Conversion of operating theatre from positive to negative pressure environment

Summary The severe acute respiratory syndrome (SARS) crisis led to the construction of a negative pressure operating theatre at a hospital in Hong Kong. It is currently used for treatment of suspected or confirmed airborne infection cases, and was built in anticipation of a return of SARS, an outbreak of avian influenza or other respiratory epidemics. This article describes the physical conversion of a standard positive pressure operating theatre into a negative pressure environment, problems encountered, airflow design, and evaluation of performance. Since entering regular service, routine measurements and observations have indicated that the airflow performance has been satisfactory. This has also been confirmed by regular air sampling checks. Computational fluid dynamics, a computer modelling technique, was used to compare the distribution of room air before and after the design changes from positive to negative pressure. The simulation results show that the physical environment and the dispersion pattern of bacteria in the negative pressure theatre were as good as, if not better than, those in the original positive pressure design.

[1]  John Colquhoun,et al.  Computational Fluid Dynamics Applications in Hospital Ventilation Design , 2003 .

[2]  J Eames,et al.  Operating theatre design. , 1968, Irish nurses' journal.

[3]  Monika Woloszyn,et al.  Diagonal air-distribution system for operating rooms: experiment and modeling , 2004 .

[4]  T. Chow,et al.  Ventilation performance in the operating theatre against airborne infection: numerical study on an ultra-clean system. , 2005, The Journal of hospital infection.

[5]  B Friberg,et al.  Inconsistent correlation between aerobic bacterial surface and air counts in operating rooms with ultra clean laminar air flows: proposal of a new bacteriological standard for surface contamination. , 1999, The Journal of hospital infection.

[6]  Qingyan Chen,et al.  Control of Airborne Particle Concentration and Draught Risk in an Operating Room , 1992 .

[7]  J. Peiris,et al.  Effectiveness of precautions against droplets and contact in prevention of nosocomial transmission of severe acute respiratory syndrome (SARS) , 2003, The Lancet.

[8]  K. Law,et al.  Tracheostomy in a patient with severe acute respiratory syndrome , 2004, British Journal of Anaesthesia.

[9]  P. Fanger Moderate Thermal Environments Determination of the PMV and PPD Indices and Specification of the Conditions for Thermal Comfort , 1984 .

[10]  Tin-Tai Chow,et al.  Performance of ventilation system in a non-standard operating room , 2003 .

[11]  Nhs Estates Ventilation in Healthcare Premises , 1994 .