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Positions


Supine position




                               The most common surgical position. The patient lies with back flat on operating room bed. [1][2][3]
                  Trendelenburg position




                               Same as supine position but the upper torso is lowered. [1][2]

                                 Reverse Trendelenburg position




                               Same as supine but upper torso is raised and legs are lowered. [1][2]

                                                    Fracture Table Position




                               For hip fracture surgery. Upper torso is in supine position with unaffected leg raised. Affected leg is extended with no lower support. The leg is strapped at the ankle and the re is padding in the groin to keep pressure on the leg and hip. [1]
                                                                      Lithotomy position




                               Used for gynecological, anal, and urological procedures. Upper torso is placed in the supine position, legs are raised and secured, arms are extended.
                                                                                         Fowler's position




                               Begins with patient in supine position. Upper torso is slowly raised to a 90 degree position.

                                                                                                            Semi-Fowlers position




                               Lower torso is in supine position and the upper torso is bent at a nearly 85 degree position. The patient's head is secured by a restraint.

                                                                                                                              Prone position




                               Patient lies with stomach on the bed. Abdomen can be raised off the bed.
                                                                                                                                                 Jackknife position




                               Also called the Kraske position.[2] Patient's abdomen lies flat on the bed. The bed is scissored so the hip is lifted and the legs and head are low. [1][2]
                                                                                                                                                                    Knee-chest position




                               Similar to the jackknife except the legs are bent at the knee at a 90 degree angle.

                                                                                                                                                                                      Lateral position




                               Also called the side-lying position, it is like the jackknife except the patient is on his or her side. Other similar positions are Lateral chest and Lateral kidney.

                                                                                                                                                                                                         Kidney position




                               The kidney position is much like the lateral position except the patient's abdomen is placed over a lift in the operating table that bends the body to allow access to the retroperitoneal space. A kidney rest is placed under the patient at the location of the lift.[2]

                                                                                                                                                                                                                            Sims' position




                               The Sims' position is a variation of the left lateral position. The patient is usually awake and helps with the positioning. The patient will roll to his or her left side. Ke eping the left leg straight, the patient will slide the left hip back and bend the right leg. This position allows access to the anus.




                               Surgical positions
From Wikipedia, the free encyclopedia




Surgical positioning is the practice of placing a patient in a particular physical position during surgery. The
goal in selecting and adjusting a particular surgical position is to maintain the patient's safety while allowing
access to the surgical site. Often a patient must be placed in an unnatural position to gain access to the
surgical site.[1]

Positioning normally occurs after the administration of anesthesia.[1][2]

In addition to considerations related to the location of the surgical site, the selection of a surgical position is
made after considering relevant physical and physiological factors, such as body alignment, circulation,
respiratory constraints, and the musculatory system to prevent stress on the patient. [1][2] Physical traits of the
patient must also be considered including size, age, weight, physical condition, and allergies. [2] The type of
anesthesia used also affects the decision.[2]
   After The




   The Back




   Gastric bypass surgery




   Knee replacement surgery

Surgical Positions
Operating Room Operating Room Procedure OR nurse
Positions


    Supine position




                                   The most common surgical position. The patient lies with back flat on operating room bed. [1][2][3]
                      Trendelenburg position




                                   Same as supine position but the upper torso is lowered. [1][2]

                                     Reverse Trendelenburg position




                                   Same as supine but upper torso is raised and legs are lowered. [1][2]

                                                        Fracture Table Position




                                   For hip fracture surgery. Upper torso is in supine position with unaffected leg raised. Affected leg is extended with no lower support. The leg is strapped at the ankle and the re is padding in the groin to keep pressure on the leg and hip. [1]
                                                                          Lithotomy position




                                   Used for gynecological, anal, and urological procedures. Upper torso is placed in the supine position, legs are raised and secured, arms are extended.
                                                                                             Fowler's position




                                   Begins with patient in supine position. Upper torso is slowly raised to a 90 degree position.

                                                                                                                Semi-Fowlers position




                                   Lower torso is in supine position and the upper torso is bent at a nearly 85 degree position. The patient's head is secured by a restraint.

                                                                                                                                  Prone position




                                   Patient lies with stomach on the bed. Abdomen can be raised off the bed.
                                                                                                                                                     Jackknife position




                                   Also called the Kraske position.[2] Patient's abdomen lies flat on the bed. The bed is scissored so the hip is lifted and the legs and head are low. [1][2]
                                                                                                                                                                        Knee-chest position




                                   Similar to the jackknife except the legs are bent at the knee at a 90 degree angle.

                                                                                                                                                                                          Lateral position




                                   Also called the side-lying position, it is like the jackknife except the patient is on his or her side. Other similar positions are Lateral chest and Lateral kidney.

                                                                                                                                                                                                             Kidney position




                                   The kidney position is much like the lateral position except the patient's abdomen is placed over a lift in the operating table that bends the body to allow access to the retroperitoneal space. A kidney rest is placed under the patient at the location of the lift.[2]

                                                                                                                                                                                                                                Sims' position




                                   The Sims' position is a variation of the left lateral position. The patient is usually awake and helps with the positioning. The patient will roll to his or her left side. Ke eping the left leg straight, the patient will slide the left hip back and bend the right leg. This position allows access to the anus.




