Patient Positioning

Question 1

Patient Positioning

Answer 1

. Provides best possible access and visualization
. Usually takes place after induction of
anesthesia
. Drawsheet will be needed to restrain the
arms during and after Sx. And support and
lift body for transfer after Sx.

Question 2

Patient Positing Considerations:

Answer 2

– All devices, tubes and catheters are protected
– Patient is moved slowly to maintain control of
the body
– Patient is moved slowly to allow circulatory
changes
– Patient is moved slowly to prevent
cardiovascular complications
– Positioning is directed by the anesthesia
provider

Question 3

Supine Position

Answer 3

• Most natural position of the body at rest
• Body regions accessed:
  – Anterior lower extremity
  – Pelvis
  – Thorax
  – Abdomen
  – Chest/breast
  – Shoulder
  – Head and neck
  – Upper extremity
  – Lower extremity
• Hazards (Table 12-11)
  – Back and neck pain
  – Corneal drying
  – Foot drop may occur
  – Electrical injury with prep
• Pressure injury
  – Brachial plexus injury (with extended arm
  board)
  – Ulnar nerve injury (with crossed legs)
  – Occiput
  – Scapula
  – Olecranon
  – Sacrum

Question 4

Trendelenburg Position

Answer 4

. Used to displace
abdominal organs
superiorly for better
visualization of the
surgical site
. Used to increase
blood flow to the
upper body
. Use shoulder rest
. Regions accessed
– Pelvis and lower abdomen
. Hazards
– Cardiopulmonary compromise
– Pressure injury (shoulder rest)
– Sliding of patient
– Venous stasis
– Blood pressure changes

Question 5

Reverse Trendelenburg

Answer 5

. Used to displace
abdominal contents
inferiorly
. Facilitation of
respiration
. Reduced upper body
blood flow
. Areas accessed
– Upper abdomen
– Head and neck
. Hazards
– Patient moves toward the foot
– Venous stasis
– Blood pressure changes
– Pt. can fall off if no padded footboard is
implemented

Question 6

Fowlers and Sitting

Answer 6

. Improved access
. Reduces blood flow
. Areas accessed
– Head
– Neck
– Ears
– Breast
– Shoulder
. Hazards
– Blood pressure
changes
– Respiratory
compromise (Air
Embolism)
– Venous stasis
– Pressure injury

Question 7

Lithotomy Position

Answer 7

. Areas accessed
– Perineum
– Anus and rectum
– Vagina
– Urethra
. Legs are symmetrical
. Stirrups at equal height
. Buttocks rests at table
break
. Remove head of the
table
. Hazards
– Pressure injuries
– Venous stasis
– Back, knee, hip pain
– Vagina is considered contaminated

Question 8

Prone Position

Answer 8

. Areas accessed
– Posterior lower
extremity
– Spine
– Posterior cranium
– Dorsal body surface
. Chest rolls applied
. Hazards
– Pressure
– Compromised respiration
– Venous stasis
– Shoulder injury

Question 9

Kraske (jackknife) Position

Answer 9

. Areas accessed
– Anus
– Pilonidal area
. Hazards
– Blood pressure
changes
– Pressure

Question 10

Lateral Position

Answer 10

. Lateral recumbent or
lateral decubitus
. Areas accessed
– Retroperitoneal space
– Hemi thorax
– Hip
. Hazards
– Respiratory compromise
– Circulatory compromise
– pressure

Question 11

Kidney Position

Answer 11

. Body accessed
– Retroperitoneal
. Kidney
. Double straps
. Double arm boards
. Body is padded
. Kidney rest to
stabilize patient

Question 12

Sims Position

Answer 12

. Modification of Lateral
Position
. Ideal position for
Endoscopic
procedure of the anus
(colonoscopy,
sigmoidoscopy)