

 Classification - 100 (particles measuring 0.5 microns or larger/cu.ft as per NABH

 for Super specialty OT)
 Bacteriological class -B (5 CFU/ m³)
 Particle decontamination kinetics -5 min
 Biological decontamination kinetics -5 min
 GMP Annex I classification -Class A
 ISO 14644/1/NABH classification -ISO 5(at rest condition)

 The air quality at the supply i.e at the grill level should be class 1000 (particles measuring 0.5 microns or larger/cu.ft as per NABH) /ISO
class 6(at rest condition) for General OT.
 The temperature at 21 +/- 3 Deg C with corresponding relative humidity between 45 to 60% should be maintained inside the OT all the
time.

 OT should be kept under positive pressure (15 pascal) as per ISO 14644 for prevention of infection. Higher pressurized air is vented out
through Pressure Control damper.
 Exhaust cabinet with blower should be equipped for ease of fumigation in OT. Return air riser should be placed at the four corners and
connected with AHU. Each return riser should have two diffuser one will be at the bottom and other at the top. Each diffuser grill should
be made of powder coated Aluminium/SS-304 and equipped with 20micron filter and damper. The fins of grill should be inclined
downwards to the floor.
 Wall and ceiling of Modular OT should be cladded with panel like SS-304/EGP backed with Gypsum board or PUF sandwiched SS-
304/EGP or SMS panel. Joints of SS-304/EGP panel backed by Gypsum shall be filled with epoxy sealant. Joints of panels shall be
 sealed with Silicon gasket for SMS Panel/PUF panel Metallic wall panel, the return air ducts at the four corners should be covered with
Corner panel in General OT/Normal OT.
 The inside wall and ceiling surface of the False ceiling shall be plastered and coated with Antibacterial paint/Epoxy/PU paints before
fitting of False Ceiling.
 Corners inside OT should have coving.
 General OT/Modular OT/Normal OT wall/ Metallic panel should be coated with antibacterial/epoxy painting by 300-400 micron
thickness after putty and primer. Panels/Finished Walls shall be smooth and perfectly flat without any undulation.
 Flooring of General OT/Modular OT/Normal OT should be made antistatic with 2 mm thick PVC Roll/3mm thick Epoxy. The floor
finish should pass over a concealed cove former and continue up the wall upto 100mm.
 Before PVC/Epoxy flooring, Copper grounding strip (0.05 thick, 50 mm width) should be laid flat on the floor in the conductive adhesive
and connected to main copper earth wire for grounding. One earthing Copper lead should be brought out of from every 150 Sq.ft. area
and attaching it to main earthing Copper strip/ground.
 Sealed (Air tight) Clean room fitting Peripheral light with dimmable facility should flush to the False Ceiling. Peripheral Light shall be
required to generate 400-500 Lux inside the OT. LED light/Fluorescent (2’x2’)/(1’x 3’) Fluorescent lights with anodized Aluminum
reflectors and optical antiglare system for adjustable light distribution.
 Laying of PVC conduits, Modular Switch Boxes, Modular Switches-sockets, Power and Light wiring including Earthing wire for all the
lighting controls, Pendant and other equipment fixtures and fittings inside the theatre Wiring with low leakage current wires of FRLS
wires should be as per requirements. 5/15 Amps antibacterial switched socket outlet set- 2 Nos shall be equidistant flushed in each wall at
325mm height from FFL of OT. Wiring for 250 volts single phase and earth 4 sq.mm and 2.5 sq.mm PVC insulated copper conductor
1100 volts stranded flexible wires should be concealed with conduit for switch & sockets. One switch and socket along with suitable size
of wire must be fitted inside the OT for operating ‘C’Arm. Installation of all electrical cabling must be of IS: 1554 (As per latest
amendment) standard and wiring as per IS: 732 standard and proper earthing of OT and other accessories in the OT room as per standard
guidelines of BIS. Fittings should be sealed on accordance with the standard IP54. Earthed equipotent bonding of all exposed metal work
should be provided.
 Medical Gas pipeline system with medical graded copper pipeline and Gas outlets should be fitted inside the OT thorough Pendant.
 General OT/Modular OT/Normal OT should be equipped with the following equipment/items.
 Anaesthetic Pendant (To be fitted at the right and Top of the head end of the patient). Pendant should have Oxygen x 2, Vacuum x 2,
Nitrous x 1, Medical Air(4 bar) x 2, AGSS x 1. Antibacterial switch and socket-8/10 Nos, Data cable-RJ45-2 Nos and adjustable Shelves.
Load bearing capacity-200 Kg
 Surgeon Pendant (To be fitted at the left and bottom of the foot end of the patient). Pendant should have Oxygen x 2, Vacuum x 2,
Surgical Air(7 bar)/Nitrogen x 2, CO2 x 1. Antibacterial switch and socket-8/10 Nos, Data cable-RJ45-2 Nos and adjustable Shelves-2
Nos. Load bearing capacity-200 Kg
 Dual dome LED OT Light (To be fitted at the centre of the OT Room). Dome should not hit the head of surgeon when it will be fitted at
the ceiling height 3m from FFL. If Camera and Flat Monitor are integrated with OT Light, they should be of full HD.
 Surgeon Control Panel should flush on the OT wall. Surgeon control panel provide 9 services (Present time, Elapsed time, Room
pressure, Gas alarm, HEPA filter status, Temperature & Humidity, Lighting system, Telephone, Music Control )in the OT.
 X-Ray viewer(2/3 plates) should be flushed on the OT wall.
 Writing Board shall be flushed on the OT wall
 Built in storage cabinet to be flushed on the OT wall.
 Pressure relief dumper shall be placed to the clean corridor and covered with grill.
 Pass Box should be flushed on the OT wall and connected with Dirty corridor/Sluice room.
 A Scrubber made of SS-304 material should be installed in the scrubber room adjacent to OT. The Scrubber sink should be 3 bay
equipped with inbuilt soap dispenser, Geyser, thermostatic control, hands free operation through infra-red sensors and have manual foot
and operation mode.