    There are various surgical positions during operations. OR nurses need to be equip with the knowledge which among these positions are appropriate during surgeries. Here are some quick guidelines for surgical positions:

o   The OR nurse should check the table and gather all the necessary equipment to be used in the surgery before the patient enters the room.

o   It is never a sin to ask for assistance

o   Check with the anesthesia team before moving the patient.

o   Do not forget your body mechanics

o   Move the patient carefully. Remember, you need to keep the patient safe

o   Watch out for IV lines, drains and other lines attach to the patient. You don’t want them pulled out right before surgery.

o   Check the patient again once you have positioned him/her. Do not stare alone at the surgical site. Look at the patient as a whole.


                                                                                                                                                                                               Here are the most common Surgical Positions:
                                                                                                                                                                                               1. Supine or Dorsal Position
                                                                                                                                                                                               The legs are uncrossed, slightly apart and both arms are at the side or at the arm boards. The palms of the hands should be f acing the body to prevent
                                                                                                                                                                                               unnecessary muscle strain on the arms. This type of surgical position is used during the induction of general anesthesia, abdominal surgeries, open-
                                                                                                                                                                                               heartsurgeries, surgeries on neck, face and mouth, and most surgeries on extremities.

                                                                                                                                                                                               The following equipment are needed for this type of position: (1) pillow & padding materials (2) shoulder roll for modifications that require hyperextension
                                                                                                                                                                                               of the patient’s neck (3) padded footrest available for reverse trendelenburg.

                                                                                                                                                                                               There are also disadvantages or possible hazards which may include skin
                                                                                                                                                                                               breakdown, lumbar strains, circulatory compromise and nerve injury.

                                                                                                                                                                                               2. Prone Position
                                                                                                                                                                                               The patient is primarily positioned in supine and then log-rolled onto abdomen after the induction of anesthesia. The patient’s arms are either on the side
                                                                                                                                                                                               or at the arm boards. Those patients who are having surgery on the posterior part such as back or spine or at the back of his or her leg are placed in
                                                                                                                                                                                               prone position.

                                                                                                                                                                                               The following equipment are needed for this type of position: (1) chest rolls (2) pillows and padding materials (3) headrest or support of head.

                                                                                                                                                                                               Possible danger to the patient may include: skin breakdown, reduced respiration, eye or ear damage, reduced circulation, damage to breast or genitals
                                                                                                                                                                                               3. Modified Trendelenburg Position
                                                                                                                                                                                               The modified trendelenburg position is usually used for lower abdominal surgery to allow gravity to assist in maintaining the intestines in the upper part of
                                                                                                                                                                                               the abdominal cavity. This position is also used in lower extremity surgery to aid in hemostasis. The patient is positioned in supine position and the
                                                                                                                                                                                               operating table is slightly tilted in order for his head to be lower than his feet by 1-5 degrees.
                                                                                                                                                                                               4. Modified Reverse Trendelenburg Position

    Modified Reverse Trendelenburg position is generally used for upper abdominal surgery and for the surgery of neck and face.This position allows improved operative exposure because gravity retains the int estines in the lower part of the abdomen.

    5. Jackknife or Kraske Position

    The patient is placed on supine position and log-rolled into abdomen. OR table is flexed approximately 90 degrees. Arms are placed at the side or at the arm boards. This position is almost exclusively used for rectal surgeries.

    The equipment needed during the surgery is the same as that of the prone position, but there is a need for a wide adhesive tape.
    6. Lithotomy Position
Positions


Supine position




                               The most common surgical position. The patient lies with back flat on operating room bed. [1][2][3]
                  Trendelenburg position




                               Same as supine position but the upper torso is lowered. [1][2]

                                 Reverse Trendelenburg position




                               Same as supine but upper torso is raised and legs are lowered. [1][2]

                                                    Fracture Table Position




                               For hip fracture surgery. Upper torso is in supine position with unaffected leg raised. Affected leg is extended with no lower support. The leg is strapped at the ankle and the re is padding in the groin to keep pressure on the leg and hip. [1]
                                                                      Lithotomy position




                               Used for gynecological, anal, and urological procedures. Upper torso is placed in the supine position, legs are raised and secured, arms are extended.
                                                                                         Fowler's position




                               Begins with patient in supine position. Upper torso is slowly raised to a 90 degree position.

                                                                                                            Semi-Fowlers position




                               Lower torso is in supine position and the upper torso is bent at a nearly 85 degree position. The patient's head is secured by a restraint.

                                                                                                                              Prone position




                               Patient lies with stomach on the bed. Abdomen can be raised off the bed.
                                                                                                                                                 Jackknife position




                               Also called the Kraske position.[2] Patient's abdomen lies flat on the bed. The bed is scissored so the hip is lifted and the legs and head are low. [1][2]
                                                                                                                                                                    Knee-chest position




                               Similar to the jackknife except the legs are bent at the knee at a 90 degree angle.

                                                                                                                                                                                      Lateral position




                               Also called the side-lying position, it is like the jackknife except the patient is on his or her side. Other similar positions are Lateral chest and Lateral kidney.

                                                                                                                                                                                                         Kidney position




                               The kidney position is much like the lateral position except the patient's abdomen is placed over a lift in the operating table that bends the body to allow access to the retroperitoneal space. A kidney rest is placed under the patient at the location of the lift.[2]

                                                                                                                                                                                                                            Sims' position




                               The Sims' position is a variation of the left lateral position. The patient is usually awake and helps with the positioning. The patient will roll to his or her left side. Ke eping the left leg straight, the patient will slide the left hip back and bend the right leg. This position allows access to the anus.




