Patient transport equipment that can also serve as an operating table offers high-volume surgery centers many benefits, chief among them efficiency and safety. When a patient can be moved from their pre-op bay to the OR to recovery without transfers and without repeated hooking up and unhooking of monitors, it saves a lot of time, reduces the risk of falls and protects your staff against lifting injuries. When we purchased convertible transport tables for our ophthalmic surgery center, we looked at models from 2 companies, the only products that were available at the time. You have a few more options now, so if you're considering bringing their benefits to your case flow, here are some features you'll want to look at.

Steady and under control
As an ophthalmic surgeon, my primary concern was the stability of a stretcher or chair table's headpiece during its use. It's to be expected that I'm going to rest my hand on a patient's head during surgery, and patients may move their heads or flex their necks in mid-procedure, so I wanted to be sure that their head would remain stable and not move outside the range of the microscope when either of these things happened. If your surgeons are doing biopsies or other procedures on other parts of the body, you'd likewise want the rest of the table to remain steady against small movements. You'll also want a weight capacity sufficient to support your patients' weights, even if they're larger than average. Actually performing a case with a demo chair table loaned to the clinic for a trial was the ultimate test, though we did have a staff member get on it and pretend to be the most restless patient possible before we brought it to surgery.

One big advantage that electrically operated convertible tables have over the mechanical stretcher beds we'd used in the past is that they're easier to operate. A single staff member can articulate the equipment without assistance from others. Contrast the manual cranking of a handle to adjust the headpiece and the muscle required to disengage release levers and reposition a table weighted down by a patient's torso, with the push-button operation of automated equipment.

Hand-held or foot-pedal controls accessible from the surgical site mean that the surgeon can reposition the patient, even in mid-procedure if necessary. That flexibility on the fly is incredibly useful in getting the patient's body or head exactly where you want it. Some models' positioning controls may not seem intuitive at first, but the controls themselves shouldn't be a deal breaker. Once you purchase a device and come to understand its arrangements, its operation becomes second nature.

Positioning possibilities
In large part, the benefits of a convertible table stem from its ability to adapt readily to the positioning that surgeons and staff require for the different stages of the perioperative process, as well as the postures that can provide patient comfort. And electrically driven automated positioning allows finer titrations of articulation than mechanically operated stretcher beds do. So you'll want to find out how many customizable pre-set positions are available on a given model. The more pre-sets, the better, especially in a multi-surgeon environment.

Consider the possibilities. You can sedate a patient who is not agile or who has mobility issues in a chair or on a lowered surface, which you can then articulate into a surgical stretcher, without the need for a stepping stool or lifting. A semi-lying position can assist in the connecting of monitors. Patients with COPD may not be ideally suited for lying flat for a long period of time before surgery, so you can find a head- and legs-raised position in which they'll be comfortable until it's time to prepare them for the procedure. After the flat horizontal position for surgery, you can convert the table into a recliner position before removing the patient from the operative suite or in recovery until the patient is ambulatory.

One frustrating thing, though, if you're purchasing more than one of these: I haven't yet seen a model that lets you save settings to a memory card and import them into another of the same equipment. Instead, once you've adjusted your pre-sets on one table, you have to repeat the settings on the others if you want to provide the same positions for every patient.

Power and motion
The positioning of a mobile surgical table is battery-operated, so another major consideration for us was how long the battery would last. We wanted dependable power, enough to last us through the day's schedule of surgeries, without having to plug in the table when we got to the OR and unplug it before we left. We didn't want another cord to manage and step over. We pushed the battery's limits during our demo trials to see how long it lasted. But a "long enough" charge depends on how many surgeries you perform on an average day as well as how many stretcher or chair tables you have at your disposal. I advise asking other surgical facilities that have purchased the models you're considering how their equipment holds up, battery-wise. Additionally, for charging at the end of the day, make sure that the equipment you choose has a standard cord and plug that fits into the outlets you already have, not a specialized plug that requires you to upgrade your electrical outlets. Mobility was another concern.

