Review Note

Last Update: 02/17/2025 02:42 AM

Current Deck: ACG Part 2::Thoracic SSU

New Card (Unpublished)

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Pending Suggestions


Field Change Suggestions:
SS_TS 1.7 Describe the techniques used to position patients for thoracic surgery and to minimise risk of postoperative position-related injury
  • Majority performed in lateral position
    • Sometimes in supine, semisupine, semiprone lateral position
  • Anaesthetist should be responsible for head, neck and airway during position change and in charge of OT team to direct repositioning
  • “Head-to-toe” survey of patient after induction & intubation, and repositioning
  • Equipment all lines and monitors will have to be secured during position change and their function reassessed after positioning
  • Check position of DLT or bronchial blocker post position change for position of tube, and adequacy of ventilation

Lateral Decubitus Position (often with broken table)
  1. Position
  2. Minimise risk of post-operative position related injury 
    • Nerves :
      • Radial nerve  : when shoulder abducted to >90 degrees for suspended are. Can be supported with designed rests of upper arm can hug a billow 
      • common peroneal : Can be pressed between table and fibular head. Should be padded 
      • Saphenous : place padding between legs 
      • Brachial plexus : support head in neutral 
      • Excessive pressure at hip can compress sciatic nerve 
    • Prevent compression of the lower arm 
      • Caudad to the axilla on the rib cage - placed in the axilla can lead to brachial plexus neuropathy 
    • Ensure ear not folded  
    • Padding pressure areas 
    • Eyes : tape shut and prevent compression 

https://resources.wfsahq.org/atotw/patient-positioning-during-anaesthesia/
Gold coast notes.