This position is commonly used in operation requiring a perineal approach such as genito-urinal or gynecologic surgery. Patient is placed on supine position and both legs are lifted together into the stirrups.

You will need stirrups, stirrup holders and paddings for this surgical position. Possible hazards could be respiratory compromise, skin breakdown, nerve damage and muskuloskeletal injury.

                                                                                                                                                                                           7. Lateral Position

                                                                                                                                                                                           The lateral position is used for operations on the kidney, chest hips or lungs. The patient is positioned supine and then rolled into his side with the
                                                                                                                                                                                           operative side up. The top leg is straight and the bottom is flexed. Both arms are placed on the arm board with the upper arm on special arm support or
                                                                                                                                                                                           pillow. Head supported in alignment with the body.

                                                                                                                                                                                           You need bean bag or other stabilization device, pillows/any padding materials, axillary roll, and headrest/head support. Possible dangers could be skin
                                                                                                                                                                                           break down, nerve injury and reduced respiration.
                                                                                                                                                                                           8. Modified Fowler’s Position
                                                                                                                                                                                           The Modified Fowler’s position or the sitting position is mostly used
                                                                                                                                                                                           in neurosurgery. This position is used to facilitate surgical access to the cranium,
                                                                                                                                                                                           neck, or shoulder and to promote drainage from the surgical site.

                                                                                                                                                                                           Possible complications may include air embolism, pneumocephalus, nerve
                                                                                                                                                                                           damage, systemic hypotension, pressure ulcers, midcervical quadriplegia and
                                                                                                                                                                                           face, tongue or neck edema due to prolonged neck flexion.




                                                                                                                                                                                           There are so many more surgical positions, and modifications. It will all depend
                                                                                                                                                                                           on the surgeon’s preference which to place the patient. OR nurses should make
                                                                                                                                                                                           sure that whatever position the patient is placed, he or she is not compromised.




Here are the most common Surgical Positions:
Positions


Supine position




                               The most common surgical position. The patient lies with back flat on operating room bed. [1][2][3]
                  Trendelenburg position




                               Same as supine position but the upper torso is lowered. [1][2]

                                 Reverse Trendelenburg position




                               Same as supine but upper torso is raised and legs are lowered. [1][2]

                                                    Fracture Table Position




                               For hip fracture surgery. Upper torso is in supine position with unaffected leg raised. Affected leg is extended with no lower support. The leg is strapped at the ankle and the re is padding in the groin to keep pressure on the leg and hip. [1]
                                                                      Lithotomy position




                               Used for gynecological, anal, and urological procedures. Upper torso is placed in the supine position, legs are raised and secured, arms are extended.
                                                                                         Fowler's position




                               Begins with patient in supine position. Upper torso is slowly raised to a 90 degree position.

                                                                                                            Semi-Fowlers position




                               Lower torso is in supine position and the upper torso is bent at a nearly 85 degree position. The patient's head is secured by a restraint.

                                                                                                                              Prone position




                               Patient lies with stomach on the bed. Abdomen can be raised off the bed.
                                                                                                                                                 Jackknife position




                               Also called the Kraske position.[2] Patient's abdomen lies flat on the bed. The bed is scissored so the hip is lifted and the legs and head are low. [1][2]
                                                                                                                                                                    Knee-chest position




                               Similar to the jackknife except the legs are bent at the knee at a 90 degree angle.

                                                                                                                                                                                      Lateral position




                               Also called the side-lying position, it is like the jackknife except the patient is on his or her side. Other similar positions are Lateral chest and Lateral kidney.

                                                                                                                                                                                                         Kidney position




                               The kidney position is much like the lateral position except the patient's abdomen is placed over a lift in the operating table that bends the body to allow access to the retroperitoneal space. A kidney rest is placed under the patient at the location of the lift.[2]

                                                                                                                                                                                                                            Sims' position




                               The Sims' position is a variation of the left lateral position. The patient is usually awake and helps with the positioning. The patient will roll to his or her left side. Ke eping the left leg straight, the patient will slide the left hip back and bend the right leg. This position allows access to the anus.




                                                                                                                                                                                           1. Supine or Dorsal Position

                                                                                                                                                                                           The legs are uncrossed, slightly apart and both arms are at the side or at the arm boards. The palms of the hands should be facing the
                                                                                                                                                                                           body to prevent unnecessary muscle strain on the arms. This type ofsurgical position is used during the induction of general anesthesia,
                                                                                                                                                                                           abdominal surgeries, open-heartsurgeries, surgeries on neck, face and mouth, and most surgeries on extremities.

                                                                                                                                                                                           The following equipment are needed for this type of position: (1) pillow & padding materials (2) shoulder roll for modifications that require
                                                                                                                                                                                           hyperextension of the patient’s neck (3) padded footrest available for reverse trendelenburg.

                                                                                                                                                                                           There are also disadvantages or possible hazards which may include skin breakdown, lumbar strains, circulatory compromise and nerve
                                                                                                                                                                                           injury.

                                                                                                                                                                                           2. Prone Position

                                                                                                                                                                                           The patient is primarily positioned in supine and then log-rolled onto
                                                                                                                                                                                           abdomen after the induction ofanesthesia. The patient’s arms are either
                                                                                                                                                                                           on the side or at the arm boards. Those patients who are having surgery
                                                                                                                                                                                           on the posterior part such as back or spine or at the back of his or her leg
                                                                                                                                                                                           are placed in prone position.

