Three versions of the beach-chair position are common practice.
To prepare the operating table for the first version, it is sufficient to provide an operating table (here Maquet 1120 position II), but definitive positioning of the patient is time consuming, and requires physical effort and commitment on the part of the staff. After consulting the anaesthetist, the patient is positioned head-down on the fitted horseshoe headrest. After placing suitable positioning pads under the patient's buttocks (here: wedge and block pads depending on the patient's size), the operating table is brought gradually into the half-sitting position. The back plate is raised alternately with a low head movement of the whole operating table until the final position is reached. At the same time, the patient is pushed right over onto the operating side until the patient's side is on the edge of the table. Finally the leg plates are adjusted manually and the head is fixed.
Replacing the leg plates for a special shoulder plate in Maquet 1120 position I results in the second possibility for a sitting/half-sitting position. The operating table is adjusted by electromechanical means using the remote control. In this version, the positioning aids are already completely fitted to the table. The patient has been arranged in position and the table can be adjusted as usual until the final position is reached. It is rarely necessary to use positioning aids (wedge and block pads). In this case, the shoulder is exposed by removing a shoulder segment. This version involves minimum personnel and physical effort and takes up a minimum of time.
The third version is described here for the universal operating table 1150.30. The operating table is equipped with the shoulder plate component before the patient is brought into the operating suite. Once again, it is not necessary to fit additional positioning aids to the operating table, and the patient is already arranged with head and shoulders in position. After starting the anaesthetic and moving the patient board onto the operating table column, the patient board is aligned so that the operating side points towards the instrument nurse. To support sturdy, firm positioning, the buttocks are moved to the outer edge of the seat plate. The operating table can also be moved to the opposite side with the tilting function. There should therefore not be any protruding pins in the area of the seat plate bars to fasten operating table pads (D Fig. 8.31).
The distance between horseshoe headrest and the head end of the operating table depends on the patient's size. The head and cervical spine are positioned in the middle/ neutral setting. The head should no longer be fixed and held to the horseshoe headrest with wide transp arent plasters over the forehead. Today the head can be positioned comfortably in a helmet with special padding for the cervical spine and secured with a padded belt across the forehead (D Fig. 8.32).
Was this article helpful?