prone position question

Q. · Mar 17, 2002

Hope I can help. My experience to OR procedures is limited to C-sections, but....

Typically, our patients are alert, etc so they can fully transfer themselves to the OR table. Since the OR tables are typically VERY narrow, two people usually stabilize her before we strap her in. If she is numb from an epidural, we use a slider to transfer to the table - with the help of 4 people; 2 to pull 2 to push. Once the patient is on the table, usually a general is administered then, or an epidural.

As far as inserting the foley, that is best done for the comfort of the patient when the epidural is effective or the general is in place - usually when the patient is on the table but before the legs are strapped.

Hope this helps.

KC CHICK · Mar 18, 2002

Try AORN's website.... http://www.aorn.org/

I tried giving you a better answer but the darn thing wouldn't post.

Anne

KC CHICK · Mar 18, 2002

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?? :rolleyes:

Anne

lindsey · Mar 18, 2002

thank you very much!!!!

last question: is the bladder catheter removed before the patient wakes up ( a surgery that was less than 2 hrs. ), or after he / she wakes up ?

KC CHICK · Mar 18, 2002

When the doc wants the foley d/c'd depends on the type of procedure and the condition of the patient. For example, for a laparoscopic cholecystectomy, if a foley is requested by the doc it's d/c'd at the end of the case. For a total abdominal hysterectomy it's left in.

Also, some cases require only a straight cath before start and no foley. Some cases don't require cathing the patient at all....usually if they are two hours or less.

Anne:)