                                                                                                                                                                                           The following equipment are needed for this type of position: (1) chest
                                                                                                                                                                                           rolls (2) pillows and padding materials (3) headrest or support of head.

Possible danger to the patient may include: skin breakdown, reduced respiration, eye or ear damage, reduced circulation, damage to breast or genitals

3. Modified Trendelenburg Position

The modified trendelenburg position is usually used for lower abdominal surgery to allow gravity to assist in maintaining the intestines in the upper part of the abdominal
cavity. This position is also used in lower extremity surgery to aid in hemostasis. The patient is positioned in supine position and the operating table is slightly tilted in order
for his head to be lower than his feet by 1-5 degrees.

4. Modified Reverse Trendelenburg Position

Modified Reverse Trendelenburg position is generally used for upper abdominal surgery and for the surgery of neck and face.This position allows improved operative
exposure because gravity retains the intestines in the lower part of the abdomen.

                                                                                                                                                                                           5. Jackknife or Kraske Position

                                                                                                                                                                                           The patient is placed on supine position and log-rolled into abdomen. OR table is flexed approximately 90 degrees. Arms are placed at
                                                                                                                                                                                           the side or at the arm boards. This position is almost exclusively used for rectal surgeries.

                                                                                                                                                                                           The equipment needed during the surgery is the same as that of the prone position, but
                                                                                                                                                                                           there is a need for a wide adhesive tape.

                                                                                                                                                                                           6. Lithotomy Position

                                                                                                                                                                                           This position is commonly used in operation requiring a perineal approach such as genito-
                                                                                                                                                                                           urinal or gynecologic surgery. Patient is placed on supine position and both legs are lifted
                                                                                                                                                                                           together into the stirrups.

                                                                                                                                                                                           You will need stirrups, stirrup holders and paddings for thissurgical position. Possible
                                                                                                                                                                                           hazards could be respiratory compromise, skin breakdown, nerve damage and
                                                                                                                                                                                           muskuloskeletal injury.
Positions


Supine position




                               The most common surgical position. The patient lies with back flat on operating room bed. [1][2][3]
                  Trendelenburg position




                               Same as supine position but the upper torso is lowered. [1][2]

                                 Reverse Trendelenburg position




                               Same as supine but upper torso is raised and legs are lowered. [1][2]

                                                    Fracture Table Position




                               For hip fracture surgery. Upper torso is in supine position with unaffected leg raised. Affected leg is extended with no lower support. The leg is strapped at the ankle and the re is padding in the groin to keep pressure on the leg and hip. [1]
                                                                      Lithotomy position




                               Used for gynecological, anal, and urological procedures. Upper torso is placed in the supine position, legs are raised and secured, arms are extended.
                                                                                         Fowler's position




                               Begins with patient in supine position. Upper torso is slowly raised to a 90 degree position.

                                                                                                            Semi-Fowlers position




                               Lower torso is in supine position and the upper torso is bent at a nearly 85 degree position. The patient's head is secured by a restraint.

                                                                                                                              Prone position




                               Patient lies with stomach on the bed. Abdomen can be raised off the bed.
                                                                                                                                                 Jackknife position




                               Also called the Kraske position.[2] Patient's abdomen lies flat on the bed. The bed is scissored so the hip is lifted and the legs and head are low. [1][2]
                                                                                                                                                                    Knee-chest position




                               Similar to the jackknife except the legs are bent at the knee at a 90 degree angle.

                                                                                                                                                                                      Lateral position




                               Also called the side-lying position, it is like the jackknife except the patient is on his or her side. Other similar positions are Lateral chest and Lateral kidney.

                                                                                                                                                                                                         Kidney position




                               The kidney position is much like the lateral position except the patient's abdomen is placed over a lift in the operating table that bends the body to allow access to the retroperitoneal space. A kidney rest is placed under the patient at the location of the lift.[2]

                                                                                                                                                                                                                            Sims' position




                               The Sims' position is a variation of the left lateral position. The patient is usually awake and helps with the positioning. The patient will roll to his or her left side. Ke eping the left leg straight, the patient will slide the left hip back and bend the right leg. This position allows access to the anus.




                                                                                                                                                                                           7. Lateral Position

                                                                                                                                                                                           The lateral position is used for operations on the kidney, chest hips or lungs. The patient is positioned supine and then rolled into his
                                                                                                                                                                                           side with the operative side up. The top leg is straight and the bottom is flexed. Both arms are placed on the arm board with the upper
                                                                                                                                                                                           arm on special arm support or pillow. Head supported in alignment with the body.

                                                                                                                                                                                           You need bean bag or other stabilization device, pillows/any padding materials, axillary roll, and headrest/head support. Possible
                                                                                                                                                                                           dangers could be skin break down, nerve injury and reduced respiration.

                                                                                                                                                                                           8. Modified Fowler’s Position

                                                                                                                                                                                           The Modified Fowler’s position or the sitting position is mostly used in
                                                                                                                                                                                           neurosurgery. This position is used to facilitate surgical access to the
                                                                                                                                                                                           cranium, neck, or shoulder and to promote drainage from the surgicalsite.

                                                                                                                                                                                           Possible complications may include air embolism, pneumocephalus,
                                                                                                                                                                                           nerve damage, systemic hypotension, pressure ulcers, midcervical
                                                                                                                                                                                           quadriplegia and face, tongue or neck edema due to prolonged neck
                                                                                                                                                                                           flexion.




