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Putting patient in    proper bodyalignment to exposethe operative site or       area
2. Special bed equipmentPOSITIONING   and Bed attachmentEQUIPMENT            2.1 Safety belt
2. Special bed equipmentPOSITIONING   and Bed attachmentEQUIPMENT       2.2 Anesthesia screen
2. Special bed equipmentPOSITIONING   and Bed attachmentEQUIPMENT            2.3 Armboard
2. Special bed equipmentPOSITIONING   and Bed attachmentEQUIPMENT        2.4 Double armboard
2. Special bed equipmentPOSITIONING   and Bed attachmentEQUIPMENT        2.5 Wrist or arm strap
2. Special bed equipmentPOSITIONING   and Bed attachmentEQUIPMENT2.6 Upper extremity table (hand table)
2. Special bed equipmentPOSITIONING     and Bed attachment EQUIPMENT2.7 (thyroid elevator)- Shoulder bridge               ...
2. Special bed equipmentPOSITIONING   and Bed attachmentEQUIPMENT  2.8 Body rests and braces-support       maintain a late...
2. Special bed equipmentPOSITIONING   and Bed attachmentEQUIPMENT 2.9 Lateral positioner (kidney rests)
2. Special bed equipmentPOSITIONING   and Bed attachmentEQUIPMENT2.10 Adhesive tape-for anal procedures
2. Special bed equipmentPOSITIONING   and Bed attachmentEQUIPMENT            2.11 Stirrups
2. Special bed equipmentPOSITIONING   and Bed attachmentEQUIPMENT               2.12 headrests
2. Special bed equipmentPOSITIONING   and Bed attachmentEQUIPMENT      2.13 Clamps and sockets
2. Special bed equipmentPOSITIONING   and Bed attachmentEQUIPMENT            2.14 Leg Prepper
1. Site of operation2. Age and size of the   patient3. Type of anesthetic   used   regional – position     patient first ...
4. Pain normally   experienced by the   patient upon   movement5. Must not hinder   respiration and   circulation
1.   IDENTIFY2.   Explain purpose of position.3.   Mobility4.   Precaution in transferring     the pt fr. One bed to anoth...
5.  OR bed is securely locked6. The anesthesia provider   guards the HEAD7. Operative site must be   adequately exposed.8....
11. Maintain good body    alignment.12. Do not allow the persons  extremity dangle over the  sides of the table13. Avoid e...
14. Avoid person resting on   hands which may impede   circulation.15. Precautions for patient’s  safety must be  observed...
Pre-operative
 face neck shoulder induction of general anesthesia
HeadAbdomen
Clamshell top viewUSED FOR:- surgeries that involve unrestrictedaccess to both sides of abdomen asin laparoscopic surgery
Supine frog leg
USED FOR: Procedures of the anterior body such as:  Neurosurgical Procedures  Posterior Cervical Spine Procedures
Surgery      of lowerabdomen or pelvis
trendelenberg
USED FOR:  Procedures of the anterior body such as: laparoscopic surgery abdominal thoracic facial anterior upper and...
For:  neurological     procedure
rectalsurgery
 For:  surgical procedures of the  kidneys
 For  rectalexaminati on in an  obese patient
For: vaginal, perineal like    D&C and rectal    procedures like   hemorrhoidectomy
   DESCRIPTION: The patient is positioned so that the hips and    knees are flexed and elevated to facilitate surgical ac...
   DESCRIPTION: The patient is positioned so that the hips and    knees are flexed and elevated to facilitate surgical ac...
bone section is raised 45 degreesFor: cranial procedure
Sitting may fieldsSitting may fields                        Sitting may fields
SittingBeach chair
   Abdominal surgeries     Supine   Bladder surgery     Slightly trendelenburg   Perineal surgery     Lithotomy   B...
 Abdominal Aneurysm Surgery:  Fowlers Cataract Surgery:Semi fowlers Craniotomy   Supratentorial:semi fowlers   Infrat...
   Gastrectomy - supine   Femoropopliteal by-pass graft –    affected extremity (extended) Hemorrhoidectomy – side lyin...
 Laryngectomy – semi fowler’s Liver biopsy – right side lying Lobectomy – semi fowler’s Lumbar Puncture –  lateral si...
 Mastectomy    – elevate on  pillow (affected extremity) Thyroidectomy – semi  fowler’s Tonsillectomy – side lying  or ...
     The removal     of as many     bacteria as    possible from    the patient’s    skin through       shaving,     mech...
