tralateral side for any issues that may cause an injury," says Brent
Klev, MBA, MSN, RN, surgical services nurse manager at South Jordan
Health Center in Utah.
2. Tuck and check.
When tucking the arms of the lithotomy
patient down to her side, between the thigh and where the stirrups
are attached to the bed, you can cause pinching injures to the hands
and fingers if you start moving the stirrups around.
Proper tucking technique will prevent the pinching. When tucking
the hands, check the patient's fingers to make sure they're out of the
way of the stirrup attachments, says Mr. Klev. "Once you've got the
patient's arms tucked, move the stirrups around before the patient is
draped, to make sure the fingers aren't being pinched," he says. "If the
patient has wide hips and you start moving the stirrups around, you
can pinch the fingers."
Remember, the anesthesia provider usually runs the bed control
from the head of the table, so he can't see the patient's hands at the
end of the bed. He could injure the patient's hand when bringing the
foot of the bed back up at the end of the case, says Dr. Brueseke.
Another key point to tucking is to make sure the arm is not pinned
underneath the body. Wrap the sheet around the arm and then push
the sheet underneath the patient's body to provide resistance so the
arm doesn't fall off the bed.
"That sheet is holding the arm on the bed," says Dr. Brueseke, "so if
you just tuck, tuck, tuck, you can accidentally tuck the arm under the
body."
After you're done tucking the arms, you'll want to look at the
patient's shoulders to make sure they're still relatively neutral. If you
tuck a little too hard, says Dr. Brueseke, with the patient's hand too
high or low, you could end up with the patient's shoulders misaligned.
5 2 • O U T PA T I E N T S U R G E R Y M A G A Z I N E • A P R I L 2 0 1 9