                                                                                               There are so many more surgical positions, and modifications. It will all
depend on the surgeon’s preference which to place the patient. OR nurses should make sure that whatever position the patient is placed, he or she is not compromised.
Positions


Supine position




                               The most common surgical position. The patient lies with back flat on operating room bed. [1][2][3]
                  Trendelenburg position




                               Same as supine position but the upper torso is lowered. [1][2]

                                 Reverse Trendelenburg position




                               Same as supine but upper torso is raised and legs are lowered. [1][2]

                                                    Fracture Table Position




                               For hip fracture surgery. Upper torso is in supine position with unaffected leg raised. Affected leg is extended with no lower support. The leg is strapped at the ankle and the re is padding in the groin to keep pressure on the leg and hip. [1]
                                                                      Lithotomy position




                               Used for gynecological, anal, and urological procedures. Upper torso is placed in the supine position, legs are raised and secured, arms are extended.
                                                                                         Fowler's position




                               Begins with patient in supine position. Upper torso is slowly raised to a 90 degree position.

                                                                                                            Semi-Fowlers position




                               Lower torso is in supine position and the upper torso is bent at a nearly 85 degree position. The patient's head is secured by a restraint.

                                                                                                                              Prone position




                               Patient lies with stomach on the bed. Abdomen can be raised off the bed.
                                                                                                                                                 Jackknife position




                               Also called the Kraske position.[2] Patient's abdomen lies flat on the bed. The bed is scissored so the hip is lifted and the legs and head are low. [1][2]
                                                                                                                                                                    Knee-chest position




                               Similar to the jackknife except the legs are bent at the knee at a 90 degree angle.

                                                                                                                                                                                      Lateral position




                               Also called the side-lying position, it is like the jackknife except the patient is on his or her side. Other similar positions are Lateral chest and Lateral kidney.

                                                                                                                                                                                                         Kidney position




                               The kidney position is much like the lateral position except the patient's abdomen is placed over a lift in the operating table that bends the body to allow access to the retroperitoneal space. A kidney rest is placed under the patient at the location of the lift.[2]

                                                                                                                                                                                                                            Sims' position




                               The Sims' position is a variation of the left lateral position. The patient is usually awake and helps with the positioning. The patient will roll to his or her left side. Ke eping the left leg straight, the patient will slide the left hip back and bend the right leg. This position allows access to the anus.

