Positioning a Prone Spine Case

In practice

The patient, an adult having lower back surgery, is identified in the room by name and date of birth and anesthetized on the stretcher. The anesthesia provider secures the breathing tube. The operating table has been prepared with chest and hip supports. Five people take part in the turn: the anesthesia provider at the head, controlling the airway and the head, and two people on each side. The circulating nurse leads the count. On the agreed count, they roll the patient as one unit from the stretcher onto the supports, face down. The anesthesia provider checks the breathing tube and settles the face on a padded headrest, making sure there is no pressure on the eyes. The circulating nurse checks that the chest and hips rest on the supports so the abdomen hangs free. The arms are placed on padded armboards, bent comfortably at the elbows, not stretched up over the head. The knees and toes are padded so they do not rest on hard surfaces. The scrub person, already gowned, watches from the back table and points out that one of the patient's breasts is compressed under the chest support; the team adjusts it. The circulating nurse documents the position and each support used. Two hours into the case, the anesthesia provider checks the face and eyes again.