Arms

Fig. 8.36. Operating table with positioning aids ready in position

Both arms are lowered about 30° in the shoulder and brought forward by max. 90° with a bend of about 90° at the elbow. The lower arms are placed on the arm positioning devices, ensuring that the elbows are free (for short arm supports) or well padded (O Fig. 8.47). The patient's upper arms must not be positioned at the lateral edges of the operating table (incorrect arm positioning O Figs. 8.42-8.45).

The rule of thumb for positioning the arms in the prone position:

Position the distal joint of the arm lower than the proximal joint.

Fig. 8.38. Head position on dimpled foam cushion

Fig. 8.37. Prone position on the CRP operating table

Fig. 8.39. Head position on gel cushion

Fig. 8.37. Prone position on the CRP operating table

Fig. 8.39. Head position on gel cushion

Fig. 8.40. Head position on gel cushion

D Fig. 8.43. Incorrect arm positioning. The arm is raised too high on the short armrest with dropped wrist

D Fig. 8.43. Incorrect arm positioning. The arm is raised too high on the short armrest with dropped wrist

D Fig. 8.42. Incorrect arm positioning. The arm is raised too high on the short armrest with dropped wrist

D Fig. 8.45. Incorrect arm positioning, dropped wrist and unfavourable position of the clamps

This means the elbow is lower than the shoulder and the wrist lower than the elbow (O Figs. 8.40, 8.46, 8.47).

8.6.3 Thorax and pelvis

The thorax and pelvis are raised using suitable positioning pads so that the abdomen is free and the patient's breathing is not affected. It is important that the pelvic pad does not to squash the blood vessels in the groin (vena cava syndrome). The dimensions for the positioning pads depend on the patient's size (O Fig. 8.48).

8.6.4 Legs

Fig. S.4S. Abdominal position on 4 special bolsters

The patient's knees and feet are positioned with protection from pressure sores by placing a wide wedge pad, roll and, if necessary, small gel mat under the knees (O Fig. 8.49).

Fig. 8.46. Safe arm position and ideal shoulder position
Fig. 8.49. Leg positioning with wedge cushion and roll

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