Positioning Flashcards
Why is collaboration with the surgical team important in patient positioning?
Collaboration ensures correct patient positioning, aligning with surgical needs for successful procedures.
What is the significance of maintaining proper body alignment during patient positioning?
Proper alignment helps maintain perfusion, protect pressure points, and prevent musculoskeletal issues.
Why aim for a natural position when positioning the patient?
A natural position supports physiological functions, reduces strain, and enhances comfort during anesthesia and surgery.
Why should joints generally be kept aligned during patient positioning?
Keeping joints aligned helps prevent strain, injury, and discomfort for the patient unless necessary for the surgical procedure.
How can pressure points be protected during patient positioning?
Pressure points can be padded to prevent injury and promote circulation.
Why is it important to understand the pathophysiologic changes that can occur due to positioning?
Understanding changes helps anticipate complications, optimize patient safety, and adjust positioning to prevent adverse effects.
What considerations should be made during the patient positioning process?
Consider positioning from head to toe, use appropriate devices, and assess the level of assistance needed for optimal patient placement.
How can safety measures be implemented during patient positioning?
Use safety belts/straps on the abdomen, pelvis, and extremities to secure the patient without causing nerve damage or injuries.
Why should belts/straps not be too tight during patient positioning?
Avoiding excessive tightness prevents nerve damage, circulatory compromise, and discomfort while securing the patient safely.
What is the significance of the supine position in anesthesia?
The supine position is commonly used for surgeries and has implications on various physiological parameters like venous return and cardiac output.
How should arm boards be secured in the supine position?
Arm boards should be properly secured to support the arms during procedures in the supine position.
What physiological impacts should be considered in the supine position?
Effects on venous return, cardiac output, and respiratory parameters must be understood for patient safety.
What defines arms abduction in patient positioning?
Arms positioned out to the side at less than 90 degrees with proper securing and padding to maintain alignment.
How should arms be orientated in arms abduction positioning?
Keep arms supine (palms up), secure with padding and Velcro strap at the axilla for stability.
What is the approach to arms adduction in patient positioning?
Arms are positioned alongside the body, secured with padding and positioning aid to maintain alignment.
How should elbows be managed during arms adduction positioning?
Ensure elbows are padded for comfort and consider tucking one arm if needed for surgical access.
What complications can arise in the supine position?
Complications in supine position include backache, pressure alopecia, brachial plexus or axillary nerve injury, ulnar nerve injury, and stretch injuries.
How can brachial plexus or axillary nerve injury occur in the supine position?
In the supine position, brachial plexus or axillary nerve injury can occur if the patient’s arms are abducted more than 90 degrees.
When can ulnar nerve injury occur in the supine position?
Ulnar nerve injury can occur in the supine position if the patient’s hand/arm is pronated (palm down).
What complications can arise in the Trendelenburg position?
Complications in the Trendelenburg position include backache, pressure alopecia, brachial plexus or axillary nerve injury, ulnar nerve injury, and stretch injuries, with the head of the patient tilted.
How can sliding cephalad be prevented in the Trendelenburg position?
To prevent sliding cephalad in the Trendelenburg position, use a non-sliding mattress/pad and avoid bean bags or shoulder braces.
What is recommended to detect sliding in the Trendelenburg position?
To easily detect sliding in the Trendelenburg position, consider marking the level of the patient’s head on the sheet or pad.
What are the pathophysiologic considerations in the Trendelenburg position?
Pathophysiologic considerations include effects on cardiac output (CO), venous return, intracranial pressure (ICP) and intraocular pressure (IOP), edema, intraabdominal pressure, FRC, pulmonary compliance, and diaphragmatic shifts.
What complications can arise in the Reverse Trendelenburg position?
Complications in the Reverse Trendelenburg position include backache, pressure alopecia, brachial plexus or axillary nerve injury, ulnar nerve injury, and stretch injuries, with the head of the patient tilted.
How can sliding be prevented in the Reverse Trendelenburg position?
To prevent sliding in the Reverse Trendelenburg position, use a non-sliding mattress/pad and a footrest or something under the patient’s feet.
What are the pathophysiologic considerations in the Reverse Trendelenburg position?
Pathophysiologic considerations include the risk of hypotension, effects on venous return and pooling in lower extremities, and downward displacement of abdominal contents affecting brain perfusion.
How should the head be stabilized in the sitting positioning for surgical procedures?
