Rules for the delivery of the patient to the operating room
Apr 20, 2018
The staff of the department, wearing shoe covers and gauze masks, brings a wheelchair from the patient to the operating room. If the patient is conscious, active, he automatically moves to the operating table from the wheelchair, if he is in serious condition, his sister and a nurse help him.
The patient must be placed in the desired position.
1. In operations on the abdominal organs, the sections of the table are at the same level. The patient occupies a horizontal position on the back. The lower extremities are fixed by the holders of the shins, thighs or with the help of a belt. The upper limbs are fixed along the trunk or diverted to special panels, if necessary, of intravenous infusions.
2. Operations on the chest:
• for posterolateral access, apply the position on the abdomen. All sections of the table are set at the same level. The head section can be removed, it is replaced with a headrest with a padded shoulder and an underfoot, which is convenient for the anesthesiologist. The upper limbs can be lowered down to the floor and laid in a special "hammock", prepared from a normal operating sheet. Sometimes they are fixed with handholds along the trunk or in lead on a special panel;
• during the operation on the side, all sections of the panel are at the same level, head restraint is used for greater stability of the head, side supports are installed to prevent the patient from tipping over to the back or abdomen. The legs are fixed on the panel with a belt. The upper limb is laid out forward on the installed panel, the other - bent at the elbow joint is placed on the palm rest;
• with front access to the thorax, the position of the table - as in abdominal operations. At operations on a neck for increase in an operational field and convenience of an operative measure, it is necessary to tilt the head and lift the upper shoulder girdle. All sections are set at the same level, remove the head section of the panel and attach the headrest with the shoulder pad. The patient lies on his back, his head is thrown back, lies on the headrest, which is lowered below the horizontal level. The upper shoulder girdle from below is on the two shoulder pads. To prevent the body from bending under the patient, a kidney bead is placed.
3. Operations on the upper and lower extremities. The position of the patient both on the back and on the stomach, depending on the location of the intended operational access.
4. When performing operations on the CNS, the patient is placed in the position on the back, abdomen, on the side. In operations on the skull, the head section of the table panel is removed and the headrest is fixed, on which the sub-balance of the required size is fastened, and in the operation in the position on the back it is replaced by a round headrest.
5. Operations on the rectum and genitalia:
• one of the patient's main positions - on the back with an elevated or lowered head end. For better fixation, it is necessary to fix the legs with the help of the hip holders;
• with Trendelenburg position - with lowered head end - at the beginning of the dorsal section of the table, stops are installed from both sides. When performing operations on the perineum, the patient is placed on his back so that the pelvis is at the edge of the hip section, with the leg lowered, the legs are bent in the hip and knee joints and fixed with straps;
6. Urological operations. The main position is on the side. To approach the operating field and reduce the depth of the wound, extend the lumbar cushion. In operations on the bladder and prostate gland, the position of the patient is the same as in operations on the rectum.