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S U P P L E M E N T T O O U T P AT I E N T S U R G E R Y M A G A Z I N E O N L I N E | A U G U S T 2 0 1 4
manufacturers are responding, now touting tables that can handle 500-, 600-,
even 700-pound patients.
Improvements in padding have also made it easier to sterilize tables between
cases, which saves time and decreases the likelihood that contaminants from a
previous case will infect subsequent patients. That's a big step forward.
What's next
Where do we go from here? What improvements can be made? One of the limi-
tations I frequently run into is the inability to X-ray patients during procedures.
There are times you can't get the view you'd like because most apparatuses are
T A B L E S & A T T A C H M E N T S
A recent study (
tinyurl.com/n9xcny6
) published in the
Journal of Bone & Joint Surgery addresses how to iden-
tify and avoid common complications related to patient
positioning during orthopedic procedures:
• Supine:
Proper positioning of upper extremities mini-
mizes pressure in the ulnar groove. Maintain the head in
a neutral position. Arms should be angled less than 90°
from the shoulder and secured to padded boards. Elbow
angles should also be less than 90°. All bony promi-
nences should be well padded. The forearm should be
neutral or slightly supinated to help avoid wrist injuries.
• Beach chair:
Complications include hypotensive bradycardic events, venous air embolism,
hypoglossal nerve palsy and neurapraxia of cutaneous nerves of the cervical plexus.
To minimize risks, support the head, neck and torso in a neutral position, stabilized by straps or
other attachments. Position and secure the thorax and trunk at the edge of the table on the same
side as the involved arm. Tilt the patient back into 10° to 15° of the Trendelenburg position, with
hips flexed to 45° to 60°, and knees to 30°. Pad all pressure points. The treated arm should be
RESEARCH
REVIEW
New Study Offers Important Positioning Tips
ADDED STRENGTH Increased versatility in
attachments improves safety and reduces
the need for manpower in the OR.
Pamela
Bevelhymer,
RN,
BSN
