Positioning

Answer 1

. 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

Considerations:

Answer 2

. Arm board must not extend beyond 90 degrees, avoid brachial plexus hyperextension
. Patients leg should not be crossed
Excessive torsion, flexion or extension must be avoided
. 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
. Hazards:
- 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

. Body regions accessed:
- Anterior lower extremity
- Pelvis
- Thorax
- Abdomen
- Chest/breast
- Shoulder
- Head and neck
- Upper extremity
- Lower extremity

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
. Lateral recumbent or lateral decubitus
. Areas accessed:
- Retroperitoneal space
- Hemi thorax
- Hip
. Hazards:
- Respiratory compromise
- Circulatory compromise
- 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)