cially for laparoscop-
ic cases," says Dr.
Dayal. "If the anes-
thesiologist isn't pay-
ing attention, the
heart can get com-
promised in that
position."
Practical pearls
Patients can suffer
everything from
sheared skin and nerve damage caused by shifting and pressure, to
serious injuries caused by falling, thanks to the Trendelenburg posi-
tion. And all of that can leave your facility open to massive lawsuits,
many of which will end in favor of the patient, says anesthesiologist
Ashish Sinha, MD, PhD, DABA, MBA, professor and vice chairman of
anesthesiology at Temple University School of Medicine in
Philadelphia, Pa. In order to avoid patient injuries and potentially
ruinous lawsuits, remember that positioning the patient carefully is
everybody's job. "It's something the anesthesia provider and nursing
staff are all responsible for," says Dr. Sinha.
Here are some tips for safely securing the patient during
Trendelenburg positioning.
• Keep time on your side. Place patients in the Trendelenburg posi-
tion for the shortest amount of time possible and take them out of
Trendelenburg's position slowly to let the body readjust to the change
in blood volume.
• Protective padding. The Trendelenburg position can cause a
patient to slip down the operating table. That slippage can leave a
7 4 • O U T PA T I E N T S U R G E R Y M A G A Z I N E • J A n U A R Y 2 0 1 8
• TOTAL TEAM EFFORT Positioning the patient carefully is everybody's job. As one
anesthesiologist puts it: "It's something the anesthesia provider and nursing staff
are all responsible for."
