Staging spaces
Our positioning process starts long
before we flip our patients over from
the stretcher onto the OSI table with a
Jackson frame we use for procedures
that require prone positioning. Prior to
surgery, our nursing staff meets with all
patients in a staging area — one of the
22 holding rooms located adjacent to
our 24 ORs — to find out any limita-
tions or restrictions that may affect the
patient's positioning. Individuals with
high BMI are at a greater risk for
injuries, especially pressure ulcers, because they put more weight and
pressure on their pressure points during surgery. In general, the heav-
ier the patient, the greater the pressure. And the greater the pressure,
the shorter the time period the patient can endure the procedure.
That's why it's so critical to get the positioning right from the start.
When patients enter the staging area pre-surgery, we're looking for
any type of apparent skin tears or redness that we need to make our
entire OR team aware of before surgery. Again, we're extra careful
with those high BMI patients, where we double-check for tiny tears
underneath areas like the panniculus or under the breasts.
While we obviously know about patients' past shoulder or neck sur-
geries, we get into the specifics about their range of motion during
this consult. We use this pre-op patient meeting to find out things that
wouldn't necessarily show up in their EMR by asking questions like
Do you have any — even very minimal — shoulder or neck pain?
The info we get via observation and consultation helps, but demon-
stration is paramount to our positioning success. Before every proce-
7 4 • O U T PA T I E N T S U R G E R Y M A G A Z I N E • M A R C H 2 0 1 9
• FEET FIRST From the foot of the patient's bed, all members of the OR
team will methodically do a final check of the patient's position.
Lehigh
Valley
Health
Network
