1. When the patient is awake, we have the patient scoot over on their own. Some of the precautions we take are making sure the pre-op cart is locked and the safety strap is on (the OR table is very narrow).
2. When the patient is asleep, we have 4-5 people assist with the transfer. One at the head (CRNA), one on each side, and one at the feet. The heavier the patient, the more people you need!!! Same precautions.
3. When transferring to a prone position, the patient is given anesthesia prior to moving. We then carefully roll the patient onto a Wilson or EasyProne frame from supine. When the patient is on the frame, you have to be sure that their "private" parts are hanging free and not squished between their body and the frame. There are also precautions taken with the arms. The palms are down on armboards with eggcrate foam under the axillas. Also, there is usually a gel pad under the knees and 2 pillows under their ankles.
4. Lateral positioning takes a lot of people to do. We usually use a deflatable sandbag to position on one side or the other. Pillows are placed between arms and legs.
5. Lithotomy positioning takes two people. The legs have to be moved up together to be placed into stirrups. When it's time for the legs to come down, anesthesia has to clear it due to possible blood pressure problems when the legs come down. Legs also have to come down together.
6. We usually cath patients after they are asleep....more comfortable for the patient. However, I have had a patient come back to the OR that had to urinate so bad it hurt her. ( She didn't want to tell the pre-op nurse that she had to go to the bathroom in front of her family.) She was so relieved when I put that foley in!!!
7. After surgery, patients are usually asleep or very groggy and need assistance for transfer. We then use the transfer board and 4-5 people to move back to the cart.
If you want a lot more OR information, try AORN's website http://www.aorn.org/
Did I write a novel or what??