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Surgical tables are long-term investments that will impact many aspects of your patient care. Buying wisely, therefore, is critical. To find out how to get the best for your facility, we talked to some facility managers and OR personnel about their tables and came up with several key questions that you'll want to ask yourself and your manufacturers before you buy.The Basics
Is this table appropriate for the types of surgery we do?
For Carolyn Wafle-Guemther, OR coordinator at the El Camino Surgery Center in Mountain View, Calif., finding a table to accommodate all their specialties (ENT, ophthalmology, orthopedics, and gynecology) is her number one priority when her facility buys new tables. Scotty Farris, an equipment planner based in Frisco, Texas, recommends that multi-specialty facilities like hers search for tables that can be positioned in several different ways and are compatible with most accessories. "Tables will last you 15 to 20 years, so you are going to want a table that will cover any procedures that you may decide to do," he reasons.
If you are in a single specialty facility or an office-based surgery center, Mr. Farris advises not to purchase more than you need. A single-specialty ophthalmology facility, for example, can possibly forego tables and invest instead in eye gurneys, which patients can stay on from pre-op to post-op.
Is the table easy to position and maneuver?
You will want to find out where the controls are on the table and how accessible they are. Lisa Cooper, Clinical Director at the El Camino Surgery Center, says her tables are controlled by a push pedal at the head of the table, which limits who controls the positioning of the table (typically this is done by the anesthesiologist). Her facility will be purchasing new tables soon, and she would like to find tables that offer more options when it comes to controlling the table position. According to Mr. Farris, most new electric tables are controlled by a corded pendant that may be attached to the table with a cord; some of the newer models have wireless keypads.
How sturdy is the table?
There was a time when tables that could support 300 lbs. were the standard. Now most support at least 400 lbs. "It's not uncommon to have a patient who weighs 400 lbs.," says Linda Mehegan, Head Nurse Manager at South Shore Hospital, South Shore, Mass."If you don't have a table that can support the weight, you run into a serious patient safety issue."
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Is the table comfortable for patients?
Padding during longer procedures is important to the patient's safety and comfort. Most tables come with foam rubber pads that are at least two inches thick and covered with vinyl, but you can upgrade the filling to better quality foam or even gel padding. The important thing, in Ms. Mehegan's opinion, the covering is soft and pliable and distributes the patient's weight evenly.
According to Mr. Farris, depending on use table padding only lasts about four to five years before you will need to replace it. You can also purchase separate cushioning pads if you find your tables' pads are not providing enough comfort and support. Pads are available with a variety of foam and gel materials and the prices can vary quite a bit.
Compatibility
Is it imaging compatible?
To ensure that a table is compatible with C-arms and X-ray machines, make sure the table has a radiolucent top and a place for an X-ray cassette.
Radiolucency. If you do pain management, you will want a table that is radiolucent from the pelvic area up to the spine. For other specialties, you will probably only need the chest and leg areas, says Mr. Farris. Most tabletops are not completely radiolucent.
X-ray cassette. Older tables used to have an X-ray cassette tray that traveled in a space down the middle of the table. However according to Mr. Farris, most new tables have the option of x-ray tops which are raised sections where you can slide an X-ray cassette under the patient from either side.
Is the table compatible with my accessories?
According to the people we talked to, most tables and accessories are pretty interchangeable regardless of brand, but be sure to ask both the table and accessory manufacturer before you buy. "Another facility I worked at had a table especially designed for obese patients, and because the table was wider, it was not compatible with our accessories," says Ms. Cooper.
New Technology
Should I buy electric?
Although they may cost more, most of the OR personnel we talked to agree that electrical tables definitely have their advantages. "All of our surgical tables are electric," says Ms. Mehegan. "We chose to buy electric because they are easy to operate and provide excellent positioning."
But cost is always an important consideration for smaller facilities, and electric tables will typically cost around $3000-$4000 more than manual varieties. So if your facility don't need all the bells and whistles, buying a manual table can definitely save you money. "I've found that if you buy a good basic model, it can last a long time," says Ann Geier, Chief Operating Officer at the Medicus Surgery Center, Anderson, SC, who still uses a manual surgical table that is over 17 years old.
Electric does not mean battery. If you do decide to buy an electric table, you will need to decide between a table that is battery-powered and one that plugs into an outlet. Mr. Farris prefers the former because he says the cord can be a safety hazard. Remember, however, that you'll have to plug the battery-powered tables in at night so they can recharge.
Should I buy motorized tables?
If you are going to be moving your OR table from room to room, you will also have to consider how movable it is. You may want to invest in a table that comes equipped with an electric motor, says Ms. Mehegan. She uses motorized tables at her facility, and she has found that they are much easier for her nurses to move.
Should I buy a float top table?
This new technology has actually been a feature of x-ray tables for more than thirty years, but only recently became a feature of surgical tables. The float top feature allows the table to move in virtually any direction, and it is especially useful in facilities that do a lot of procedures involving C-arms, such as pain management. The float top allows the surgeon to position the tabletop in relation to the C-arm instead of having the tech position the C-arm in relation to the table. Cost Issues
Should I buy refurbished?
Several of the people we talked to had purchased refurbished tables and were very satisfied with their warrantee and service. As with buying any refurbished equipment, it is important to buy from a reputable refurbisher or go through the manufacturer. If you are buying a used battery-powered electric table, Mr. Farris recommends asking the company to include the batteries in the warrantee. They can cost a couple hundred dollars to replace. If you have an older table that is still meeting your facility's needs, you may want to have your tables rebuilt.
Can I negotiate with the manufacturer on price?
"Everything is negotiable," says Mr. Farris, "Warranty, service, freight, price. No matter what they tell you, it's all negotiable."
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