Prone position
Clinical Procedure
 
Aliases:
Prone

Topic aliases are alternate phrasings for a particular topic.


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Breast implants may cause pressure areas and bruising in the prone position. Place a gel pad or roll in between the breasts prior to rolling to transmit some of the pressure onto the sternum.

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CPR can be performed in prone position, with compression between the scapula, if the patient can't be turned supine. If head is in pins, have the surgeon unscrub and loosen the frame from the table to free the head to prevent neck injury.

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An antisialogogue such as glycopyrrolate at the beginning of case may reduce oral secretions, particularly in smokers.

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In prolonged cases, airway oedema may result from gravitational forces. Consider assessing ability to breathe around the endotracheal tube prior to extubation.

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Saliva may loosen adhesive tape. Tracheostomy tape may be more reliable for securing the endoteacheal tube.

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The person in charge of the patient's head during transfer should pre-emptively cross hands in a manner that results in them uncrossing as the patient is transferred. This improves head stability during the transfer.
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Avoid excessive padding over eyes which will negate protective effects of periorbital bony prominances.

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Disconnect all IV lines prior to transferring patient to prevent them from being pulled out.

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Ensure no rotational forces in axial plane on rolling. Head, torso, and feet move together.

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Ensure sufficient staff available for turning patient. Roll controlled by person controlling head. In unstable/degenerative spine, involve surgeon in roll.

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Prone position in the awake patient with the horshoe device.
Figure from Miller's Anaesthesia

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Prone position with mayfield head pins and arms in.
Figure from Miller's Anaesthesia

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Prone position with wilson frame with arms out.
Figure from Miller's Anaesthesia

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To secure the patient's head during the roll, place the hand closest to operating table on the patient's face and the other behind the head. The hand on the face allows you to protect the eyes as the head comes to rest on the support.
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When turning the patient onto the operating table place the foam/gel rest onto the patient's face first. Hold the head rest onto the patients face with the hand closest to the table, and the other hand behind the head. Turn the patient with the headrest already in place.

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