padding is placed behind the non-operative shoulder to relieve
stretching of the brachial plexus. Mr. Landess notes that the non-
operative arm should be flexed at the elbow at 90 degrees, with the
forearm in a neutral or slightly supine position. Additionally, there
should be sufficient staff available to ensure that the patient's head
isn't lifted too quickly.
Nerve injury isn't your only concern in beach chair, says Ms. Van
Wicklin. Since the patient's head is elevated and feet are lowered,
there is an increased risk for poor venous return. She suggests reposi-
tioning after 4 hours, if possible, and considering sequential compres-
sion devices for patients at risk for vascular complications. Mr. Klev
notes that research has shown high blood pressure is also something
to carefully monitor. "A patient is more likely to stroke in this position
than have a nerve injury," he says. OSM
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O U T P A T 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 P R I L 2 0 1 5
Positioning
non-operative
extremities is as
important as the
operative ones.
Pamela
Bevelhymer,
RN,
BSN
E-mail kgapinski@outpatientsurgery.net.