2. Integrated Modular OT GENERAL

 Integrated Modular OT should have all requirements of Modular OT

 Integration of equipment (Endoscopi camera, In light camera, Room camera, C-Arm, Navigation system, Microscope, Patient vital sign,
Conferencing solution, archiving system etc.) inside the Integrated Modular OT
 Integration of Modular OT with the Conference Room/Auditorium having projector and Monitor facility, consultant room and outside the
hospital
 Integration OT to OT.
 Integration requires following features in the OT:
 Digital Display Monitor
 Audio Visual communication system
 Central Control System
 High definition Monitor for Image data management system
 PTZ camera
 All Monitors should be of full HD. Monitors on the wall should be flushed
 Touch screen should be medical graded.
 Dual dome LED OT Light (To be fitted at the centre of the OT Room). Light dome should not hit the head of surgeon when it will be
fitted at the ceiling height 3m from FFL. Camera and Flat Monitor integrated with OT Light should be of full HD.

3. MINOR OT GENERAL

 Size of Minor OT may be same as/ smaller than the General OT

 Flooring of General OT/Modular OT/Normal OT should be made antistatic with 2 mm thick PVC Roll/3mm thick Epoxy. The floor
finish should pass over a concealed cove former and continue up the wall upto 100mm.
 Before PVC/Epoxy flooring, Copper grounding strip (0.05 thick, 50 mm width) should be laid flat on the floor in the conductive adhesive
and connected to main copper earth wire for grounding. One earthing Copper lead should be brought out of from every 150 Sq.ft. area
and attaching it to main earthing Copper strip/ground.
 Ceiling of Minor OT should be with panel like SS-304/EGP backed with Gypsum board or PUF sandwiched SS-304/EGP. Joints of SS-
304/EGP panel backed by Gypsum shall be filled with epoxy sealant. Silicon gasket should be used for PUF sandwiched Metallic panel.
 The inside wall and ceiling surface of the False ceiling shall be plastered and coated with Antibacterial paint/Epoxy/PU paints before
fitting of False Ceiling.
 All Corners inside OT should have coving
 Sealed (Air tight) Clean room fitting Peripheral light with dimmable facility should flush to the False Ceiling. Peripheral Light shall be
required to generate 400Lux-500 Lux inside the OT. LED light/Fluorescent (2’x2’)/(1’x 3’) Fluorescent lights with anodized Aluminum
reflectors and optical antiglare system for adjustable light distribution.
 Laying of PVC conduits, Modular Switch Boxes, Modular Switches-sockets, Power and Light wiring including Earthing wire for all the
lighting controls, Pendant and other equipment fixtures and fittings inside the theatre Wiring with low leakage current wires of FRLS
wires should be as per requirements. 5/15 Amps antibacterial switched socket outlet set- 2 Nos shall be equidistant flushed in each wall at
325mm height from FFL of OT. Wiring for 250 volts single phase and earth 4 sq.mm and 2.5 sq.mm PVC insulated copper conductor
1100 volts stranded flexible wires should be concealed with conduit for switch & sockets. One switch and socket along with suitable size
of wire must be fitted inside the OT for operating ‘C’Arm. Installation of all electrical cabling must be of IS: 1554 (As per latest
