What is Kraske's position in surgery?
Etymology: Paul Kraske, Swiss surgeon, 1851-1930. an anatomical position in which the patient is prone, with hips flexed and elevated, head and feet down. The position is used for renal surgery, as it enlarges the costovertebral angle, allowing the surgeon to have optimal access to the kidneys.
What is the jackknife position used for?
In this variation of the prone position, the patient’s head and feet are both lower than the hips. The jackknife position is used most frequently for proctologic procedures. It is also the gold standard in anorectal surgical procedures (Kneedler & Dodge, 1994).
What kind of positioner is used for kidney surgery?
A variation of lateral position with kidney elevation (flexion) is most commonly used for kidney and thoracic procedures. Lateral positioners, arm boards, headrests and restraint straps are used to safely position the patient for this procedure. Positioning for Orthopedic Procedures
Why is the lithotomy position used?
The lithotomy position was the standard birthing position used by many hospitals. It was often used during the second stage of labor, when you start pushing. Some doctors prefer it because it gives them better access to both mother and baby.
What is the best description of the jackknife position?
A position in which the patient lies on the back, shoulders elevated, legs flexed on thighs, thighs at right angles to the abdomen. It is used when introducing a urethral sound.
What surgeries use Fowler's position?
Standard Fowler's position, also known as sitting position, is typically used for neurosurgery and shoulder surgeries. The bed angle is between 45 degrees and 60 degrees. The legs of the patient may be straight or slightly bent. This position is often used for head, chest, and shoulder surgeries.
What is the semi prone position used for?
a position to facilitate a vaginal examination, with the patient lying on her side with the lower arm behind the back, the thighs flexed, the upper one more than the lower.
What procedures are done in jackknife position?
The patient is placed in the prone jackknife position and the buttocks are taped apart. An incision is made over the lower sacrum and coccyx down to the anoderm, being cautious to avoid damage to the sphincter complex. Coccygectomy can facilitate exposure and resection of large tumors.
What is jackknife position truck?
One of the most common types of truck accidents involves a vehicle that “jackknifes.” Jackknifing is the term used to describe when the trailer of a large semi-truck or big rig pushes the front towing vehicle to one side.
Why does Fowler's position help breathing?
Fowler's position is used in nursing to promote oxygenation to allow for maximum chest expansion, minimizing abdominal muscular tension and minimizing the effects of gravity on the chest wall, therefore, a useful maneuver for patients in mild to moderate respiratory distress.
Why does semi Fowler's position help breathing?
In the semi-Fowler's position, the diaphragm moves downward, the work of breathing relatively decreases, lung volume and ventilation increases, and lung dilatation is promoted; these changes can improve oxygenation and increase oxygen saturation [13].
Is Semi Fowler's good for pneumonia?
A semi-upright position (45° position) in ventilated patients is recommended to prevent ventilator-associated pneumonia (VAP) and is one of the first steps in progressive early mobility.
What is the benefit of proning a patient?
Research has found that when proning is used in patients with severe ARDS and hypoxemia not improved by other means, it has the benefit of: better ventilation of the dorsal lung regions threatened by alveolar collapse; improvement in ventilation/perfusion matching; and. potentially an improvement in mortality.
Why does proning improve oxygenation?
Proning lets the lungs, particularly their dependent areas, expand, resulting in improved oxygenation that occurs primarily within the first hour. In the prone position, lung compression is decreased, secretions drain better, and collapsed alveoli reopen.
When is the Trendelenburg position used?
Trendelenburg position is typically used for lower abdominal surgeries including colorectal, gynecological, and genitourinary procedures as well as central venous catheter placement.
What is the jackknife position used for?
In this variation of the prone position, the patient’s head and feet are both lower than the hips. The jackknife position is used most frequently f...
What is the Kraske position used for?
What is the kraske position used for? Jackknife position, also known as Kraske, is similar to Knee-Chest or Kneeling positions and is often used fo...
What is the difference between jackknife position and supine position?
In Supine position, the patient may risk pressure ulcers and nerve damage. This position causes extra pressure on the skin and bony prominences ove...
What are some common concerns about the prone Jack Knife position?
One of the most common concerns about the prone jack knife position is the safety of the airway during anesthesia. Patients are occasionally placed...
What is the Kraske position?
Kraske or jackknife position. In this variation of the prone position, the patient’s head and feet are both lower than the hips. The jackknife position is used most frequently for proctologic procedures. It is also the gold standard in anorectal surgical procedures (Kneedler & Dodge, 1994).
