Operating Room Light Fixtures Part Ⅱ
6. Operating table accent lighting
The operating table is the lighting center and focal point of the operating room.
Therefore, the accent lighting of the operating table occupies the first place in the surgical lighting.
Operating table lighting usually adopts a surgical shadowless light with multiple mirrors.
Conventional operating rooms mostly use surgical shadowless lights with a large disc structure, which are suspended on the ceiling above the operating table, and can be moved horizontally and vertically as required and fixed, which has the advantages of high illumination and good shadowless effect.
The clean operating room adopts the air purification measures of vertical laminar flow and positive pressure air supply, and the air supply port is also set on the ceiling above the operating table.
In order not to obstruct the flow of purified airflow from the top floor of the operation to the operation area, a combination of a small phase-fixed shadowless light and a multi-head universal joint easy-to-hang structure light head with a fixed base of the shed is usually used.
Surgical shadowless lights are composed of multiple small light heads with the help of connecting rods, each connecting rod can provide 360° horizontal and vertical flexible adjustment and can be fixed at any position.
Its installation position needs to be coordinated with fixed devices such as indoor air supply outlets, taking good care of lighting and purification effects.
The selection of the light source of the surgical shadowless light should meet the following four conditions:
① The color temperature of the light source should be an intermediate color (white).
It should be between 3500-6700K, so that the human tissue can achieve good color fidelity.
② The color rendering index of the light source should be close to natural light (Ra=100).
In order to enable doctors to clearly identify the actual state of various tissues and organs, and correctly determine whether the surgical site is diseased.
③ The light source should strictly prohibit the stroboscopic effect.
Because during surgery, surgeons and assistants often work in a darkened field for a long time.
If the operating light is flickering, it will increase the visual burden of the operator, cause visual fatigue, and easily cause the operator to have delusions and bring adverse consequences.
④The operating light source should have a long service life.
At present, the surgical shadowless light with LED as the light source has the following five advantages that the traditional surgical shadowless light cannot match:
①Cold light source. There is almost no temperature rise during the surgical treatment, the operator and the patient do not feel extremely uncomfortable, and at the same time, the risk of dehydration that may be caused by the traditional light source irradiation is avoided.
②Cool white light with a color temperature of more than 4300K, which is closest to natural light, is used, and its light quality is much better than that of traditional light sources.
This ideal index makes it possible to maintain the standard of 95 even in dark places, allowing the surgeon to make more accurate judgments during the operation.
③ Color temperature can be adjusted. By controlling the system and the chip to mix light, various color changes and image formation are realized, which effectively relieves the doctor’s visual fatigue during surgery, distinguishes fresh and bad external tissues, and improves the quality of surgery.
④The LED light is shock-resistant, impact-resistant and not easy to be broken, the waste is recyclable, and there is no mercury pollution. It is a truly environmentally friendly and energy-saving product.
To meet the hospital’s JCI certification with “patient safety” as the core, the core values of the review are: risk reduction, safety assurance, and continuous improvement of medical quality.
⑤Long life, up to 50,000h or more, saving electricity.
7. Viewing light lighting
X-ray viewing lights should be installed in the operating room as needed.
In order to keep clean, save space, and facilitate observation, the viewing light is generally installed opposite to the doctor, and the front side is flush with the wall.
The seams are glued and sealed, or the four sides are used to take stainless steel flanging, and the convenience of replacing the internal light source should be considered.
The number of viewing lights for the operation rate can be considered according to the size and type of the operating room, and it should be negotiated with professional medical personnel.
Under normal circumstances, there are 3-5 lights (consider clighting the diagnostic film and the reference standard film at the same time).
Regardless of the number of in-wall viewing lights, the height is mostly 400-600mm. In the operating room, standing observation should be considered. The installation height of the viewing lights can be +1300-1400mm from the bottom edge to the indoor floor.
Multi-unit viewing lights are usually controlled individually for each unit, and the switch is usually located on the control panel on the underside of the viewing lights.
The brightness of the medical film viewing light has an important influence on the diagnostic quality of X-ray films.
The low-brightness film viewing light can intercept the density image recorded by the film, resulting in misdiagnosis or missed diagnosis in the library.
Therefore, the maximum brightness of the center of the viewing light should not be lower than 4200cd/m2, and the brightness of the viewing screen should not be greater than 15%.
When extremely high brightness is required (for observing high-density missed diagnosis), the maximum brightness in the center of the viewing light should not be lower than 4200cd/m2, and the brightness difference of the viewing screen should not be greater than 15%.
When extremely high brightness is required (for observing high-density X-ray films), the light box should be equipped with strong light), and the continuous dimmable control method (including light source and strong light) should be adopted for the medical film viewing light in the operating room.
There are two reasons for this:
①The central operating department of the general hospital often performs various types of operations, and adopts a dimmable viewing light, which can adapt to the reading of X-ray films of various optical densities.
②The general illumination of the operating room is very high, and the head is dimmable. The film viewing light also adopts the dimming control method, which is easy to balance with the external light source of the reading environment.
In addition, it should also be noted that other lighting sources should not directly illuminate the film viewing light, so as not to reduce the reading effect.
8. Signal lighting
With all kinds of modern medical equipment entering the operating room, operating room indicator lighting has attracted more and more attention, mainly including:
(1) Operating door light
The operating door light indicates that the operation is running, and can use a red signal light or a red in-operation signal subtitle.
The door lights are mostly installed above the outer side of the door of the easy passage in the operating room, and the bottom edge is 200-300mm away from the door frame.
However, it should be noted that the indicator lights can be clearly observed from all directions of the waiting hall.
The operating door light can be set with a separate control switch on the indoor side. It should be noted that it is obviously different from other light switches, but it is advisable to sell it together with the equipment that marks the beginning of the operation, such as the operating room door.
A relatively simple and practical method is to use the same power control switch for the door light and the shadowless light.
(2) Insulation monitoring sound and light alarm
In places where cardiac surgery may be performed, in order to prevent micro-shocks from threatening the life safety of patients, a 1:1 isolation transformer must be installed, and a local IT system should be used for power supply.
Since the secondary measurement of the isolation transformer is not grounded, when the first ground fault occurs, the fault current is only the line-to-ground capacitance current, which is extremely small and does not endanger the patient, and the operation can continue.
But at this time, the insulation monitor must be linked to send out an audible and visual alarm signal.
The sound and light alarm can be installed on the wall facing the surgeon in the operating room, about 18m from the ground.
Indoor personnel can turn off the sound alarm through the switch on the control box, but the light alarm signal is not allowed to be turned off until the fault is removed.
(3) Fire sound and light alarm
Accept the command of the building’s fire alarm and linkage system. When a fire occurs in the fire division or other related areas where the operating room is located, which may threaten the safety of the operating room, an audible and visual alarm signal will be issued.
In order to facilitate the emergency treatment of doctors, indoor personnel are allowed to turn off the sound alarm, but the light alarm is not allowed to be turned off.
The fire sound and light alarm should be set independently and should not be used in combination with other alarms.
(4) Equipment failure or sound and light alarm of medical gas system
When a medical device fails, the system will emit a light alarm.
The medical gas system alarm includes four kinds of oxygen, air pressure, nitrous oxide and negative pressure. It monitors the working conditions of the four kinds of gas-making equipment and alarms the faults, and at the same time, it gives a state alarm for the abnormal pressure of the four kinds of medical gas in the operating room.
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