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Changing position in theatre (Supine - problems (Brachial plexus injury,…
Changing position in theatre
During position change
Must be in charge of the operating team to direct positioning
Take responsibility for the head, neck and airway
Secure all lines and monitors
Supine - problems
Brachial plexus injury
Pressure areas to occiput, sacrum, heel
Loss of lumbar lordosis - back pain (lumbar roll)
Knee hyperextension - knee pain (pillow under)
Lithotomy - problems
Cephalad movement of ETT
Haemodynamics (increased VR and CO, reduced BP in lower legs, calf compression -DVT risk)
Injuries - legs, lumbar spine, digits
Nerve injury - sciatic and obturator nerve stretch and femoral nerve compression. Compression of common peroneal nerve lateraly and saphenous nerve medially (avoid hip flexion > 90 deg, lots of padding)
Lateral decubitous - problems
Movement of ETT
Pressure injuries - brachial plexus, subscapular, sciatic, common peroneal and saphenous nerves
Pressure injuries - dependent ear folding, eye compression
Poor access to airway