Why do surgeons use jack knives?
The primary reason that many surgeons prefer the prone jack knife position is the excellent visibility provided during anorectal procedures. The exposure provided for office procedures, such as excision of thrombosed external hemorrhoids or drainage of abscesses is not equaled by other positions.
Why do patients go in lithotomy position?
Patients are occasionally placed in lithotomy position rather than the preferred prone jack knife position because of the concern for the airway. While patient safety is a prime concern, there are no reports of the loss of control of airway during repositioning.
What happens if you use a prone jack knife?
If the patient is improperly positioned, transmitted pressure on the vena cava may cause blood pooling in the lower extremities and result in decreased venous return.
What are the factors that prevent a patient from lying prone on the operating table?
Patient Factors. Individual physical limitations of the patients occasionally prevent the use of the jack knife position. Physical factors that would prevent a patient from lying prone on the operating table, such as obesity, pregnancy, and tense ascites, may require the use of a different position.
Is the Jack Knife precarious?
Similarly, more than one person can visualize the operating field without crowding or being in an awkward body position (Bailey & Snyder, 2000). The jack knife position has been described as the most precarious of surgical positions. Both respiration and circulation can be most adversely affected.
Does prone jackknife change heart rate?
There was no change in heart rate, mean arterial pressure, and systemic vascular resistance with change from the supine position to the prone jack-knife position, but there was a decrease in the left ventricular stroke work index and a significant increase in the pulmonary capillary wedge pressure.
What is the position of a jackknife?
Jackknife position, also known as Kraske, is similar to Knee-Chest or Kneeling positions and is often used for colorectal surgeries. This position places extreme pressure on the knees. While positioning, surgical staff should place extra padding for the knee area.
When to use a face positioner?
A face positioner is used when the patient's head is in midline. Prone position is often used for spine and neck surgeries, neurosurgery, colorectal surgeries, vascular surgeries, and tendon repairs. Foam or gel positioners may also be used for spinal procedures.
What is a lithotomy position?
In Lithotomy position, the patient can be placed in either a boot-style leg holder or stirrup-style position. Modifications to this position include low, standard, high, exaggerated or hemi. This position is typically used for gynecology, colorectal, urology, perineal, or pelvis procedures. The risks posed to a patient in a Lithotomy position for a procedure include fractures, nerve injuries, hip dislocation, muscle injuries, pressure injuries, and diminished lung capacity. While positioning a patient in this position, surgical staff should avoid hyperabduction of the patient's hips and leaning against their inner thighs. Stirrups used on a patient in this position should disperse support and pressure over wide areas. 2,3
Why is patient positioning important?
THE IMPORTANCE OF PATIENT POSITIONING. Patient positioning is vital to a safe and effective surgical procedure. Proper patient positioning depends on the type and length of procedure, anesthesia access to the patient, devices required and other factors. Safely positioning the patient is a team effort. All members of the surgical team play ...
What happens when you are in a supine position?
In Supine position, the patient may risk pressure ulcers and nerve damage. This position causes extra pressure on the skin and bony prominences over the occiput, scapulae, elbows, sacrum, coccyx and heels. 2,3.
What is the most commonly used position for a patient?
Supine position, also known as Dorsal Decubitus, is the most frequently used position for procedures. In this position, the patient is face-up. The patient's arms should be tucked at the patient's sides with a bedsheet, secured with arm guards to sleds.
What is the Fowler position?
Fowler's Position. Fowler's position, also known as sitting position, is typically used for neurosurgery and shoulder surgeries. The beach chair position is often used for nasal surgeries, abdominoplasty, and breast reduction surgeries. When positioning a patient in Fowler's position, the surgical staff should minimize the degree ...
What is the position of the kidney?
Kidney position. The kidney position is much like the lateral position except the patient's abdomen is placed over a lift in the operating table that bends the body to allow access to the retroperitoneal space. A kidney rest is placed under the patient at the location of the lift.
What is surgical positioning?
Surgical positioning is the practice of placing a patient in a particular physical position during surgery. The goal in selecting and adjusting a particular surgical position is to maintain the patient's safety while allowing access to the surgical site.
What position is the torso in for hip fracture surgery?
For hip fracture surgery. Upper torso is in supine position with unaffected leg raised. Affected leg is extended with no lower support. The leg is strapped at the ankle and there is padding in the groin to keep pressure on the leg and hip.
