Outpatient Surgery Magazine

Why Can't He Eat or Drink After Midnight? - March 2016 - Subscribe to Outpatient Surgery Magazine

Outpatient Surgery Magazine, providing current information on Surgical Services, Surgical Facility Administration, Outpatient Surgery News and Trends, OR Excellence and more.

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S urgery has changed dramatically in the last 10 or 15 years, and so should many of the practices related to the Trendelenburg position — especially steep Trendelenburg. Laparoscopic and robotic cases, practi- cally unheard of when many of us were residents, are now standard. We're tackling increasingly complex and longer proce- dures on heavier patients. Taken together, those factors should strongly influence whether, and to what degree, we decide to tilt our patients backwards to gain better access. I visit a lot of hospitals and surgery centers and watch a lot of sur- geons operate. So I see firsthand that a lot of folks are still operating as though it's 1996, instead of adapting to the often-challenging reali- ties of 2016. Here are 12 suggestions to consider before you lower the head and raise the feet of another patient. 7 2 • 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 6 12 Tips for Safe Trendelenburg Positioning Read this surgeon's advice before you lower the head and raise the feet of another patient. Ali Ghomi, MD, FACOG | Buffalo, N.Y. • STEEP THOUGHTS Some anatomy is independent of gravity, so a 40-degree tilt may be no more beneficial than 20 degrees. Pamela Bevelhymer, RN, BSN

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