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Theoter positions

  • 1. Positions Supine position The most common surgical position. The patient lies with back flat on operating room bed. [1][2][3] Trendelenburg position Same as supine position but the upper torso is lowered. [1][2] Reverse Trendelenburg position Same as supine but upper torso is raised and legs are lowered. [1][2] Fracture Table Position For hip fracture surgery. Upper torso is in supine position with unaffected leg raised. Affected leg is extended with no lower support. The leg is strapped at the ankle and the re is padding in the groin to keep pressure on the leg and hip. [1] Lithotomy position Used for gynecological, anal, and urological procedures. Upper torso is placed in the supine position, legs are raised and secured, arms are extended. Fowler's position Begins with patient in supine position. Upper torso is slowly raised to a 90 degree position. Semi-Fowlers position Lower torso is in supine position and the upper torso is bent at a nearly 85 degree position. The patient's head is secured by a restraint. Prone position Patient lies with stomach on the bed. Abdomen can be raised off the bed. Jackknife position Also called the Kraske position.[2] Patient's abdomen lies flat on the bed. The bed is scissored so the hip is lifted and the legs and head are low. [1][2] Knee-chest position Similar to the jackknife except the legs are bent at the knee at a 90 degree angle. Lateral position Also called the side-lying position, it is like the jackknife except the patient is on his or her side. Other similar positions are Lateral chest and Lateral kidney. Kidney position The kidney position is much like the lateral position except the patient's abdomen is placed over a lift in the operating table that bends the body to allow access to the retroperitoneal space. A kidney rest is placed under the patient at the location of the lift.[2] Sims' position The Sims' position is a variation of the left lateral position. The patient is usually awake and helps with the positioning. The patient will roll to his or her left side. Ke eping the left leg straight, the patient will slide the left hip back and bend the right leg. This position allows access to the anus. Surgical positions From Wikipedia, the free encyclopedia Surgical positioning is the practice of placing a patient in a particular physical position during surgery. The goal in selecting and adjusting a particular surgical position is to maintain the patient's safety while allowing access to the surgical site. Often a patient must be placed in an unnatural position to gain access to the surgical site.[1] Positioning normally occurs after the administration of anesthesia.[1][2] In addition to considerations related to the location of the surgical site, the selection of a surgical position is made after considering relevant physical and physiological factors, such as body alignment, circulation, respiratory constraints, and the musculatory system to prevent stress on the patient. [1][2] Physical traits of the patient must also be considered including size, age, weight, physical condition, and allergies. [2] The type of anesthesia used also affects the decision.[2] After The The Back Gastric bypass surgery Knee replacement surgery Surgical Positions Operating Room Operating Room Procedure OR nurse
  • 2. Positions Supine position The most common surgical position. The patient lies with back flat on operating room bed. [1][2][3] Trendelenburg position Same as supine position but the upper torso is lowered. [1][2] Reverse Trendelenburg position Same as supine but upper torso is raised and legs are lowered. [1][2] Fracture Table Position For hip fracture surgery. Upper torso is in supine position with unaffected leg raised. Affected leg is extended with no lower support. The leg is strapped at the ankle and the re is padding in the groin to keep pressure on the leg and hip. [1] Lithotomy position Used for gynecological, anal, and urological procedures. Upper torso is placed in the supine position, legs are raised and secured, arms are extended. Fowler's position Begins with patient in supine position. Upper torso is slowly raised to a 90 degree position. Semi-Fowlers position Lower torso is in supine position and the upper torso is bent at a nearly 85 degree position. The patient's head is secured by a restraint. Prone position Patient lies with stomach on the bed. Abdomen can be raised off the bed. Jackknife position Also called the Kraske position.[2] Patient's abdomen lies flat on the bed. The bed is scissored so the hip is lifted and the legs and head are low. [1][2] Knee-chest position Similar to the jackknife except the legs are bent at the knee at a 90 degree angle. Lateral position Also called the side-lying position, it is like the jackknife except the patient is on his or her side. Other similar positions are Lateral chest and Lateral kidney. Kidney position The kidney position is much like the lateral position except the patient's abdomen is placed over a lift in the operating table that bends the body to allow access to the retroperitoneal space. A kidney rest is placed under the patient at the location of the lift.[2] Sims' position The Sims' position is a variation of the left lateral position. The patient is usually awake and helps with the positioning. The patient will roll to his or her left side. Ke eping the left leg straight, the patient will slide the left hip back and bend the right leg. This position allows access to the anus. There are various surgical positions during operations. OR nurses need to be equip with the knowledge which among these positions are appropriate during surgeries. Here are some quick guidelines for surgical positions: o The OR nurse should check the table and gather all the necessary equipment to be used in the surgery before the patient enters the room. o It is never a sin to ask for assistance o Check with the anesthesia team before moving the patient. o Do not forget your body mechanics o Move the patient carefully. Remember, you need to keep the patient safe o Watch out for IV lines, drains and other lines attach to the patient. You don’t want them pulled out right before surgery. o Check the patient again once you have positioned him/her. Do not stare alone at the surgical site. Look at the patient as a whole. Here are the most common Surgical Positions: 1. Supine or Dorsal Position The legs are uncrossed, slightly apart and both arms are at the side or at the arm boards. The palms of the hands should be f acing the body to prevent unnecessary muscle strain on the arms. This type of surgical position is used during the induction of general anesthesia, abdominal surgeries, open- heartsurgeries, surgeries on neck, face and mouth, and most surgeries on extremities. The following equipment are needed for this type of position: (1) pillow & padding materials (2) shoulder roll for modifications that require hyperextension of the patient’s neck (3) padded footrest available for reverse trendelenburg. There are also disadvantages or possible hazards which may include skin breakdown, lumbar strains, circulatory compromise and nerve injury. 2. Prone Position The patient is primarily positioned in supine and then log-rolled onto abdomen after the induction of anesthesia. The patient’s arms are either on the side or at the arm boards. Those patients who are having surgery on the posterior part such as back or spine or at the back of his or her leg are placed in prone position. The following equipment are needed for this type of position: (1) chest rolls (2) pillows and padding materials (3) headrest or support of head. Possible danger to the patient may include: skin breakdown, reduced respiration, eye or ear damage, reduced circulation, damage to breast or genitals 3. Modified Trendelenburg Position The modified trendelenburg position is usually used for lower abdominal surgery to allow gravity to assist in maintaining the intestines in the upper part of the abdominal cavity. This position is also used in lower extremity surgery to aid in hemostasis. The patient is positioned in supine position and the operating table is slightly tilted in order for his head to be lower than his feet by 1-5 degrees. 4. Modified Reverse Trendelenburg Position Modified Reverse Trendelenburg position is generally used for upper abdominal surgery and for the surgery of neck and face.This position allows improved operative exposure because gravity retains the int estines in the lower part of the abdomen. 5. Jackknife or Kraske Position The patient is placed on supine position and log-rolled into abdomen. OR table is flexed approximately 90 degrees. Arms are placed at the side or at the arm boards. This position is almost exclusively used for rectal surgeries. The equipment needed during the surgery is the same as that of the prone position, but there is a need for a wide adhesive tape. 6. Lithotomy Position
