Week 1 - positioning Flashcards
(25 cards)
Why is positioning important in surgery?
Ensures surgical access & visibility, prevents positioning-related complications, maintains airway & ventilation, promotes patient safety & comfort
Who is responsible for patient positioning in surgery?
Anesthesia providers are involved in coordinating & directing patient positioning
What factors affect physiological changes associated with surgical positioning?
Surgical position, length of time, padding & positioning devices used, anesthesia type, operative procedure
What systems are most frequently affected by physiological changes during surgical positioning?
CV system, respiratory system, nervous system, skin, eyes, breasts, genitalia
What are the primary mechanisms responsible for nerve injuries?
Transection, compression, stretch
What is transection in the context of nerve injury?
Nerves may be transected by surgical maneuvers or by trauma
What causes compression nerve injuries?
Occurs when a nerve is forced against a bony prominence or hard surfaces
What is an example of a nerve subjected to a stretch injury?
Traction injuries can occur when a peripheral nerve is pulled over or under immovable structures
What common factors contribute to nerve injuries during surgery?
Incorrect surgical positioning, perioperative factors, patient factors, intraoperative occurrences
What are some perioperative factors contributing to nerve injuries?
Ancillary positioning devices, prolonged surgical procedures, anesthetic technique
What patient factors can contribute to nerve injuries?
Gender, advanced age, extremes in body habitus, preexisting medical conditions
What is ulnar neuropathy?
One of the most frequently reported injuries after surgery; associated with male gender
What are the consequences of ulnar nerve damage?
Inability to oppose 5th finger & diminished sensation to 4th & 5th finger, clawlike contracture
What is the brachial plexus?
A network of nerves vulnerable to injuries in almost every surgical position
What surgical position is associated with increased risk of brachial plexus injuries?
Steep Trendelenburg position
What is Spinal Cord Injury (SCI) primarily associated with?
Neuraxial blocks in anticoagulated patients & blocks for acute/chronic pain management
What is postoperative visual loss?
Rare but devastating complication of nonophthalmic surgery, can occur in one or both eyes
What are the common causes of postoperative visual loss?
- Ischemic optic neuropathy (ION) * Central retinal artery occlusion (CRAO) * Central retinal vein occlusion * Cortical blindness * Glycine toxicity
What is a potential contributing factor to ischemic optic neuropathy (ION) and central retinal artery occlusion (CRAO)?
Patient positioning
What are some complications that can arise from surgical positioning?
Tissue necrosis, infection, renal failure, paralysis, loss of limbs, even loss of life
What are some examples of surgical positions?
- Supine (Dorsal Decubitus) * Trendelenburg/Reverse Trendelenburg * Lithotomy * Lateral Decubitus * Sitting * Prone
What is the best method for decreasing the incidence of position-related injuries?
Prevention
What should anesthesia providers recognize and anticipate during surgeries?
Publicized complications & potential for damage inherent in each surgical position
Fill in the blank: The precise incidence & cause of position-related injuries are often ______.
difficult to determine
