The Telegraph
Wednesday , June 18 , 2014
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OT cries out for chill pill

- RIMS surgeons threaten scalpel strike over flawed air-conditioning

Doctors at Rajendra Institute of Medical Sciences (RIMS) are losing their cool and for a genuine cause.

The state-run hospital in Ranchi, which caters to 5000-odd patients on any given day, has reduced its three operating theatres into microbe breeding chambers in the absence of proper temperature and humidity control. So much so that surgeons have threatened a scalpel down strike if the entire air-conditioning system is not overhauled soon.

Besides the obvious regulation of two mentioned parameters, circulating and cleaning air are also very important in any operating theatre to maintain a high standard of microorganism filtration and thereby avoid contamination of wounds.

Under HVAC (heating, ventilation and air-conditioning) rules, every operating theatre must be supplied clean and dry air through a central system and not by individual split or window ACs.

At the surgery complex of RIMS, two archaic air-conditioners that ask for repair almost every month service the largest operating theatre of around 600sqft.

There is a single new machine too, but its paltry 1.5-tonne capacity isn’t even enough to cool the operating room, let alone maintain the very low temperature required during surgeries.

Another 400sqft operating theatre has one new air-conditioner, which again does not serve the purpose being of moderate capacity. In the third OT, the lone archaic machine is defunct. Also, neither of the two recovery rooms for the three surgery OTs have anything remotely close to air-conditioning.

The abysmal state of health affairs had on Monday spurred the 27-odd doctors, professors and associate professors to take up the matter with acting RIMS director S.K. Choudhary.

Their threat to stop operating on patients until OT air-conditioning was thoroughly revamped prompted the hospital authorities to procure two 1.5-tonne ACs on Tuesday, which are likely to be installed by Wednesday.

But is that enough?

“Definitely not,” said Dr Nawal Kishore Jha, the head of surgery. “Absence of a central and functional air-conditioning system is detrimental to patient health. It retards the pace of recovery.”

Temperature and humidity control in post-operative units were equally important. “If a patient sweats, it is an open invite to bacterial infection because the wound is fresh. We must have written to the hospital authorities at least a dozen times, but in vain,” Dr Jha noted.

Dr Sheetal Malua, an associate professor in the surgery wing who is following up with the RIMS administration, said the three operating rooms needed at least six cooling machines each of 1.5-tonne capacity or more.

“We know a centralised system is the best option. Split ACs come with health hazards. But, we have little choice,” he said.

According to HVAC engineers, hygiene controls at any operating theatre must be far more sophisticated than offered by window or split ACs.

“Higher ventilation rate for cleaner air and implementing laminar flow technique (parallel flow without lateral mixing) along with antibacterial filters better known as HEPA-filters are necessary to lower the risk of infection,” said Debarshi Mukherjee, a senior engineer of electro-mechanical MNC Sterling & Wilson, which designs hospital cooling systems.

Acting director Choudhary admitted that the demand of doctors was legitimate, but said: “I have joined recently and it will take me some days to understand what can be done to fix the problem and how. Our super specialty wing boasts central AC.”