Patient positioning for surgery, associated positioning injuries, and the anesthesia technician's supportive role tested on the Cer.A.T. certification exam.
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- Supine positioning places the patient
- Flat on the back, face up
- A key nerve at risk of injury in supine positioning with arms abducted too far
- Brachial plexus
- Ulnar nerve injury in the supine position is most often caused by
- Direct compression of the nerve at the elbow against a hard surface
- Trendelenburg position refers to
- Supine with the head lower than the feet
- A common indication for Trendelenburg positioning
- Improving venous return during hypotension or improving surgical exposure in lower abdominal or pelvic surgery
- A key physiologic concern with steep Trendelenburg positioning
- Increased intracranial and intraocular pressure, and impaired ventilation from abdominal contents pressing on the diaphragm
- Reverse Trendelenburg position refers to
- Supine with the head elevated above the feet
- A common indication for reverse Trendelenburg positioning
- Improving surgical exposure in upper abdominal surgery or reducing aspiration risk
- Lithotomy position places the patient's legs
- Elevated and abducted in stirrups, with hips flexed
- A nerve commonly at risk in lithotomy position
- Common peroneal nerve, from compression against the stirrup near the fibular head
- Common peroneal nerve injury classically causes
- Foot drop
- Prone positioning places the patient
- Face down
- A key eye safety concern in prone positioning
- Direct pressure on the eyes can cause central retinal artery occlusion and vision loss
- Proper prone positioning requires supporting the chest to allow for
- Adequate diaphragmatic excursion and ventilation
- Lateral decubitus position is commonly used for
- Thoracic, hip, or kidney surgery
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