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Duke Hospital, InterGom
completely in heavy muslin covers
which can be opened on the front side
and need not be changed until worn
out. Fully loaded and covered, the
shelves can be rolled off their trucks
into a sterilizer. To change the cov
ers, the shelves will be raised on liooks
installed in Central Supply; the old
cover peeled off; a new one fitted on;
and the shelves replaced on their
DR. DERYL HART. Appointed to the
chair of surgery in March 1929, Dr. Hart
was a member of the original faculty of
Duke Medical School. He is an alumnus of
Emory University and of Johns Hopkins
School of Medicine. Dr. and Mrs. Hart
have six children, one of whom, Elizabeth
Hart King, will be graduated from Duke
Medical School in June.
truck. When ready for use these
shelves will contain all of the sterile
instruments and material need for the
operations in the 18 operating rooms.
The instruments will be in three units:
a work tray, a basic set used in all
operations, and a specialty set for that
particular operation. All fixed wall
shelves for reserve supplies in the
Preparation Area have been built high
enough to allow tables to be stored
underneath.
Clean-Up Area. The operation com
pleted, all materials and instruments
are placed on the supply table and
returned to this room for cleaning or
disposal. Two persons can staff' this
area which provides both for the
clean-up and for stacking of instru
ments for later o])erations. Two ty[)es
of techniques are used: one for
“clean” operations and one for oper
ations involving infected material.
When a table comes back from a clean
operation, gloves, syringes, basins and
the like are stacked on rolling shelves
to be sent down by elevator to Central
Supply for cleaning. Linen is put
down the linen chute. Instruments
are put to soak and rinsed off. With
all joints o])en, they are stacked in
wire mesh baskets and put in the
ultrasonic instrument cleaner. This
machine i)roduces 18,000 vibrations
per second in the detergent solution
in which the instruments are cleaned,
and can do a thorough cleaning job
in three to five minutes. The instru
ments then go through a rinser and
dryei-; their joints are closed; and
they are stacked in trays to be ster
ilized and returned to the Preparation
Area.
Following an operation on a patient
with an infection, the linen and sup
plies which are contaminated, together
with the instruments, are placed in a
rolling, stainless steel container fitted
with a valve in the bottom. This con
tainer is rolled to the clean-up area
and into a special sterilizer, designed
through the combined efforts of the
Duke Department of Surgery and the
American Sterilizer Company. This
sterilizer is equipped with a drainage
valve opening directly into a sewer
line and W'ith a powerful cold water
spray. When the container is rolled
into the sterilizer, the valve on the bot
tom of the container opens automati
cally and the door is closed. The cold
w'ater spray is turned on, and the in
fected linens and instruments are
soaked and drained inside the sealed
sterilizer. After soaking, they are
sterilized and cooled, and then proc
essed in the same manner as material
used in clean operations.
Operating Area. The new operat
ing rooms are finished with wall tile
in a soft grey-green. The new cor-
Dr. K. Takeshima, Duke Hospital anesthe
tist, administers nitrous oxide, an analgesic
or pain-blocking gas. Earlier, the patient
had gone to sleep under the influence of
another drug.
ridors and anesthesia rooms are pan
elled with stainless steel to eliminate
scarring. As collateral equipment for
surgery (such as the lieart-lung ma
chine or the blood heat exchanger) be
comes more conij)licated, the operating
team may number as many as ten or
twelve persons. To accommodate this
])ersonnel and equipment, the new
operating rooms are larger than the
old. Above each operating room is a
visitors’ gallery equipped with micro
phones for two-way conversation. The
microphones can be silenced and the
gallery darkened from the operating
room. The visitors’ galleries, sepa
rated from the operating rooms by
glass, are on a separate air condition
ing system to reduce pollution of the
air in the operating rooms. All elec
trical outlets including the X-ray view
boxes are equipped with explosion
proof switches or connections. Con
ductive flooring discharges static elec
tric current from all equipment and
from all individuals who must wear
shoes with conductive soles. Water
temperature in scrub basins is thermo
statically controlled. An explosion
proof heating unit heats solutions
when necessary. Ultra-violet lights to
purify the air are shaded to protect
the eyes from glare which can produce
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