FINAL- Positioning and thermoregulation Flashcards
Risk associated with sitting position
-VAE (Venous air embolism)
-Pneumocephalus
-Quadriplegia
-Peripheral nerve injury (Ulnar, sciatic)
-Profound hypotension and bradycardia (Activation of Bezold-Jarisch reflex)
Supine position. Arms abducted. What degree of angle do you want?
< 90 degrees
Arm abduction >90 degrees stretches brachial plexus around head of the humerus = injury
Ulnar nerve injury presentation
Claw hand
Median nerve injury presentation
Hand of benediction (inability to make a clenched fist)
Ape hand
Radial nerve injury presentation
Wrist drop
When does the greatest amount of heat loss occur?
During first hour in the perioperative setting
What accounts for the majority of heat loss in patients undergoing surgery
Radiant heat loss
(Transfer of body hear into a cooler environment)
Transfer of body heat into a cooler environment
Radiant
Ex: Getting out of sauna, radiating heat outward
Loss from liquids on the skin or from expiration of warm moist air
Evaporation
Ex: Swamp cooler
Moving cool air
Convective
Ex: Cool air blowing over patient
Contact with a cooler object - OR table
Conductive
Ex: Jump in a cold plung - cold water all around warm body
Transfer of lower temperature blood from periphery to central compartment
Redistribution
Patient presents with foot drop. What’s injured?
Sciatic nerve
Common peroneal nerve
Positioning recommendations to prevent ulnar nerve injury
Arm abducted <90 degrees
Arm flexed <90 degrees
Forearm supinated or neutral position at sides/palms facing inward
Elbow padded
Elbow not allowed to hang over edge of OR table
Positioning recommendations to prevent radial nerve injury
Place adequate padding between or ensure arm is not pressed against vertical posts or pole