Prevention     of infection
1.   Determine the area     to be shaved and     its extent; know     the operation to be     done; the organ     involved...
   Cranial surgery – depends upon surgeon   Thyroid or neck surgery – chin to nipple plus    shoulder and axilla   Eye ...
2.   Practice     modesty       and     provide     privacy
3. Ask the  patient’spermission in cutting     theeyelashes  and hair.
4.   Examine the       area to be       shaved for     any signs of      irritation or           any       abnormal       ...
5.    Do not cut     the patient’s     skin.6.    In abdominal     operations,     pay particular     attention to     the...
7.    Shave the operative site     the day or the night     before the operation8.    Discard soiled sponges     in your k...
9.  In shaving, follow the    direction of the growth    of the hair while the free    hand exerts an opposite    force by...
 Definition:      Is the procedure of    covering patient and  surrounding areas with a   sterile barrier to create  and...
1. Allow  sufficient time to   permit careful application2. Allow sufficient space to   observe sterile technique3. Handle...
5. If in doubt as to its sterility,   consider it contaminated.6. If end of sheet falls below   waist level, discard it.7....
8.   Take the towel clips to the side of     the table from which the surgeon is     going to apply them before handling  ...
10. Hold drapes high enough to  avoid touching them on the  blanket but avoid touching the  light.11. Do not let your glov...
13. If a drape is incorrectly placed, the   circulating nurse discards it from   the table without contaminating   other d...
15. A towel clip that has  been fastened through a  drape has its point  contaminated. Removed it  only if absolutely  nec...
1. Blood  and fluid resistant   to keep the drape dry   and prevent migration of   microorganism.2. Lint free to prevent  ...
3.  Antistatic to eliminate   risk of spark from static   electricity.4. Sufficiently porous to   eliminate heat build-up ...
5. Drapable  to fit around   contours of the   patient, furniture, and   equipment6. Dull, nonglaring to minimize   color ...
8.Flame  resistant to self-extinguish rapidly on removal of an ignition source
Positioning, skin prep, incision & draping
Positioning, skin prep, incision & draping
Positioning, skin prep, incision & draping
Positioning, skin prep, incision & draping
Positioning, skin prep, incision & draping
Positioning, skin prep, incision & draping
Positioning, skin prep, incision & draping
Positioning, skin prep, incision & draping
Positioning, skin prep, incision & draping
Positioning, skin prep, incision & draping
Positioning, skin prep, incision & draping
Positioning, skin prep, incision & draping
Positioning, skin prep, incision & draping
Positioning, skin prep, incision & draping
Positioning, skin prep, incision & draping
Positioning, skin prep, incision & draping
Positioning, skin prep, incision & draping
Positioning, skin prep, incision & draping
Positioning, skin prep, incision & draping
Positioning, skin prep, incision & draping
Positioning, skin prep, incision & draping
Positioning, skin prep, incision & draping
Positioning, skin prep, incision & draping
Positioning, skin prep, incision & draping
Positioning, skin prep, incision & draping
Positioning, skin prep, incision & draping
Positioning, skin prep, incision & draping
Positioning, skin prep, incision & draping
Positioning, skin prep, incision & draping
Positioning, skin prep, incision & draping
Positioning, skin prep, incision & draping
Positioning, skin prep, incision & draping
Positioning, skin prep, incision & draping
Positioning, skin prep, incision & draping
Positioning, skin prep, incision & draping
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Positioning, skin prep, incision & draping

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Transcript of "Positioning, skin prep, incision & draping"

  1. 1. Putting patient in proper bodyalignment to exposethe operative site or area
  2. 2. 2. Special bed equipmentPOSITIONING and Bed attachmentEQUIPMENT 2.1 Safety belt
  3. 3. 2. Special bed equipmentPOSITIONING and Bed attachmentEQUIPMENT 2.2 Anesthesia screen
  4. 4. 2. Special bed equipmentPOSITIONING and Bed attachmentEQUIPMENT 2.3 Armboard
  5. 5. 2. Special bed equipmentPOSITIONING and Bed attachmentEQUIPMENT 2.4 Double armboard
  6. 6. 2. Special bed equipmentPOSITIONING and Bed attachmentEQUIPMENT 2.5 Wrist or arm strap
