Positioning Goals
To what are we trying to accomplish when positioning patients? Name at least 1 goal
What is maintain airway/breathing, protect skin/pressure points, or ensure optimal surgical access
These can occur as a result of positioning
What are pressure injuries, nerve injuries, falls, compartment syndrome, musculoskeletal injuries?
Fall prevention starts with__________
After a long lateral decubitus case, a patient reports numbness, decreased grip strength, and difficulty extending the wrist on the dependent arm. Review shows the axillary roll was misplaced, the arm was not neutrally aligned, and the BP cuff cycled for hours on the same limb.
This combination of factors resulted in what preventable complication related to improper positioning?
What is peripheral nerve injury?
Name 3 goals of proper patient positioning
What is maintain physiologic function, prevent pressure injury, ensure comfort and privacy, maintain access to IVs/lines
Communication of risk assessment findings
What is handoff communication, documentation in the EMR, team briefings and time outs?
Peripheral Nerves injuries occur when
What is stretching, compression, ischemia, improper padding, prolonged surgical time?
Fall preventative measures are_________
What is use of safety straps, siderails, proper communication, keeping limbs secured, ensuring patient awareness pre-anesthesia, use of proper positioning devices?
A sedated patient slides partially off the OR table during transfer into prone position. Contributing factors include failure to verbalize the maneuver, uncoordinated sequencing, unsecured safety straps, and no designated leader guiding the turn.
This event represents a breakdown in which critical team‑based OR process?
What is standardized communication and safety protocol adherence during high-risk positioning maneuvers?
Considerations when tucking arms are______
What is use of padding, avoiding compression of ulnar nerve, ensuring neutral alignment?
Name the major pressure points in the supine position
What is the occiput, scapulae, elbows, sacrum and heels?
What is ensuring eyes are closed/taped, avoid pressure on face, careful draping?
Perioperative Safe Positioning Principles for all patients ____________
What is maintaining alignment, protect pressure points, secure devices, avoid hyper extension, ensure access to airway?
A postoperative patient emerges from a 10‑hour spine case with deep‑tissue pressure injuries on the chest and iliac crests. Investigators find inadequate padding, unrelieved pressure, poor redistribution, and failure to reassess during intraoperative imaging.
This represents a failure of what critical positioning-based safeguard?
What is implementing and reassessing an effective pressure‑injury prevention plan during prolonged procedures?
Considerations when placing arms on bilateral armboards are__________
What is less than 90 degrees abduction, support, padding, keeping palms up/neutral?
What are the cheeks, eyes, breasts, hips, genitalia in males, knees, toes?
Concerns for lithotomy position are____
What is nerve injury (peroneal/sciatic), compartment syndrome, hip strain, reduced perfusion?
Risks associated with Trendelenburg position are___
What is sliding, increased intracranial pressure, facial/airway edema, compromised ventilation?
During a shoulder arthroscopy in Beach Chair position, the patient experiences sudden hypotension and decreased cerebral perfusion pressure. Review shows failure to correct BP measurement for height differences, excessive neck flexion, and delayed detection of head malalignment.
This reflects a breakdown in what essential monitoring and positioning principle?
What is maintaining cerebral perfusion and neutral head/neck alignment in the Beach Chair position?
Tell me about lateral positioning
What is Padding between knees/ankles, axillary roll, securing patient with straps, protecting dependent shoulder/arm, maintaining spine alignment?
This occurs when an adverse event happens_____
What is a care event/debrief?
Tell me about Beach Chair positioning
What is this position is commonly used for shoulder procedures, places patients at increased risk for hypotension, decreased cerebral perfusion, airway obstruction, and pressure on the sacrum, scapulae, and heels, requiring careful attention to head alignment, blood pressure monitoring, and padding of bony prominences?
Fall prevention for obese patients requires?
What is OR bed designed to support obese patients, bed extensions, non-slip padding, additonal safety straps, safety briefing preoperatively?