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KEYWORDS Patient positioning / Safety / Pressure sores / Nerve compression / Deep vein thrombosis / Compartment syndrome
Patient positioning in theatre pertains to how a patient is transferred and positioned for a specific procedure. Patient safety is a central focus of care within the NHS and every healthcare practitioner must ensure that patients are protected from harm where possible. Mal-positioning of the patient has important implications in terms of associated problems of pressure sores, nerve compressions, deep vein thrombosis and compartment syndrome, and should be avoided.
Patient positioning in theatre pertains to how a patient is transferred and positioned for a specific procedure. A number of different positions can be adopted depending on the exposure required for the procedure, but must ensure the comfort and safety of the patient at all times. Careful planning must consider not only the procedure itself, but also the type of anaesthesia or sedation that needs to be administered, the duration of the procedure and any co-morbidities the patient may have. The importance of patient positioning can often be overlooked and underestimated, despite the evidence that proper patient positioning can prevent immediate problems and reduce the risk of long-term pain and disability (Warner 2004). In this article, we discuss the importance of correct patient positioning and associated problems, look at common positions adopted in theatre and highlight important considerations.
Why patient positioning is important
Patient safety is a central focus of care within the NHS framework (Carruthers & Philip 2006) and every healthcare practitioner must ensure that patients are protected from harm where possible. Proper positioning reduces the risk of pressurerelated damage to nerves, muscle, skin, and joints. The anaesthetised or sedated patient is unable to communicate if they have been placed in a compromising or dangerous position, hence a proactive approach should be taken to prevent the deleterious effects of patient mal-positioning.
Correct positioning of a patient allows optimum exposure of the operative field (Millsaps 2006). Positioning must also take into account the degree of movement that may be necessary during the procedure, for example knee and shoulder arthroscopy require significant movement of the lower and upper limbs respectively during the procedure and the surgical field must be setup accordingly. Additional equipment e.g. fluoroscopy, may also...