  7. 7. 2. Special bed equipmentPOSITIONING and Bed attachmentEQUIPMENT2.6 Upper extremity table (hand table)
  8. 8. 2. Special bed equipmentPOSITIONING and Bed attachment EQUIPMENT2.7 (thyroid elevator)- Shoulder bridge towel roll
  9. 9. 2. Special bed equipmentPOSITIONING and Bed attachmentEQUIPMENT 2.8 Body rests and braces-support maintain a lateral position
  10. 10. 2. Special bed equipmentPOSITIONING and Bed attachmentEQUIPMENT 2.9 Lateral positioner (kidney rests)
  11. 11. 2. Special bed equipmentPOSITIONING and Bed attachmentEQUIPMENT2.10 Adhesive tape-for anal procedures
  12. 12. 2. Special bed equipmentPOSITIONING and Bed attachmentEQUIPMENT 2.11 Stirrups
  13. 13. 2. Special bed equipmentPOSITIONING and Bed attachmentEQUIPMENT  2.12 headrests
  14. 14. 2. Special bed equipmentPOSITIONING and Bed attachmentEQUIPMENT 2.13 Clamps and sockets
  15. 15. 2. Special bed equipmentPOSITIONING and Bed attachmentEQUIPMENT 2.14 Leg Prepper
  16. 16. 1. Site of operation2. Age and size of the patient3. Type of anesthetic used  regional – position patient first  general – position patient last
  17. 17. 4. Pain normally experienced by the patient upon movement5. Must not hinder respiration and circulation
  18. 18. 1. IDENTIFY2. Explain purpose of position.3. Mobility4. Precaution in transferring the pt fr. One bed to another. ▪ 2: Conscious ▪ 4: unconscious, anesthetized, weak and obese.
  19. 19. 5. OR bed is securely locked6. The anesthesia provider guards the HEAD7. Operative site must be adequately exposed.8. Avoid undue exposure.9. Strap the person to prevent falls.10. Maintain adequate respiratory function.
  20. 20. 11. Maintain good body alignment.12. Do not allow the persons extremity dangle over the sides of the table13. Avoid excessive muscle strain.
  21. 21. 14. Avoid person resting on hands which may impede circulation.15. Precautions for patient’s safety must be observed, particularly with thin, elderly or obese patients.16. Don’t cross ankles (cause
  22. 22. Pre-operative
  23. 23.  face neck shoulder induction of general anesthesia
  24. 24. HeadAbdomen
  25. 25. Clamshell top viewUSED FOR:- surgeries that involve unrestrictedaccess to both sides of abdomen asin laparoscopic surgery
  26. 26. Supine frog leg
  27. 27. USED FOR: Procedures of the anterior body such as:  Neurosurgical Procedures  Posterior Cervical Spine Procedures
  28. 28. Surgery of lowerabdomen or pelvis
  29. 29. trendelenberg
  30. 30. USED FOR: Procedures of the anterior body such as: laparoscopic surgery abdominal thoracic facial anterior upper and lower extremity procedures
  31. 31. For: neurological procedure
  32. 32. rectalsurgery
  33. 33.  For:  surgical procedures of the kidneys
  34. 34.  For  rectalexaminati on in an obese patient
  35. 35. For: vaginal, perineal like D&C and rectal procedures like hemorrhoidectomy
  36. 36.  DESCRIPTION: The patient is positioned so that the hips and knees are flexed and elevated to facilitate surgical access to the perineum and abdomen. USED FOR: Procedures of the anterior body such as: gynecologic procedures perineal perirectal/anal
  37. 37.  DESCRIPTION: The patient is positioned so that the hips and knees are flexed and elevated to facilitate surgical access to the perineum and abdomen. This is the most physiologically compromising of any position, especially if the patient is obese. USED FOR: Procedures of the anterior body such as: gynecologic procedures perineal perirectal/anal
  38. 38. bone section is raised 45 degreesFor: cranial procedure
  39. 39. Sitting may fieldsSitting may fields Sitting may fields
  40. 40. SittingBeach chair
  41. 41.  Abdominal surgeries  Supine Bladder surgery  Slightly trendelenburg Perineal surgery  Lithotomy Brain surgery  Semi-fowler’s Spinal cord surgeries  Prone mostly Lumbar puncture  Side lying, flexed body
  42. 42.  Abdominal Aneurysm Surgery: Fowlers Cataract Surgery:Semi fowlers Craniotomy  Supratentorial:semi fowlers  Infratentorial:flat
  43. 43.  Gastrectomy - supine Femoropopliteal by-pass graft – affected extremity (extended) Hemorrhoidectomy – side lying Hip surgery – keep legs in abduction Hypophysectomy – elevate head Laminectomy – keep back straight
  44. 44.  Laryngectomy – semi fowler’s Liver biopsy – right side lying Lobectomy – semi fowler’s Lumbar Puncture –  lateral side lying: during procedure  Flat: post-op
  45. 45.  Mastectomy – elevate on pillow (affected extremity) Thyroidectomy – semi fowler’s Tonsillectomy – side lying or prone Vein Stripping & Ligation - keep legs elevated.
