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Patient Positioning Dr. Shailendra.V.L. Specialist in Anesthesia, Al Bukariya general hospital.
Introduction  ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Goal of positioning ,[object Object],[object Object]
Physiologic effects of change from vertical to horizontal position ,[object Object],[object Object],[object Object],[object Object],[object Object]
Erect position to Supine position ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Erect posture effect on pulmonary system ,[object Object],[object Object]
Supine posture effect on pulmonary system ,[object Object],[object Object]
Supine position ,[object Object],[object Object]
Supine position – Pressure points
Arm tucking in supine position ,[object Object]
Arm tucking  Note the arms is tucked  using draw  sheet & arm is secured by the side  of the patient
Lithotomy  ,[object Object],[object Object],[object Object],[object Object]
Lithotomy positioning - I
Lithotomy positioning - II
Final lithotomy position
Lithotomy position with stirrups
Lithotomy position
Urology -- Lithotomy position
Lithotomy position
Various types of Lithotomy stirrups
Lithotomy position
Nerve injuries in lithotomy ,[object Object],[object Object],[object Object],[object Object]
Lithotomy position – Nerve injuries Peroneal nerve Saphenous nerve Femoral nerve Obturator nerve
Lithotomy – nerve injuries
Nerve injuries in lithotomy ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Lithotomy position - problems
Compartment syndrome in lower limbs during lithotomy position ,[object Object],[object Object],[object Object],[object Object]
Upper limb injury during lithotomy position ,[object Object],[object Object]
Chemical burns in lithotomy position ,[object Object],[object Object]
Lateral position ,[object Object],[object Object],[object Object],[object Object],[object Object]
Lateral position
Lateral position
Lateral position
Higher chest exposure in lateral position ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Lateral position with kidney bridge ,[object Object],[object Object]
Lateral position with kidney bridge
Lateral oblique  Three quarters prone position ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Lateral oblique position Surgeon Assistant
Lateral oblique position Surgeon Assistant
Lateral oblique position Surgeon  Assistant
Lateral oblique position
Lateral oblique position
Lateral oblique position
Problems in lateral oblique position ,[object Object],[object Object],[object Object],[object Object],[object Object]
Prone position ,[object Object],[object Object],[object Object],[object Object],[object Object]
Prone position - problems ,[object Object],[object Object],[object Object],[object Object],[object Object]
Prone position – induction on trolley
Prone position Ist stage
Prone position
Prone position
Prone position
Prone position with laminectomy frame - pressure points
Trendlenberg’ s position ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Effects of Trenlenberg’ s position ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Trendlenburg position
Reverse Trenlenberg’s position ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Reverse Trenlenberg position
Jack knife position ( Kraske ) ,[object Object],[object Object]
Jack knife position
Knee chest position ,[object Object],[object Object],[object Object]
Knee chest position – pressure points
Orthopedic surgeries positions ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Orthopedic surgeries needing Wattson-Jone’s table ,[object Object],[object Object],[object Object]
Wattson Jone’s table used for Ortho surgery
Wattson Jone’s table used for Ortho surgery
Lateral position on Wattson Jone’s table
Problems with this position ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Positions for shoulder surgery ,[object Object],[object Object],[object Object],[object Object]
Beach chair position for shoulder surgery (Semi Fowler position)
Sitting position--Fowler position ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Sitting position -  Neuro surgery
Sitting position – pressure points
Sitting position
Relative contra-indication to sitting position ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Problems in sitting position ,[object Object],[object Object],[object Object]
Venous air-embolism ,[object Object],[object Object]
Air embolism ,[object Object],[object Object]
Air – embolism monitor warnings
Mandatory monitoring ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Pre-cordial Doppler device ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Mechanism of peripheral nerve injury  ,[object Object],[object Object],[object Object],[object Object],[object Object]
Types of nerve injury ,[object Object],[object Object],[object Object]
Neuropraxia  ,[object Object],[object Object],[object Object],[object Object]
Axonotomesis  ,[object Object],[object Object],[object Object],[object Object],[object Object]
Neurometesis  ,[object Object],[object Object]
Course of Upper limb nerves
Brachial plexus in the axilla
Coarse of nerves in thigh
Coarse of nerves in leg
Cubital-tunnel external compression syndrome ,[object Object],[object Object],[object Object]
Ulnar nerve injury Pronated arm Unpadded elbow Supinated arm Elbow padded Ulnar nerve pressure
Ulnar nerve @ cubital fossa
Eye injury ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Eye injury  ,[object Object],[object Object]
Eye injury ,[object Object],[object Object]
Summary  ,[object Object]
Summary  ,[object Object],[object Object],[object Object],[object Object],[object Object]
Summary  ,[object Object],[object Object],[object Object],[object Object],[object Object]
Thank you

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Patient Positioning