The stretcher beds we'd been using required 2 staff members to efficiently and safely move them from one place to another, so we wondered if 1 person could move the convertible tables into the OR and back. The electrical actuation of the steering and wheels, however, made them extremely maneuverable for a single staffer. We found the ability to lock and unlock wheels not just from the hand-held or foot-pedal controller, but also at the head and foot of the bed, very useful.

Even before you trial the devices you're considering, you can compare their dimensions against your current equipment. We were also pleasantly surprised to find that the convertible tables we were trialing occupied less space in the OR than the stretcher beds we'd been using. At 20 years old, our ORs are not as spacious as we'd like, and we occasionally had to squeeze between equipment and the old beds while gowned and gloved, which was not optimal. Gaining back some space in the OR was a welcome change.

The lifespan of any equipment depends on its reliability and your access to service. That can be hard to assess during a demo period, when a manufacturer's representative is present, attentive and eager to make a sale. So you'll want to seek out opinions from other facilities that have dealt with the manufacturer, and preferably have bought the product you're considering. Ask them what kind of maintenance the product demanded. How able were they to get service? And, specifically to stretcher and chair tables, how long has the battery been able to charge and recharge before it needs to be replaced? If you're a heavy-use facility, this will be important, as you don't want to have to replace it every year.

Gendron
EC1600 Extra Care Bariatric Stretcher
(800) 537-2521
www.gendroninc.com
List price: $5,600
FYI: Supports a patient weight capacity of 1,000 pounds, is fully electrically operated with the use of a hand pendant and can run about 12 cycles between battery charges, says the company. Features a Fowler back rest, Trendelenburg and reverse Trendelenburg positioning, knee gatch positioning, 4-wheel central locking and a low-shear fabric mattress cover.

MAC Medical
PT2000-EYE Eye Surgery Stretcher
(877) 828-9975
www.macmedical.com
List price: $5,500
FYI: Newly redesigned eye surgery stretcher offers an easy-to-adjust, dual-articulating headpiece. The stretcher's low profile allows the surgeon plenty of legroom to operate instrument pedals during procedures, says the company. All MAC Medical eye stretchers are equipped with a manual Fowler backrest and knee gatch positioning, total and directional locking 8-inch casters and a 2-hook IV pole.

NK Medical Products
Power Transport Lift (PL 1000E)
(800) 274-2742
www.nkmedicalproducts.com
List price: $6,865
FYI: Battery-powered patient lift uses "sheets" to transport patients to the stretcher tables that support them during procedures, says the company. The sheets are placed beneath patients and secured to a patient lift frame, which is elevated or lowered with a handset to meet the stretcher surface. Adjustable wheelbase fits around different-sized stretchers or beds. A crank-operated Manual Patient Lift Transport (PL 1000M) is also available.

Steris Corporation
Hausted APC All-Purpose Chair Series
(800) 548-4873
www.steris.com
List price: $7,000
FYI: Multi-position chair and stretcher adjusts easily from sitting to supine and provides a stable work surface during patient treatment, says the company. Has simple controls for adjusting height, backrest and leg sections as well as for Trendelenburg positioning.

Stryker
Eye Surgery Stretcher
(800) 787-9537
www.stryker.com/medical
List price: not disclosed
FYI: Eye surgery stretcher offers ample head-end clearance, giving surgeons legroom to maneuver while performing delicate eye procedures, says the company. The firmly locking work surface and mobile design combine to increase patient security and improve surgical throughput.

TransMotion Medical
TM11 Outpatient Surgery Chair Package
(866) 860-8447
www.transmotionmedical.com
List price: $10,000 to $15,000
FYI: Motorized mobile surgical stretcher chair easily converts from a transport chair to a surgical stretcher, offers variable positioning and lets patients go from pre-op bays to the procedure to recovery and discharge on a single surface, eliminating transfers, says the company.

UFSK International-OSYS
500 XLE Mobile Surgery Table
(888) 783-7891
www.visionequip.com
List price: $12,000 to $18,000
FYI: Increases staff safety by reducing the risk of back injury, since the low egress provides zero-lift patient entry and exit, says the company. Its direct-drive lifting system enables smooth and precise positioning via remote control, and its rechargeable batteries allow for a full day of surgery on a single charge. Distributed in the United States by VisionEquip.