  46. 46.  The removal of as many bacteria as possible from the patient’s skin through shaving, mechanical, washing, and chemical disinfection
  47. 47. Prevention of infection
  48. 48. 1. Determine the area to be shaved and its extent; know the operation to be done; the organ involved and its location and the proposed incision.
  49. 49.  Cranial surgery – depends upon surgeon Thyroid or neck surgery – chin to nipple plus shoulder and axilla Eye surgery – cut eyelashes of affected eye Nasal surgery – no shaving unless with mustache Ear surgery – 2 ½ inches around ear Chest surgery – base of neck to waist, axilla and inner arm Abdominal and pelvic surgery – nipple to symphysis pubis, vulva, perineum, thigh Kidney – anterior – nipple to perineum, side to side; supra scapular region to buttocks Vaginal, scrotal, rectal – waist to perineum plus anterior and inner aspect of thigh and 6 inches from groin; posterior – entire buttocks and anus Lower extremities – digits 2 inches above knee, entire extremity and groin Upper extremities – distal arm 2 inches above elbow; elbow up to axilla
  50. 50. 2. Practice modesty and provide privacy
  51. 51. 3. Ask the patient’spermission in cutting theeyelashes and hair.
  52. 52. 4. Examine the area to be shaved for any signs of irritation or any abnormal condition. Report this to your head nurse
  53. 53. 5. Do not cut the patient’s skin.6. In abdominal operations, pay particular attention to the umbilicus.
  54. 54. 7. Shave the operative site the day or the night before the operation8. Discard soiled sponges in your kidney basin.
  55. 55. 9. In shaving, follow the direction of the growth of the hair while the free hand exerts an opposite force by pulling the skin to the opposite direction.10. If a wound is present on the area to be shaved, start from the clean area to the dirty area
  56. 56.  Definition:  Is the procedure of covering patient and surrounding areas with a sterile barrier to create and maintain an adequate sterile field during operation
  57. 57. 1. Allow sufficient time to permit careful application2. Allow sufficient space to observe sterile technique3. Handle the drape as little as possible4. If a drape becomes contaminated, do not handle
  58. 58. 5. If in doubt as to its sterility, consider it contaminated.6. If end of sheet falls below waist level, discard it.7. Never reach across the operating room table to drape the opposite side; go around the table
  59. 59. 8. Take the towel clips to the side of the table from which the surgeon is going to apply them before handling them to him9. Carry the folded drapes to the operating room table, watch the front of the sterile gown; it may bulge and touch the nonsterile table or blanket of the patient...Stand well back from the nonsterile table.
  60. 60. 10. Hold drapes high enough to avoid touching them on the blanket but avoid touching the light.11. Do not let your gloved hand touch the skin of the patient.12. Hold the linen high until it is directly over the proper area then lay it down where it is to remain.
  61. 61. 13. If a drape is incorrectly placed, the circulating nurse discards it from the table without contaminating other drapes or site.14. In unfolding the sheet on the operative site, toward the foot or the end of the table, protect the gloved hand by enclosing it in the turned back cuff of the sheet provided for that purpose.
  62. 62. 15. A towel clip that has been fastened through a drape has its point contaminated. Removed it only if absolutely necessary then discard it.16. Place a drape on a dry area.
  63. 63. 1. Blood and fluid resistant to keep the drape dry and prevent migration of microorganism.2. Lint free to prevent airborne contaminants and shedding into the surgical site.
  64. 64. 3. Antistatic to eliminate risk of spark from static electricity.4. Sufficiently porous to eliminate heat build-up so as to maintain an isothermic environment appropriate for pt body temp.
  65. 65. 5. Drapable to fit around contours of the patient, furniture, and equipment6. Dull, nonglaring to minimize color distortion from reflected light.7. Free of toxic ingredient, such as laundry
  66. 66. 8.Flame resistant to self-extinguish rapidly on removal of an ignition source
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