The Prone position is a patient position used during surgical procedures that provide surgical access to the dorsal aspects of the patient’s body. 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 than 90 degrees with the elbows flexed and palms down to maintain neutral alignment of the arms and wrists. Some common procedures that are performed while the patient is in the prone position include spine and neck surgeries, neurosurgeries, colorectal surgeries, vascular surgeries, and tendon repairs.
WHEN WOULD YOU PUT A PATIENT IN THE PRONE POSITION?
The prone position is often used for spine and neck surgeries, neurosurgery, colorectal surgeries, vascular surgeries, and tendon repairs. The prone position produces an increase in functional residual capacity and alterations in the distribution of both ventilation and perfusion throughout the lungs.
When positioning a patient in prone, surgical staff should use safe practices and guidelines:
- 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
- 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 of risks to the patient in the prone position. The patient’s face should be monitored when in the prone position. Pressure should be kept off of the patient’s eyes, cheeks, and ears. At a minimum, four people should be available when turning a patient prone and both the cart and Operating Room table should be locked.
ADVANTAGES OF THE PRONE POSITION
The prone position offers surgical access to the dorsal (posterior) aspects of the patient’s body, such as the spine, neck, and shoulders. The prone position produces an increase in functional residual capacity and alterations in the distribution of both ventilation and perfusion throughout the lungs. This leads to an improvement in the ventilation/perfusion matching and consequently, an improvement in oxygenation.
When performing surgery in the prone position, care should be taken to protect the head, elbows, chest, knees, and feet. Hemorrhoids are prone to occur in the prone position. we designed a prone position headrest, and arm pad, a prone position bow chest pad, a concave treatment table pad, and a multi-purpose position pad.
