quickly, which decreases
their pressure-redistrib-
uting qualities.
Shoulders
Surgeon preference
determines how patients
are positioned for shoul-
der surgery; some prefer
the lateral decubitus
position and others uti-
lize beach chair posi-
tioning. Each option has associated benefits and drawbacks. The lat-
eral decubitus position improves visualization of and access to lateral
pathology during stabilizing procedures. However, the position
involves placing patients in a non-anatomic position and can increase
the risk of thromboembolic complications. The beach chair is a more
anatomic position that reportedly results in fewer neurovascular com-
plications and provides increased visualization of the entire joint. It
can lead to higher rate of hypotensive and bradycardic events, and
limits access to the posterior areas of the joint.
Ms. Prevatt says there are several high-risk areas to protect on
patients placed in the beach chair position:
• Non-operative arm. The arm is often supported on the patient's
abdomen in a sling or holder, or on an armboard. When using an arm-
board, place the arm with the palm facing down. Pad the elbow and
secure the arm to the armboard.
• Sacrum. To protect the sacral area, use an atraumatic foam sili-
cone dressing that covers the entire bony prominence in conjunction
with an air-filled pressure redistributing pad under the sacrum. The
J U L Y 2 0 2 0 • O U T P A T I E N T S U R G E R Y . N E T • 5 5
HOLD STEADY Innovative positioning devices are designed for ease of use,
increased stability and improved traction.