The head must be stabilized by taping it to a special headrest or using rigid pins to prevent movement.
What is the recommended hip and knee positioning in sitting positioning for surgical procedures?
Hips should be flexed to less than 90 degrees, and knees slightly flexed for balance.
How can nerve injuries be prevented in sitting positioning during surgical procedures?
To prevent nerve injuries, stretching of the sciatic nerve should be reduced.
Why is it important to maintain a distance between the chin and sternum in sitting positioning?
Keeping a two-finger distance between the chin and sternum helps prevent airway obstruction and facilitates proper alignment.
What is the common positioning used in shoulder cases in sitting positioning for surgical procedures?
The beach chair position is frequently used in shoulder cases for optimal surgical access and patient comfort.
What are some medical risks associated with sitting positioning during surgical procedures?
Medical risks include cerebral hypoperfusion, air embolism, pneumocephalus, quadriplegia, spinal cord infarction, cerebral ischemia, and nerve injuries.
What pathophysiologic considerations should be addressed in sitting positioning for surgical procedures?
Considerations include the risk of hypotension due to venous pooling in the lower extremities, requiring monitoring of parameters like MAP, CI, and cerebral perfusion pressure.
How should a patient be positioned in prone positioning for surgical procedures?
The patient lies on the stomach with arms at the side tucked or outstretched, head supported face down, and legs slightly flexed at the knees and hips.
What are some risks associated with prone positioning during surgical procedures?
Risks include facial and airway edema, nerve injuries, ulnar nerve injury, brachial plexus injury, post-operative visual loss, eye injuries, endotracheal tube dislodgement, and monitor/IV line issues.
What pathophysiological considerations are observed in the Prone Position?
Edema in face, conjunctiva, larynx, and tongue; abdominal pressure affecting venous return; improved cardiac output; enhanced ventilation.
How does the Prone Position affect ventilation and perfusion in the lungs?
Ventilation is enhanced, leading to a shift in ventilation and perfusion towards dependent lung areas.
Describe the positioning in Lithotomy: legs, arms, and elevation.
Patient lies supine with legs in stirrups at 80-100 degrees hip flexion, legs abducted 30-45 degrees, knees flexed, and arms tucked or on boards.
What caution must be taken during lithotomy positioning to prevent crush injuries?
Lower extremities must be raised and lowered simultaneously. Hands and fingers must be protected when lowering the foot of the bed.
What risks are associated with the Lithotomy Position?
Back pain, nerve injuries (brachial plexus, ulnar nerve, etc.), and compartment syndrome are common risks.
How can complications during Lithotomy surgeries lasting long durations be prevented?
Periodically lowering the legs is essential to prevent complications during surgeries lasting over 2-3 hours.
What physiological parameters are influenced by the Lithotomy Position?
Venous return, cardiac output, intracranial pressure, intraabdominal pressure, lung compliance, and tidal volume are affected.
How does intraabdominal pressure influence the positioning in Lithotomy?
Intraabdominal pressure displaces the diaphragm cephalad in Lithotomy positioning.
What is the lateral decubitus positioning in healthcare?
It involves the patient lying on the non-operative side with specific support and limb positioning for neutral alignment.
How should head support be ensured during lateral decubitus positioning?
Head support should be provided with no pressure on the eyes or ears to maintain proper alignment.
Why is an axillary roll used in lateral decubitus positioning?
The axillary roll is placed to prevent brachial plexus compression between the chest wall and bed, caudal to the axilla.
What are the considerations for leg positioning in lateral decubitus positioning?
The dependent leg should be slightly flexed, and padding is required between the knees for proper alignment.
How should arm placement be managed in lateral decubitus positioning?
Arms should be in front of the patient, both supported, abducted < 90 degrees to prevent nerve injuries like ulnar nerve or brachial plexus injury.
What complications are associated with lateral decubitus positioning?
Complications include inferior vena cava compression risk, nerve injuries, and the need for optimal lung expansion and caution to prevent ETT dislodgement.
How do compression stockings/devices help in lateral decubitus positioning?
Compression stockings/devices are used to address venous pooling in the lower extremities to improve circulation.
What is the risk associated with nerve injuries in lateral decubitus positioning?
Despite optimal positioning, nerve injuries can still occur, and they may result from stretch, pressure, or ischemia, potentially leading to permanent damage.
