3. Do a tilt test.
Before you prep and drape, get the patient
properly positioned and tilt the table into the Trendelenburg position.
You want the patient in a good position for the procedure and the tilt
test will let you know if the patient is sliding, says Mr. Klev.
It only takes an extra minute or two. Because once you start the
procedure and get the patient prepped and draped, if you have prob-
lems with sliding, you may have to stop the procedure and re-position
and re-drape the patient. That costs you some time as well as money
with having to open new supplies.
The tilt test also helps you check if there are any problems with the
patient's ventilation, which also can be an issue in steep
Trendelenburg. When you get the patient in that position, you're plac-
ing significant weight onto the diaphragm, and consequently the
lungs, and that could cause breathing problems.
But the tilt test is beneficial for a few other reasons as well, accord-
ing to Mr. Klev. You can tell right away how the patient is going to
respond to the steep Trendelenburg and it also lets the patient get into
the position that they're going to be resting in during the procedure.
And it's not out of the question to do a second tilt test after seeing
what happens in the first tilt test.
"Once you tilt that patient back, you can tell how far they're going to
slide," says Mr. Klev. "They've already slid that distance and rested
into that spot. So, if there are any adjustments that need to be made,
we'll do a second tilt test to make sure the patient is in a good spot."
4. Speed bumps and sticky pads.
You can place axial
skeleton stabilizers around the neck and shoulders of patients to help
keep them stabilized while in the Trendelenburg position. Dr.
Brueseke calls these devices "speed bumps."
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