OPERATING THEATRE DESIGN


procedure. Installation was also ‘fixed’, and the control panel could not be updated without somebody drilling new holes to insert new switches and indicators into the stainless steel sheet – ‘again, not very future-proof’.


More configurable control panels Adrian Hall said: “So, thinking about how modern technologies might help us here, we can use more modern control platforms using configurable interfaces, touchscreens, and soft controls etc. We can effectively build everything we know into that box that you might need as you commission the future hospital, and then simply turn off the things we don’t need. We can standardise the hardware and software, dramatically reducing our costs in manufacture, design, and support, which then helps pay for the extra hardware capability, and the development of embedded learning about the product. Because we can now constantly improve it, it is more reliable and easier to support, and, having used configurable controls, we can support late configuration. So, when somebody says: ‘In fact it’s not two light switches we need, but four lighting circuits’, while previously we have had to drill holes for switches, now we can just add them to our touchscreen via soft controls.”


Pointing to a slide of a modern Brandon Medical touchscreen control panel, he said: “You can see that we’ve now got a touchscreen which is sharing our controls; the controls are much more visual; we can use greater contextual information, and we can use animation, audio, and speech. So, when the fire alarm goes off and we have a zone alarm, instead of the panel just flashing yellow, the panel can actually announce: ‘Fire in adjacent zone; prepare to evacuate.’ We can even add supporting information like a picture of the evacuation routes. We can offer much more flexible use of space on the control panel, and create a more intuitive experience, and a more aesthetic panel.” Other features typically integrated into a ‘smart’ theatre control panel might include a time server- linked clock, a programmable stopwatch for timing the operation, and an alarm summary display, indicating to the lead surgeon that as long as everything in the box is ‘green’, they can safely proceed, but that ‘amber’ or ‘red’ warning lights mean ‘Only proceed with surgery with caution, if at all’.


Multiple capabilities


Adrian Hall went on to explain that a ‘modern’ Brandon Medical control panel also offered the ability to control room access and signage controls, theatre temperature and humidity, and – located in the ‘flexible space’ – tabs for controlling specific equipment such as ultraclean ventilation, AGSS, and medical gas, plus


From left: Scott Pickering, Adrian Hall, and Richard McAuley.


the doors and the theatre lighting, and even a music player, negating the need for the surgical team to bring in external audio devices, with the accompanying infection risk. He added: “We can even incorporate controls for capturing footage of surgery. However, the key innovation here in us supporting Modern Methods of Construction isn’t that we have a much nicer control panel, but that the product is now full fully configurable on deployment. So, let me show you what I mean; in this area incorporating the digital input for the alarms, this multicoloured box on the right shows that for every one of the 40 digital inputs on this panel, I can turn them off and on, and assign them to a different icon. I can tell when a digital input for that relay closes, whether it’s going to give me a green, yellow, or red indicator. Similarly on the digital output, when I press a button here to activate the ‘Room in use’ sign, I can configure which output it will trigger, which icon I use to show what it is, and how that button behaves – is it a latching or a pulsing button for dimming the light etc?” He continued: “In the centre, if I am going to use analogue I/O for the heating and ventilation, I can configure how that I/O works – is it 0-10 V, 4-20 mA, or am I going to use BACnet or Modbus?


Alarm configuration


“On the right here,” he added, “I can configure how an alarm will respond. In the panel’s centre, I can apportion these tabs to, say, camera controls, a recording system, medical gas alarms, or ultraclean ventilation. As you configure the panel, it’s got everything in the box. Equally, if something has changed in the project specification, we can reconfigure it right up to commissioning, and even post- handover. So, we now have a product bristling with every element of connectivity that our 25 years’ experience tells us we can connect to everything. The user can thus connect to everything from medical gas, heating, and ventilation, to UPS and IPS; all these elements will connect to the control panel, whether via relay contacts, BACnet, Modbus, or Ethernet. Whatever kit you’re bringing into the operating room, we’ve designed the connectivity, already in the box, ready to


go. Similarly,” Adrian Hall continued, “on the output side, we know you are going to have to connect to a BMS, perhaps via modern BACnet, Modbus, or even relay contacts.”


‘Cloud’ monitoring


Brandon Medical control panels now also offer connectivity via Ethernet, and ‘gateways out to the cloud’, to offer cloud monitoring’, not only for its own systems, but equally ‘for everything connected through the control ‘hub’ – meaning Brandon’s team often becomes aware of a potential equipment issue in a theatre before the hospital. In summary, Adrian Hall said: “So, the control panel becomes a connectivity hub. The concept is everything in the box. If there’s something you’ve forgotten about in the 'spec', or something changes, we can reconfigure it to address any initial ‘unknowns’. We’re using the flexibility and the scalability of technology to support modern manufacturing construction methods.” With this he handed over to National Specification manager, Richard McAuley,


Medical imaging devices Richard McAuley’s first slide showed the ‘typical components and layout’ of medical imaging devices in a modern operating theatre. He said: “You can see we have a room overview camera, two pendant systems which can have laparoscopic endoscopic devices attached, the main surgical operating theatre light with embedded camera, and dual surgical monitors, usually on an arm, plus, sometimes, a larger wall-mounted display, useable either as a room display or a PACS viewer. Typically, we have a central marshalling unit – to which all the components connect – located on a pendant, or in a wall cabinet inside or outside the theatre.” The key here was that the same type of cabling infrastructure was used for all the devices. He explained: “All the video and audio signals are encoded on a dedicated core network which we call OR-Net; it doesn’t matter to the connectivity whether a device is an input device like a camera, or an output device such as a display screen. You’ll also see an external connection at the bottom


August 2021 Health Estate Journal 51


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