What is the sims position?
The Sims' position is a variation of the left lateral position. The patient is usually awake and helps with the positioning. The patient will roll to his or her left side. Keeping the left leg straight, the patient will slide the left hip back and bend the right leg. This position allows access to the anus.
What are the forces that damage the body?
Other forces that may damage the body are the folding of the tissue, called shear, friction from the tissue rubbing against other tissue, and moisture on the skin that can cause it to be more vulnerable to the other forces and factors, called maceration.
Why is it important to change the position of a patient?
Changing positions. If the patient has been immobilized, it may be important to change the patient's position periodically to prevent blood pooling, to stimulate circulation, and to relieve pressure on tissues. The patient should not be placed in unnatural positions for an extended period of time.
What is prone position?
The Prone position is a patient position used during surgical procedures that provide surgical access to the dorsal aspects of the patient’s body. 1 In the prone position, the patient is positioned face-down with their head in a neutral position without excessive flexion, extension, or rotation. The patient’s arms should be abducted less ...
When to use face positioner?
Use a face positioner when the patient’s head is in midline. Prevent direct pressure on the patient’s eyes. Ensure a gurney is always readily accessible to reposition the patient from the prone position to the supine position if cardiopulmonary resuscitation becomes necessary. As with all surgical positions, surgical staff should be aware ...
What position is the patient's head in?
The arms may also be tucked at the patient’s side. The patient’s head is in a neutral position without excessive flexion, extension, or rotation. The patient is face-up, with their head resting on a pad positioner or pillow and their neck in a neutral position.
What is anesthesia armboard?
Anesthesia Armboards - Lightweight and carbon fiber, these Anesthesia Armboards are designed to allow access for anesthesia caregivers during a procedure while a patient is in the prone position.
What is the best practice for positioning a patient?
Regardless of what position is being used for a patient during a procedure, it’s important to follow best practices for positioning. 1 Surgical Staff should always refer to their facility's positioning policies, procedures and training when positioning a patient.
How to use chest support?
Use chest supports that extend from the clavicle to the iliac crest. Ensure the breast, abdomen, and genitals are free from pressure. Pad the patient’s knees. Elevate the patient’s toes off the bed with padding under the shins. Use a face positioner when the patient’s head is in midline.
Why is it important to have an adequate number of personnel, devices, and equipment available during positioning activities?
Have an adequate number of personnel, devices, and equipment available during positioning activities helps to ensure patient and personnel safety. Respect the patient’s dignity and privacy during positioning: only necessary personnel in the room when the patient is exposed.
Positioning
Anesthesia Factors
- One of the most common concerns about the prone jack knife position is the safety of the airway during anesthesia. Patients are occasionally placed in lithotomy position rather than the preferred prone jack knife position because of the concern for the airway. While patient safety is a prime concern, there are no reports of the loss of control of airway during repositioning. Although this l…
Patient Factors
- Individual physical limitations of the patients occasionally prevent the use of the jack knife position. Physical factors that would prevent a patient from lying prone on the operating table, such as obesity, pregnancy, and tense ascites, may require the use of a different position. Orthopedic considerations, such as hip and knee joint problems, long leg casts, and kyphosis m…
Surgeon Factors
- The primary reason that many surgeons prefer the prone jack knife position is the excellent visibility provided during anorectal procedures. The exposure provided for office procedures, such as excision of thrombosed external hemorrhoids or drainage of abscesses is not equaled by other positions. In the operating room, whether the surgeon is dissecting the rectum off of the prostat…
Physiologic Factors
- The jack knife position has been described as the most precarious of surgical positions. Both respiration and circulation can be most adversely affected. Vital capacity is reduced due to restricted diaphragmatic movement and increased blood volume in the lungs, reducing lung compliance (Kneedler & Dodge, 1994). Careful positioning of patients when they are under anest…
References
- Bailey, H. R., & Snyder, M. J. (2000). Ambulatory Anorectal Surgery. New York: Springer. Jaffe, R. A., & Samuels, S. I. (2004). Anesthesiologist’s Manual of Surgical Procedures (3rd ed.). New York: Lippincott Williams & Wilkins. Kneedler, J. A., & Dodge, G. H. (1994). Perioperative Patient Care: The Nursing Perspective (3rd ed.). Sudbury, Massachusetts: Jones and Bartlett Publishers. Spry…