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Special report: In the OR, the ceiling's getting crowded

by Kathy Mahdoubi, Senior Correspondent | April 22, 2011
From the April 2011 issue of HealthCare Business News magazine


“There are some big challenges,” says Viviano. “In order to do the design work we need to know what vendor it’s going to be and this could be any piece of equipment in a cath lab, a CT or an X-ray room. Sizing the room and making sure we are addressing all of the utility requirements is probably the biggest challenge.”

Ceiling infrastructure
Once the vendors and equipment have been chosen for a suite, the engineering really begins. There is very limited space inside the ceiling for all of the wire, hose and ducts required, let alone the heavy-duty infrastructure onto which the heaviest equipment is bolted.

“Above the finished ceiling, there is a lot of structure required to hold everything depending on the weight of the booms, or ceiling rails, or robots, and lighting and such,” says Viviano. “Each one of those has requirements from vendors, including the physical weight and moment loads they carry. This means those elements that the equipment bolts to needs to be designed by a structural engineer.”

Specific materials are not necessary for bolting equipment such as C-arms or equipment booms, he says. As long as the loads are met, any material from structural steel to Unistrut framing and tubing can be used. What Viviano means by “moment loads” is the increased weight of a piece of equipment as it is articulated toward its most expanded point. For instance, an equipment boom that is hanging down and stretched to capacity holding surgical equipment and whatever else is mounted there.

“When an equipment boom hangs off the ceiling and there’s an arm, it creates a moment function on that support,” says Viviano. “It’s pretty heavy when you support something from a distance laterally. Some of them I see reaching up to the thousands of pounds.”

If that sounds like a challenge, consider installing something like a hybrid OR in an existing, renovated space. Viviano says this is often the case, and it’s an obstacle course to make everything fit as it should.

“In a renovation you really don’t have a lot to work with and you pretty much know what your barriers are,” he says. “The other factor to consider is that almost all pieces of medical equipment in the room, whether they are on the floor or mounted in the ceiling, have a very specific floor-to-ceiling height, especially for C-Arms.”

Building automation takes it one step further
The final frontier for the hybrid OR seems to be going in the direction of near-complete building automation, or essentially, being able to control an entire rooms’ worth of equipment, whether mounted on the ceiling or the floor, from a single control panel. Viviano says this requires an entirely new set of equipment to make this run smoothly.

This trend is already taking over the latest and greatest hybrid suites, and it is just a snapshot of the future for the hybrid OR from floor to ceiling.

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