Page 54 - 2022 Risk Basics - Anesthesiology

SVMIC Risk Basics: Anesthesiology

injury, burns, and other OR/anesthesia mishaps, many of

which could have been prevented. The remainder of this
course will touch upon these and other miscellaneous areas of

potential risk in the anesthesia practice.

Positioning

Improper Positioning

Positioning the patient for a surgical procedure is a shared
responsibility among the surgeon, the anesthesiologist, and the

non-physician team members in the operating room. The
optimal position may require a compromise between the best

position for surgical access and the position the patient can
tolerate. The chosen position may result in physiologic

changes and can result in soft tissue injury (e.g., nerve

damage, pressure-induced injury or ulceration, or
compartment syndrome). Unfortunately, the best positioning

for surgery and the patient may not be the optimal position for

administering anesthesia.

This topic will discuss the basic principles for positioning and

specific concerns for a variety of positions. Postoperative visual

loss, which may be related to patient positioning, is not
discussed.

Trial Positioning

When possible, the position during surgery should be one that

would be comfortable with the patient fully awake. Patients
should be questioned about limited range of motion and their

ability to lie comfortably in the expected position. If questions
arise, the patient should be placed in the anticipated position

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