amendment) standard and wiring as per IS: 732 standard and proper earthing of OT and other accessories in the OT room as per standard
guidelines of BIS. Fittings should be sealed on accordance with the standard IP54. Earthed equipotent bonding of all exposed metal work
should be provided.
 Two nos Diffusers (Size-610 x 610)mm for supply air shall be placed at the centre of the OT and four nos diffusers (Size-610 x 610)mm
for return air at the four corners of the False ceiling inside the Minor OT.
 The temperature at 21 +/- 3 Deg C with corresponding relative humidity between 45% to 60% should be maintained inside the OT all the
time.
 Medical Gas pipeline system with medical graded copper pipeline should be concealed to the wall and Gas outlets (Oxygen x 2, Vacuum
x 2, Nitrous x 1, Medical Air (4 bar) AGSS x 1 should be fitted to the wall or Anaesthetic Pendant (To be fitted at the right and Top of
the head end of the patient). Pendant should have Oxygen x 2, Vacuum x 2, Nitrous x 1, Medical Air(4 bar) x 2, AGSS x 1. Antibacterial
switch and socket-8/10 Nos, Data cable-RJ45-2 Nos and adjustable Shelves. Load bearing capacity-200 Kg inside the OT.
 Double leaf Hinge door(SS-304/PCGI) with view panel
 Dual dome LED/Halogen ceiling OT light to be placed at the centre of the OT room. Dome should not hit the head of surgeon when it
will be fitted at the ceiling height 3m from FFL.
 Each Minor OT should have preferably be one hermetically sealed window (Size-1500 x 1200 Approx) with double toughened glass and
Motorized Venetian blinds sandwiched/toughened Frosted glass with dark film to prevent claustrophobia of the Surgeon and other OT
staff. OT window should be flushed to inside wall of the OT.
 X-Ray viewer(2/3 plates) should be flushed on the OT wall.
 A Scrubber made of SS-304 material should be installed in the scrubber room adjacent to OT. The Scrubber sink should be 2/3 bay
equipped with inbuilt soap dispenser, Geyser, thermostatic control, hands free operation through infra-red sensors and have manual foot
and operation mode.
 1. Works sequence in OT after inside plastering is as following:
Coating of antibacterial paint/Epoxy/PU paints at the concrete ceiling and the walls inside the false ceiling

Internal ducting including supply air and return air ducting and fitting of Laminar plenum with suspended GI string.

Fitting of OT light Bracket and Pendants’ brackets

Laying of Gas pipelines

Wall panelling and False ceiling

Fitting of hermetically sealed window and other equipment, OT Light and Pendants, Pass Box, Surgeon control panel, X-Ray Viewer, Writing
Board

Wall painting

Antistatic flooring

Fitting of Hermetically sealed sliding door

Fitting of Scrubber
 OPERATION THEATRE COMPLEX– SES/OT COMPLEX

1. GENERAL-

2. OT Complex is divided into four following zones :

 ZONE 1– PROTECTIVE
Reception, Waiting, Trolley Bay, Change Rooms, Rooms for administrative staff, Stores & Record and Conference Room

 ZONE 2– CLEAN AREA

Pre Operative, Post Operative, Plaster Room, Staff lounges, Stores

 ZONE 3– STERILE AREA

Operating Theatre, Scrub Room, Anesthesia Room, Setup Room

 ZONE 4– DISPOSAL AREA

Dirty Utility, Disposal areas from each OT & Corridor leading to disposal zone, Disposal Corridor

