Presentation on theme: "COMPROMISE TO BODY SYSTEMS MUST BE PREVENTED"— Presentation transcript:
1COMPROMISE TO BODY SYSTEMS MUST BE PREVENTED PATIENT POSITIONINGAfter administration of AnesthesiaBest possible accessBest possible visualizationCauses the least compromise in functionPOSITIONING CONCEPTSAccess must be provided--surgical site--airway--I V’s--monitoring devicesCOMPROMISE TO BODY SYSTEMS MUSTBE PREVENTED--Integumentary system--Nervous system--respiratory system--musculoskeletal system
2BASIC POSITIONS SUPINE- Is the most basic position ---Flat on back ---Arms secured at sides/palms inward---Elbows protected (eggshell crate)---Legs straight and parallel---Safety belt 2 inches proximal to knees---Arm-boards no more than 90 degree angle (if used)to prevent hyperextension of shoulder---Heels must be protectedBody regions that may be accessed in the supine positionAnterior lower extremity, Pelvis, Abdomen, Chest/breastShoulder head and neck and upper extremity
4TRENDELENBURG--- Is a modification of the supine position. It is used todisplace the abdominopelvic organs cephaladto provide better visualization.(laparoscopic cholecystectomy)-- Apply safety strap proximal to knees- -Another benefit from this position, is that blood flow tothe lower body is reduced and venous drainage is pro-moted. This position may be used to increase bloodflow to the upper body. (treatment of shock or for dis-tention of blood vessels to be cannulated)
5REVERSE TRENDELENBURG -- Modification of the supine position. It is used to displacethe abdominal organs caudad to provide better visual-ization of the surgical site. Other benefits include, bloodflow to the upper body is reduced, venous drainage ispromoted, and respiration is facilitated.-- Apply safety strap snugly approximately 2 inches distalto the knees.
6FOWLER’S POSITION AND SITTING POSITION -- Fowler’s position is a modification of the supineposition provides improved access to the surgical siteand reduces blood flow to the upper body, promotesvenous drainage, and facilitates respirations. Airembolisms are a concern when in this position.-- Patients arms may be secured on arm-boards oracross the abdomen.-- Apply safety strap 2 inches proximal to the knees
7SITTING POSITIONS-- The sitting position is a modification of Fowler’sposition. The torso is in an upright position. Theflexed arms rest either on a lap pillow or on anadjustable table in front of the patient.-- A body strap should support the shoulders, pad forsciatic nerve damage. Head will be in a cranialhead rest.
8LITHOTOMY POSITION--The lithotomy position is a modification of the supineposition. Variety of positioning devices.--Candy cane stirrups--Low lithotomy stirrups/built-in padding--Not usually safety strap usedBody regions that may be accessed in this position are--Perineum--Anus/rectum--Vagina--Urethra
9Table accessories for Lithotomy Position CANDY CANE STIRRUPS
10PRONE POSITION-- Prior to placement into the prone position, the pt isanesthetized on the gurney first and then moved tothe operating table.-- Placement of catheters and all pre-operative proceduresneed to be preformed before moving the pt into proneposition.BODY REGIONS ACCESSED--posterior lower extremities--dorsal body surface
11KRASKE POSITION -- Kraske is a modification of the prone position. BODY REGIONS ACCESSED-anus-pilonidal area
12LATERAL POSITION ( Right lateral) -- The lateral position is also referred to as the recumbentor lateral decubitus position. Rt lateral position, pt isplaced on the operating room table with the right sidedown. Exposing the left side of the body. Left lateralleft side downward so right side is exposed for surgery.
14RIGHT KIDNEY POSITION SIMS POSITION -- The kidney position is a modification of the lateralposition. Regions accessed: Retroperitoneal space.-- Kidney rests-- Flex in tableSIMS POSITION-- Sims position is a modification of the left lateral positionthis is the preferred position for endoscopy performedvia the anus. (not used very often in surgery more soin office procedures)
15DRAPES/DRAPING DRAPE MATERIALS -- Surgical drapes are used by the surgical team to isolateand protect the operative site from contaminants thatcan cause SSI’s.Serve as barriers to eliminate the migration of micro-organisms from non-sterile areas to the sterile field.EFFECTIVE DRAPE MATERIALS SHOULD BELint freeFluid resistantAntistaticTear and puncture resistantFree of toxic residuePorous escape of body heatFinished with a color that does not reflect OR lightsFlame retardantDRAPE MATERIALSNon-woven fabrics (disposable, made from compressedsynthetic fibers) Nylon or polyester.light, but strong.Disposable drapes have reinforced layers of materialSurrounding the fenestration (opening) extremity drape.
16DRAPE TYPES WOVEN TEXTILE FABRICS- reusable drapes are Becoming popular with hospitals:CheaperImpermeable to liquidsTreated with Fluor chemical finish increases fluid repellantHave to be launderedFoldedInspected for wearSterilized after each usePLASTIC ADHESIVE DRAPES- Made of thin, clear,Plastic material that has an adhesive backing, can beApplied with out blocking viewINCISE DRAPES- Made of thin, clear, plastic materialThat has adhesive backing that may be impregnatedWith an antimicrobial iodine agent.APERTURE DRAPES- Are small, clear plastic drapesWith openings that are surrounded by an adhesivebacking. They are commonly used to drape eyes.DRAPE TYPESFenestrated: openings for exposure of area incisedNonfenestrated: ¾ sheet; ½ sheet
17STOCKINETTES Fenestrated drape example: Lap sheet Pediatric lap sheet Thyroid sheetNonfenestrated drape exampleLeggingsUnder-buttocksAbdominal drape??Split sheets/u-drape/tailsSTOCKINETTES-- Stretchable tubes to cover extremities, one end isclosed, some are covered with plastic, rolled-up(shoulder surgery) (total knees, total hips)