Reanimations

In recent years in Kazakhstan huge attention is paid to quality of treatment in medical and treatment institutions. It goes without saying that an important role in it is played by correct arrangement of work of medical staff, right selection of necessary diagnostic, operational equipment, implementation of construction and designing works in operational units with strict observation of adequate regulatory documents, observation of route and maintaining of the set classes of cleanliness of rooms excluding development of internal hospital infections.

LLP Surgicare Kazakhstan leaning on the advanced experience of foreign partners and its own experience in implementation of such projects is glad to offer you its services in equipment and reconstruction of operational units and reanimation wards.

Clean room is a room where the size and number per cubic meter of such particles as dust, microorganisms, aerosol particles and chemical vapors are kept in a certain set range in the air. If necessary also other parameters, for example, humidity, pressure and temperature can be controlled there. Such premises, as a rule, are built and used so that receipt, generation and accumulation of such particles inside the premises could be minimized.

In general clean premises include the following basic elements:

• Enclosing wall structures (carcass, dumb wall panels, doors, windows);
• Hermetically sealed panel and cassette ceilings we built-in spotlights;
• Anti-static floors;
• System of preparation of air (inflowing, exhaust recirculatory ventilation equipment, air induction apparatus, air distributors with finish filters, air regulating machines, detector apparatus and automatization elements etc.);
• System of controlling of Engineering Systems of clean rooms;
• Air Chambers;
• Pass through windows;
• Filter and ventilation modules for creation of clean zones inside clean premises.

In Medical Institutions clean rooms are necessary in operational unit, reanimation wards and delivery departments.

The basic tasks of a clean room is reduction of the risk of development of post operational infectious complications, preliminary treatment of development of internal hospital infections.

Creation of clean rooms is regulated by the rules of production of medicines of the European Union (EU guide to good manufacturing practice for medicinal products), also known as the rules of GMP. GMP rules are aimed at prevention of conditions which may lead to release of low quality production and contain requirements to buildings, equipment and staff, correct construction of technological process of production, training of the staff, control, reporting and validation of production.

In medicine on the basis of the proposed basic elements the following objects are created:

• Module facilities for cleaning and disinfecting air in small clean premises (procedural, wrapping, operational, anesthetic) of medical institutions and companies of electronic industry.
• Aseptic wards with laminar airflow for treatment of patients with immune depressed conditions, for intensive therapy of leukemia, care for patients after transplantation of bone marrow, care for patients with intensive burns.
• Aseptic operational rooms with laminar airflow for creation of air environment with low level of microbe pollution inside the zone of open wound at implementation of surgery.
• Aseptic reanimation rooms and wards of intensive therapy of patients who underwent complex surgical intervention, premature children and babies traumatized at labor, patients with burns etc.
• Complexes of clean production premises;
• Local clean working places and clean zones;
• Auxiliary clean rooms (wardrobe, washer, sterilization, corridors etc.).
• Sterile laminar cupboards which are individual protective working places at work with products that are in some way dangerous for humans and environment or require protection from affection of environment.

Use of clean rooms in intensive care rooms and wards of intensive therapy is caused by the need for protection from infection penetration into organism of a patient weakened either by surgery, or as a result of disease. Cleanliness of air environment is provided by use of the principle of dilution and removal of aerosol particles by low turbulent air flows, maintenance of extra pressure inside premises.

Construction norms and rules of the Republic of Kazakhstan at designing reanimation departments:

1. Departments of anesthesiology and reanimation, reanimation and intensive therapy are arranged within multi profile hospitals for 500 beds and more at availability of at least 70 beds of surgery profile; in children's hospitals - at availability of 300 beds and at least 50 beds of surgery profile, and also in delivery units for 300 beds and more or in one of the delivery units of less potential at availability of delivery units of the city of at least 300 beds (cumulative delivery and gynecological profile). Departments of reanimation of intensive therapy are arranged in infection hospitals with account of 1 reanimation bed / 25 infection beds, at anti-tuberculosis medical institutions - at availability of at least 70 beds of surgery profile. Department of regulation and intensive therapy can be organized in cities with population of 500,000 people. And more within large multi profile hospitals (at availability of 800 beds and more in adult hospitals and 400 beds and more in children's hospitals). The number of beds in department should not exceed 25.
2. Department of anesthesiology and reanimation, reanimation and intensive therapy should consist of two subunits: for patients who come from ward departments of the hospital, and for patients who come to hospital through registry. At availability in the medical hospital of the department of purulent surgery, within a large departments of anesthesiology and reanimation it is important to provides separate non-passing ward unit, and within departments of 6-12 beds - wards with gateways for patients with purulent infection.
3. Staircases, lifts and elevators leading to department should be equipped with gateway with independent exhaust hood.
4. Location of Department in hospital depends on category of hospital and profile of patients’ disease who will be receiving medical aid. Internal hospital departments are located closer to the major flow of patients who arrive from departments of the hospital. Departments aimed at rendering services to patients from the streets are located near registry departments of the hospital or maximally close to them; in case of prevailing of internal hospital flows of severely ill patients their location closer to the surgery unit under condition of convenient transportation of patients from the streets is possible. At location of departments above the registry department it is important to provide their connection through separate lift. And arrangement of combined department one of its part is located at the registry department and the second one is closer to internal hospital flows of severely ill patients.
5. Structure of premises of departments of anesthesiology in the reanimation, resuscitation and intensive therapy depends on the type and potential of the hospital and the structure of its departments. Number of auxiliary premises, rooms of relaxation of medical personnel, bathroom passing and hand washers must be provided in accordance with the requirements of sanitary and epidemiological requirements to the objects of healthcare. The area of premises of department of anesthesiology and reanimation, reanimation and intensive therapy must be provided with the view of requirements of sanitary rules of sanitary and epidemiological requirements to the objects of healthcare.