0. Surgical Positioning. Jeffrey Groom PhD, CRNA Nurse Anesthetist Program Florida International University. SURGICAL POSITIONING OBJECTIVES. Identify the role and responsibility of the anesthesia provider in patient positioning.
Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author.While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server.
JackKnife - Kneeling
When you sleep, you reposition yourself to prevent pressure ischemia. Under anesthesia, the patient does not reposition (protect) them self so the responsibility falls to the surgical team to prevent pressure ischemia & positioning injuries.
Why is there a risk for injury ?
Preexisting patient attributes associated with increased incidence of perioperative neuropathies:
Ulnar nerve injury
Brachial Plexus Injury
Nurse anesthetists should “monitor and assess patient positioning and protective measures at frequent intervals.”
Failure to follow professional standards and guidelines may result in positioning injuries and liability.
55 y.o female w/fractured hip
2hr 20 min surgery
Developed peroneal palsy post-op
Protective and monitoring measures were not taken nor documented. No prior injury present. Conclusion at trial – injury would not have occurred had there not been negligence – res ipsa loquitur.
Protective and monitoring measures were taken and documented. Brachial plexus injury reported postop. No prior injury present. Conclusion at trial – injury was a risk of the procedure however personnel took precautions according to standards and were not negligent.
ASA Practice Advisory – Sets a legal standard of careLINK to Advisory in the Course Outline Page
During clinical this semester – spend time after cases learning the operation of the OR table and proper positioning. Practice on each other to appreciate “positioning” from patient’s perspective.