1. OT complex should have easy access from outside hospital. OT complex should be located where public movement will be less and
noise also will be less.
2. OT Complex should have unidirectional flow movement. No criss-cross of the movement inside the OT complex.
3. OT complex should be connected with other floors of the hospital through more than two lifts. One or more lifts for Patients’ and One
or more lifts for doctors’ and staff.
4. OT complex should have one entry and exit for Patients and other entry and exit for doctors and staff through Change rooms.
5. Airlock should be there at the entry and exit of the OT Complex if change room is not there.
6. Dirty corridor should be leading to Dirty lift/Dirty Dumb waiter/Dirty chute. Clean corridor also leading to Clean lift/Clean Dumb
waiter. Dirty lift/Dirty Dumb waiter/Dirty linen chute should preferably at nearby place of the dirty area of Laundry and CSSD. Wash
Basin should be fitted at the sluice area connected to the Dirty corridor.
7. OT should be linked to the Dirty corridor through Pass Box/Hatch Box. Clean corridor is linked to the OT through door.
8. Pre-OP and Post OP Rooms should be placed as such that there should not be any criss-cross of the Pre and Post Op patient.
 9. Entry into Pre-Op should preferably be at the entry Airlock of the OT complex
10. Scrubber should preferably be in between OTs or at the nearby place of OT. Scrubber area should always be equipped with plumbing
line for supply of soft water and drain line.
11. TSSU room in the OT complex should be well ventilated and equipped with requisite plumbing system for supply of RO water of
15PPM and drain line with flow trap system..
12. OT complex should not have any toilet inside the clean area. Toilet should be before entry to the change room.
13. No toilet should be placed in the top floor of the OT complex. There should not be any sewage or drain pipe or any other water
pipeline passing through OT complex.
14. Seepage or dampness inside the OT should not be present in the OT complex .
15. OT complex should have auto sliding door or double swing door with vision panel at the entry and exit for ease of movement.
16. OT complex should be consisting of Operation Theatres, Scrubber room, Clean corridor, Dirty corridor, Pre Op, Post Op, TSSU,
Equipment store, Linen store, Pharmacy store, Doctors’ room, Nurses’ Room, Anesthetists’ room, Sluice area,
Preparation/Anaesthesia room, Staff rest room, Conference room, Reception, Trolley bay, Record room, Change rooms (M & F) and
Toilet before Change room. OT complex should have rooms for AHUs, UPS and OT control Panel in its adjacent area. Waiting area
for patients should be adjacent to the entry to the OT complex.

3. Finishing schedule of OT complex

3.1 Flooring

2 mm PVC roll with self levelling compound for flooring. The floor finish should pass over a concealed cove former and continue up the
wall for 100mm. The floor should be provided flat to within a tolerance of ±3mm over any 30 Sq.mtr area. The joints in the flooring
should be sealed by using a PVC welding bar of matching colour and hot air gun for fusion of welding bar with flooring to provide a
continuous sealed surface.
3.2 Ceiling

False Ceiling should be of metallic (PCGI/ACP)/ Calcium Silicate/Gypsum/Mineral fibre). In case of Calcium/Gypsum board are used,
they should be coated with antibacterial paint/epoxy/PU(Poly Urethene). Height of False Ceiling should be 2400-3000 mm (minimum)
from FFL. Colour of the False ceiling shall be white.

3.3 Wall

Brick Plastered Wall should be finished with Putty, Primer and Antibacterial/Epoxy/PU painting with thickness 300 to 400 micron.
Painted wall surface should be smooth, flat and matt finished. Paint should be of light colour(Off white/Light grey/Light green/Light
Blue/Light beige/Client preferred colour) and soothing to eye. Antibacterial painted SS-304/EGP panel/SMS panel is also used for
construction of OT and OT complex.

3.4 Coving

All corners of OT Complex should be coved.

3.5 Door (2100H x 2000W)mm

Automatic sliding/Hinge door(Double Leaf) of 50 mm thick with vision panel (300 x 500 mm) should be fitted. (Door shall be of Glass
or PUF sandwiched with PCGI/HPL/SS. Colour of the doors should be same.

3.6 Door (2100H x 1000W)mm- Single leaf

Flushed door of 50 mm thick with vision panel (300 x 500 mm) should be fitted. (Door shall be of PUF sandwiched with PCGI/SS/PC.
Colour of the doors should be same.
3.7 Light

Clean room light fitting should be used for lighting of clean area of the complex. Light should be flushed to the ceiling. Light should be
of LED/CFL/Fluorescent (Lux level from 250 to 350). Size-2’ x 2’/3’ x 1’

3.8 Corner Guard

Corner Guard should be provided at each projected sharp edge of the wall. Corner Guard should be of SS-304/Aluminium reinforced
PVC material. Height of Corner guard shall be 1000m – 1200m.

3.9 HVAC

6 -15 ACPH shall be maintained with comfort condition of Temperature 23±2⁰C and RH- 45 -65% throughout year. Air pressure of
corridor and Scrubber area shall be less than the air pressure prevailed inside the Operation Theatre. Dedicated AHU should be equipped
with fine filters for OT complex. Continuous air circulation system (24x7) should be provided inside OT complex with AHU.
 1 2 2a 3 4 5 6 7 8 9

H H

G2

G1
G G

F F

E E

D D

C C

B2 B2

B1 B1

B B

A A

1 2 2a 3 4 5 6 7 8 9 10