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Hospital Units: Repositioning patients on the operating table

Question

Hello, we are trying to find some information regarding the repositioning of patients on the operating table. Different procedures require different needs and the Drs. want it done at speed. We have no overhead hoists, unfortunately!

Kim Harper
Fremantle Hospital


Answer

Dear Kim:

Your question is becoming more and more relevant, especially with today’s sophisticated surgeries and as surgeons handle ever increasing numbers of heavier patients. We can approach this question from a couple of different standpoints: 1) Repositioning the patient while ON the operating table, 2) repositioning the patient TO/FROM the operating table.

  1. Repositioning the patient while ON the operating table

    1. Manually moving the patient If the Dr simply wishes to reposition the patient on the table, you might consider using low friction sliding sheets or sliding tubes placed under the main sheet. Caution: due to the risk of the patient slipping off the table, low friction sheets should not be left under the patient without exercising precautions such as using restraints to stabilize the patient in place

    2. Raising or adjusting the patient’s torso One recently introduced product that might be of interest is an inflatable wedge-shaped pillow that employs an air supply to raise/adjust your patient’s head and shoulders into an elevated position. Originally designed to facilitate intubation procedures for bariatric patients, surgeons are pioneering innovative new uses for these devices, including adjustment of the patient’s torso while in mid-operation to enable access to various parts of the anatomy. (See data sheet here.)

    3. Positioning and holding the patient in place for a procedure Proper positioning techniques, used with supportive equipment and devices, contribute to patient safety, according to the (U.S.) Association of Perioperative Registered Nurses. A wide variety of surgical positioning accessories are available to enable you to optimally position your patients before and during surgery. (See examples here.)

  2. Repositioning the patient TO/FROM the operating table

    1. Lateral transfers using air pads Air transfer pads work by releasing low-pressure air through perforated chambers beneath the pad. The pad is placed under the patient in the same manner as changing a bed sheet. A lightweight portable Air Supply is then attached to the pad and inflates it, then the air "lifts" the patient as it is released through the perforated underside. The patient is literally transferred on a cushion of air, allowing two staff members to perform a task which previously required four to eight. (See data sheet here.)

    2. Roller type Patient Transfer Boards These lightweight, padded boards are used often used to transfer patients between stretchers and operating tables. They permit less traumatic transfers for the patient and do not require lifting on the part of caregivers. Some versions are elongated and thus enable Fowler Position (seated) transfers. See one typical Patient Transfer Board below:
      Patient Transfer Board
Please note: be sure to maintain sterile precautions for all items used in the surgical field. – including any necessary sterilization procedures for lift equipment, straps, low friction pads, etc.

Stay safe,
The Lift Doctor*