NEED TO KNOW

TABLE MANNERS





Who Should Know?
It is essential that all members of the theatre staff familiarize
Themselves with the operation table and its accessories which
must be easily available and ready for immediate use.
To insure this, passing on of this information is a part of the introductory briefing of all new staff.
- The whole apparatus must be maintained in good working order
and checked before each operation list.
Careful and correct positioning of the patient is very important.
- It is essential to provide good access for surgery.
- And also to take into account patient safety.
- Anesthesia technique requirements.
- Monitoring and position of i.v. lines.
- The table top rubber mattress must provide insulation and
Prevent harm to the patient due to pressure, especially on
Nerves and bony prominences.
Most of the following positions are demonstrated on an general
purpose operation table which incorporates the majority of the
features described already.

What are the Positions?
In Supine or Dorsal Recumbent Position (Fig.2)
In this position the patient lies on his back and is used for MOST operations, including those on the
- Eye
- Ear
- Face
- Chest
- Abdomen
- Legs or Feet
- And with modifications is suitable for operations on the breast
and arms or hands, which may be placed across the chest or
extended on an arm table.

WHAT IS BREAST AND AXILLA POSITION?
This is the position for operations on the breast and axilla. It
is a modified supine position, either with both arms extended and
secured on arm tables, or one arm secured by the side of the
patient and the other on the affected side abducted and
supported by a nurse (Fig 3).

WHAT IS NECK POSITION?
This position is used for operations on the neck, especially
Thyroidectomy, and tracheotomy.
The patient is placed in the supine position with a pillow or sandbag under the shoulder blades, and the head is held by a nurse or assistant with the neck well extended, a padded horse-shoe provides a good support for the head in such operations.

WHAT IS SUPINE HIP POSITION?
This is used mainly for nailing a femoral neck fracture, but is
suitable for osteotomy, slipped femoral epiphysis,etc.
The patient is in a supine position, with his pelvis supported by a
supplementary table top which is translucent to X-rays and
incorporates a slot for introducing anterior position film
cassettes under the pelvis fig 4.

WHAT IS THE TRENDELENBURG POSITION (HEAD DOWN)?
This position, a modification of supine, is used for intrapelvic
operations. Fig 5.
- The object being to allow the intestines to displace away from
the pelvic cavity by gravity towards the upper abdomen.
- They may also be packed off readily to leave easier access to
the pelvic organs.

HOW IS THE GALL-BLADDER AND LIVER POSITION ARANGED?
This is another modified supine position which is used for
operations on the gall-bladder or liver.The patient is
positioned over the back elevator which is raised to produce
extension; and thereby push the gall-bladder towards the anterior
abdominal wall. Fig.6

HOW TO ARRANGE FOR LITHOTOMY POSITION?
This is used for operations on the external genital organs,
perineum and anal region. The buttocks project well over the
edge of the table at the junction of the centre and foot section
which is lowered or removed.The legs are flexed at the hips and
knees, and raised with the feet supported in webbing slings
suspended from the lithotomy poles. A douching funnel may be
fitted below the perineal area to collect blood.
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