How to place the orthopedic floating position

Side decubitus position

Position description

Commonly used in thoracolumbar surgery and hip surgery. It has the advantages of fully exposing the surgical field and making it easy for the surgeon to operate.

Placement Tutorial

The patient is in a 90° lateral position, with the back flush with the edge of the bed. At this time, the iliac and hand restraints are extremely important. Without affecting the scope of disinfection, a chest strap can be reinforced under the armpits to support the posture.

A suitable side-lying cushion should be used when lying on the side. The padding for the head should be kept at an appropriate height so that the head is in a relatively neutral position when lying on the side. At the same time, it should be noted that there needs to be a groove under the side lying positioning pad for the arm to place the arm to avoid crushing injuries. A pillow can be placed under the armpit of the arm facing upward.

It should be noted that because the venous pressure of the lower limb increases in the lateral position, it is not suitable to place a venous access in the lower arm. Likewise, bony protrusions need to be protected with padding. Extended information

Positional complications and prevention

Most of the complications in the lateral position are similar to those in the supine position. The patient's physiological changes caused by this position can lead to respiratory and circulatory disorders.

The head needs to be cushioned with a soft pillow and kept in a neutral position to avoid lowering the head, which will cause poor blood return in the jugular vein. Bony structures need to be protected by padding. Do not put pressure on or overextend your arm to prevent compression of the brachial plexus.

Practical tips

There are many reports in the literature related to arthroscopic surgery in the lateral position and traction of the affected limb. Brachial plexus palsy, traction-related soft tissue injury, finger nerve compression, ischemic injury, etc. may occur. The weight of upper limb traction should be kept below 9kg.