  • 3. Positions Supine position The most common surgical position. The patient lies with back flat on operating room bed. [1][2][3] Trendelenburg position Same as supine position but the upper torso is lowered. [1][2] Reverse Trendelenburg position Same as supine but upper torso is raised and legs are lowered. [1][2] Fracture Table Position For hip fracture surgery. Upper torso is in supine position with unaffected leg raised. Affected leg is extended with no lower support. The leg is strapped at the ankle and the re is padding in the groin to keep pressure on the leg and hip. [1] Lithotomy position Used for gynecological, anal, and urological procedures. Upper torso is placed in the supine position, legs are raised and secured, arms are extended. Fowler's position Begins with patient in supine position. Upper torso is slowly raised to a 90 degree position. Semi-Fowlers position Lower torso is in supine position and the upper torso is bent at a nearly 85 degree position. The patient's head is secured by a restraint. Prone position Patient lies with stomach on the bed. Abdomen can be raised off the bed. Jackknife position Also called the Kraske position.[2] Patient's abdomen lies flat on the bed. The bed is scissored so the hip is lifted and the legs and head are low. [1][2] Knee-chest position Similar to the jackknife except the legs are bent at the knee at a 90 degree angle. Lateral position Also called the side-lying position, it is like the jackknife except the patient is on his or her side. Other similar positions are Lateral chest and Lateral kidney. Kidney position The kidney position is much like the lateral position except the patient's abdomen is placed over a lift in the operating table that bends the body to allow access to the retroperitoneal space. A kidney rest is placed under the patient at the location of the lift.[2] Sims' position The Sims' position is a variation of the left lateral position. The patient is usually awake and helps with the positioning. The patient will roll to his or her left side. Ke eping the left leg straight, the patient will slide the left hip back and bend the right leg. This position allows access to the anus. This position is commonly used in operation requiring a perineal approach such as genito-urinal or gynecologic surgery. Patient is placed on supine position and both legs are lifted together into the stirrups. You will need stirrups, stirrup holders and paddings for this surgical position. Possible hazards could be respiratory compromise, skin breakdown, nerve damage and muskuloskeletal injury. 7. Lateral Position The lateral position is used for operations on the kidney, chest hips or lungs. The patient is positioned supine and then rolled into his side with the operative side up. The top leg is straight and the bottom is flexed. Both arms are placed on the arm board with the upper arm on special arm support or pillow. Head supported in alignment with the body. You need bean bag or other stabilization device, pillows/any padding materials, axillary roll, and headrest/head support. Possible dangers could be skin break down, nerve injury and reduced respiration. 8. Modified Fowler’s Position The Modified Fowler’s position or the sitting position is mostly used in neurosurgery. This position is used to facilitate surgical access to the cranium, neck, or shoulder and to promote drainage from the surgical site. Possible complications may include air embolism, pneumocephalus, nerve damage, systemic hypotension, pressure ulcers, midcervical quadriplegia and face, tongue or neck edema due to prolonged neck flexion. There are so many more surgical positions, and modifications. It will all depend on the surgeon’s preference which to place the patient. OR nurses should make sure that whatever position the patient is placed, he or she is not compromised. Here are the most common Surgical Positions:
  • 4. Positions Supine position The most common surgical position. The patient lies with back flat on operating room bed. [1][2][3] Trendelenburg position Same as supine position but the upper torso is lowered. [1][2] Reverse Trendelenburg position Same as supine but upper torso is raised and legs are lowered. [1][2] Fracture Table Position For hip fracture surgery. Upper torso is in supine position with unaffected leg raised. Affected leg is extended with no lower support. The leg is strapped at the ankle and the re is padding in the groin to keep pressure on the leg and hip. [1] Lithotomy position Used for gynecological, anal, and urological procedures. Upper torso is placed in the supine position, legs are raised and secured, arms are extended. Fowler's position Begins with patient in supine position. Upper torso is slowly raised to a 90 degree position. Semi-Fowlers position Lower torso is in supine position and the upper torso is bent at a nearly 85 degree position. The patient's head is secured by a restraint. Prone position Patient lies with stomach on the bed. Abdomen can be raised off the bed. Jackknife position Also called the Kraske position.[2] Patient's abdomen lies flat on the bed. The bed is scissored so the hip is lifted and the legs and head are low. [1][2] Knee-chest position Similar to the jackknife except the legs are bent at the knee at a 90 degree angle. Lateral position Also called the side-lying position, it is like the jackknife except the patient is on his or her side. Other similar positions are Lateral chest and Lateral kidney. Kidney position The kidney position is much like the lateral position except the patient's abdomen is placed over a lift in the operating table that bends the body to allow access to the retroperitoneal space. A kidney rest is placed under the patient at the location of the lift.[2] Sims' position The Sims' position is a variation of the left lateral position. The patient is usually awake and helps with the positioning. The patient will roll to his or her left side. Ke eping the left leg straight, the patient will slide the left hip back and bend the right leg. This position allows access to the anus. 1. Supine or Dorsal Position The legs are uncrossed, slightly apart and both arms are at the side or at the arm boards. The palms of the hands should be facing the body to prevent unnecessary muscle strain on the arms. This type ofsurgical position is used during the induction of general anesthesia, abdominal surgeries, open-heartsurgeries, surgeries on neck, face and mouth, and most surgeries on extremities. The following equipment are needed for this type of position: (1) pillow & padding materials (2) shoulder roll for modifications that require hyperextension of the patient’s neck (3) padded footrest available for reverse trendelenburg. There are also disadvantages or possible hazards which may include skin breakdown, lumbar strains, circulatory compromise and nerve injury. 