Outpatient Surgery Magazine

Special Outpatient Surgery Edition - Orthopedics - August 2018

Outpatient Surgery Magazine, providing current information on Surgical Services, Surgical Facility Administration, Outpatient Surgery News and Trends, OR Excellence and more.

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Page 78 of 86

A U G U S T 2 0 1 8 • O U T PA T I E N T S U R G E R Y. N E T • 7 9 O rthopedic surgeons appreciate working with high- torque drills and high-speed shavers, but they mostly want to move their instruments in and around joints freely and easily. That requires placing patients just so on the surgical table with their extremities supported and their joints exposed. "The importance of patient positioning to a surgeon is all about, in a word, access," says James H. Lubowitz, MD, founding director emeri- tus of the Taos (N.M.) Orthopaedic Institute in New Mexico. With that in mind, here's how to ensure your surgeons have no trou- ble getting to where they need to go during joint repairs and replace- ments. Seeing the shoulder To provide shoulder access, patients are placed in the lateral or "beach chair" position for shoulder arthroscopies and replacements. When positioning patients laterally, place positioner pegs at the ster- num, pelvis and back to stabilize the patient. Use an axillary nerve protector underneath the armpit to protect the patient's skin. When placing patients in the beach chair position, ensure the patient is tilted 30 to 40 degrees in the chair to prevent slippage. The non-oper- ative arm can be secured in the patient's lap or in a sling to keep it away from the operative field. "The beach chair position is good for obese patients because it doesn't constrict ventilation," says Reagan Rose, BA, BSN, RN, CNOR, Mike Morsch | Associate Editor Position Patients for Surgical Success Surgeons want easy access and maximum exposure when working in shoulders, hips and knees.

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