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P A T I E N T
P O S I T I O N I N G
(from bed sheets or drapes), heels, thighs, sacrum, elbows, humerus,
vertebrae and occiput. The heels, lower legs, knees, greater
trochanter, humerus and ears are at risk on patients placed in the lateral position. Patients placed in the prone position must have their
toes, patella, thighs, rib cage and ears protected. Finally, pad the
shoulder blades, buttocks, heels and balls of the feet on patients
placed in sitting positions.
During longer cases, occasionally lift and massage areas susceptible
to pressure ulcers or skin injuries while taking care to ensure the airway is always maintained. Also ensure patients are secured to the surgical surface with safety straps to keep them from moving during procedures, particularly when placed in the Trendelenburg position.
6. Rely on positioning aids
Reducing incidences of pressure ulcers demands collaboration with
surgeons and wound care specialists, and a clear understanding of the
devices available to limit risks and how they're used in practice.
Always employ appropriate pressure-reduction and positioning tools
such as viscoelastic polyethylene-urethane mattresses, absorbent
table cover sheets, gel pads, heel suspension boots and soft silicone
dressing. Wicking pads and drapes placed between the patient and
positioning devices pull moisture from the skin and maintain the
skin's microenvironment.
For patients in the common supine position, place heels in suspension boots, which offload the sensitive areas and facilitate circulation.
During shorter cases, placing pillows under the calves — and ensuring
the calves remain in place — will lift the heels off the surgical surface.
Apply absorbent, soft silicone, self-adherent bordered dressings on the
sacrum as appropriate — based on identified risk factors — to wick
moisture from the skin and decrease friction and shear injury risks.
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O U T PAT I E N T S U R G E R Y M A G A Z I N E O N L I N E | J U N E 2013