2. Prone Position The patient is primarily positioned in supine and then log-rolled onto abdomen after the induction ofanesthesia. The patient’s arms are either on the side or at the arm boards. Those patients who are having surgery on the posterior part such as back or spine or at the back of his or her leg are placed in prone position. The following equipment are needed for this type of position: (1) chest rolls (2) pillows and padding materials (3) headrest or support of head. Possible danger to the patient may include: skin breakdown, reduced respiration, eye or ear damage, reduced circulation, damage to breast or genitals 3. Modified Trendelenburg Position The modified trendelenburg position is usually used for lower abdominal surgery to allow gravity to assist in maintaining the intestines in the upper part of the abdominal cavity. This position is also used in lower extremity surgery to aid in hemostasis. The patient is positioned in supine position and the operating table is slightly tilted in order for his head to be lower than his feet by 1-5 degrees. 4. Modified Reverse Trendelenburg Position Modified Reverse Trendelenburg position is generally used for upper abdominal surgery and for the surgery of neck and face.This position allows improved operative exposure because gravity retains the intestines in the lower part of the abdomen. 5. Jackknife or Kraske Position The patient is placed on supine position and log-rolled into abdomen. OR table is flexed approximately 90 degrees. Arms are placed at the side or at the arm boards. This position is almost exclusively used for rectal surgeries. The equipment needed during the surgery is the same as that of the prone position, but there is a need for a wide adhesive tape. 6. Lithotomy Position This position is commonly used in operation requiring a perineal approach such as genito- urinal or gynecologic surgery. Patient is placed on supine position and both legs are lifted together into the stirrups. You will need stirrups, stirrup holders and paddings for thissurgical position. Possible hazards could be respiratory compromise, skin breakdown, nerve damage and muskuloskeletal injury.
  • 5. Positions Supine position The most common surgical position. The patient lies with back flat on operating room bed. [1][2][3] Trendelenburg position Same as supine position but the upper torso is lowered. [1][2] Reverse Trendelenburg position Same as supine but upper torso is raised and legs are lowered. [1][2] Fracture Table Position For hip fracture surgery. Upper torso is in supine position with unaffected leg raised. Affected leg is extended with no lower support. The leg is strapped at the ankle and the re is padding in the groin to keep pressure on the leg and hip. [1] Lithotomy position Used for gynecological, anal, and urological procedures. Upper torso is placed in the supine position, legs are raised and secured, arms are extended. Fowler's position Begins with patient in supine position. Upper torso is slowly raised to a 90 degree position. Semi-Fowlers position Lower torso is in supine position and the upper torso is bent at a nearly 85 degree position. The patient's head is secured by a restraint. Prone position Patient lies with stomach on the bed. Abdomen can be raised off the bed. Jackknife position Also called the Kraske position.[2] Patient's abdomen lies flat on the bed. The bed is scissored so the hip is lifted and the legs and head are low. [1][2] Knee-chest position Similar to the jackknife except the legs are bent at the knee at a 90 degree angle. Lateral position Also called the side-lying position, it is like the jackknife except the patient is on his or her side. Other similar positions are Lateral chest and Lateral kidney. Kidney position The kidney position is much like the lateral position except the patient's abdomen is placed over a lift in the operating table that bends the body to allow access to the retroperitoneal space. A kidney rest is placed under the patient at the location of the lift.[2] Sims' position The Sims' position is a variation of the left lateral position. The patient is usually awake and helps with the positioning. The patient will roll to his or her left side. Ke eping the left leg straight, the patient will slide the left hip back and bend the right leg. This position allows access to the anus. 7. Lateral Position The lateral position is used for operations on the kidney, chest hips or lungs. The patient is positioned supine and then rolled into his side with the operative side up. The top leg is straight and the bottom is flexed. Both arms are placed on the arm board with the upper arm on special arm support or pillow. Head supported in alignment with the body. You need bean bag or other stabilization device, pillows/any padding materials, axillary roll, and headrest/head support. Possible dangers could be skin break down, nerve injury and reduced respiration. 8. Modified Fowler’s Position The Modified Fowler’s position or the sitting position is mostly used in neurosurgery. This position is used to facilitate surgical access to the cranium, neck, or shoulder and to promote drainage from the surgicalsite. Possible complications may include air embolism, pneumocephalus, nerve damage, systemic hypotension, pressure ulcers, midcervical quadriplegia and face, tongue or neck edema due to prolonged neck flexion. There are so many more surgical positions, and modifications. It will all depend on the surgeon’s preference which to place the patient. OR nurses should make sure that whatever position the patient is placed, he or she is not compromised.
  • 6. Positions Supine position The most common surgical position. The patient lies with back flat on operating room bed. [1][2][3] Trendelenburg position Same as supine position but the upper torso is lowered. [1][2] Reverse Trendelenburg position Same as supine but upper torso is raised and legs are lowered. [1][2] Fracture Table Position For hip fracture surgery. Upper torso is in supine position with unaffected leg raised. Affected leg is extended with no lower support. The leg is strapped at the ankle and the re is padding in the groin to keep pressure on the leg and hip. [1] Lithotomy position Used for gynecological, anal, and urological procedures. Upper torso is placed in the supine position, legs are raised and secured, arms are extended. Fowler's position Begins with patient in supine position. Upper torso is slowly raised to a 90 degree position. Semi-Fowlers position Lower torso is in supine position and the upper torso is bent at a nearly 85 degree position. The patient's head is secured by a restraint. Prone position Patient lies with stomach on the bed. Abdomen can be raised off the bed. Jackknife position Also called the Kraske position.[2] Patient's abdomen lies flat on the bed. The bed is scissored so the hip is lifted and the legs and head are low. [1][2] Knee-chest position Similar to the jackknife except the legs are bent at the knee at a 90 degree angle. Lateral position Also called the side-lying position, it is like the jackknife except the patient is on his or her side. Other similar positions are Lateral chest and Lateral kidney. Kidney position The kidney position is much like the lateral position except the patient's abdomen is placed over a lift in the operating table that bends the body to allow access to the retroperitoneal space. A kidney rest is placed under the patient at the location of the lift.[2] Sims' position The Sims' position is a variation of the left lateral position. The patient is usually awake and helps with the positioning. The patient will roll to his or her left side. Ke eping the left leg straight, the patient will slide the left hip back and bend the right leg. This position allows access to the anus.