Quiz: Surgical Ergonomics – Bed and Patient Positioning

Ergonomics in eye surgery is a subject that is under-emphasized. This video and quiz highlight the importance of proper bed and patient positioning. Consistent and optimal positioning translates into equally consistent and optimal surgical outcomes while allowing a surgeon to maintain the healthy practices necessary for efficiency, stamina, and the physical well-being necessary for a long and successful career.

Review the video of Dr. Wyche Coleman, MD discussing bed and patient positioning and then test your knowledge with the quiz below!

Transcript

Hey everybody, I’m Dr. Wyche Coleman. We’re going to go over a few things that I think are not talked about very much in residency. Let’s start with patient positioning. I have a vertical crosshair pointed straight down from the ceiling. This is a super useful tool to get the patient in a consistent position.

Now, let’s talk about the position of the head and the brow relative to the cheek. So, we can see that the brow is elevated far above the cheek. We want them to be approximately equal so that we’re not blocked by the brow coming in superior. So, I’m going to lower his head until we get the brow approximately equal to the cheek. It’s not possible in everyone especially people who have prominent brows. So this is as close as we can get with him to having a level line between the cheek and the brow, but our goal is to get that close to level so that the brow is not blocking you.

So we’ve got the head in a pretty good position now, but I can’t get my foot under the bed. So we’re going to raise the bed up. And I’ve positioned my chair at the correct height; my pedals are far enough away from me, spaced apart, let’s call it 45 degrees. I’m going to go up enough to where I have plenty of clearance. The problem is as it gets too high, the scope gets too high. So, what I want to do is get the bed as low as I can without restricting the movement of my left leg. Now, this is a time where it’s important to not have the microscope pedal too close because as you get it close, your knee gets higher. So we want a slight down angle of our leg. So now I’m going to bring the bed down to where it just touches the top of my leg. So it’s not restricting my movement; it’s just barely touching. I’ve got him as low as I can get the patient without being restrictive on my left leg. We want to make one more point on the rotation of the bed. Here, you can see that the feet are rotated too far in towards me. This is bringing the shoulder in contact with me. It’s getting in my way. What I’ll do now is I’ll rotate the feet away and that frees up some space for me. Now, that’s not interfering with my arm. I’m approaching from a straight temporal position. If you get a bigger patient, we want to rotate the feet slightly further in to get it out of the way. So, if you feel crowded, you want to rotate the feet away from you. You want to basically be at a temporal approach, but if you feel crowded you can go a little bit superior to clear their torso out of your way and free up your left arm.

Author:

Curtis Martin, MD, WK Eye Institute, Shreveport, LA; Wyche T. Coleman III, MD, WK Eye Institute, Shreveport, LA

39 thoughts on “Quiz: Surgical Ergonomics – Bed and Patient Positioning”

  7. In some special situations like heart disease the head should be elevated because of dyspnea.
    And in case of deep orbit with prominent frontal margin if the chain is slightly elevated it will be comfortable for surgeon

    Reply

  24. There should be more of this ergonomic quiz we really need this as a lot of us go through discomfort while operating

    Reply

  25. I want to be part of the team.
    I am a nurse with vise experience over 10 years on wound Dressing and management as certificate in nursing in Sierra Leone.

    Reply

    • Dear Awio George,

      Thank you for your comment!

      Please feel free to peruse our Cybersight Library, which contains our previous quizzes available for your review: https://cybersight.org/library/

      Regarding certificates, please note the following for our live webinars and courses respectively:

      If you attend a Cybersight webinar for at least 80% of the scheduled time, and you have a Cybersight account, you will automatically receive a certificate of attendance within 24 hours.

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      Should there be any questions, please do not hesitate to contact us at [email protected].

      Reply

    • Dear Awio George,

      Thank you for your comment!

      Please feel free to peruse our Cybersight Library, which contains our previous quizzes available for your review: https://cybersight.org/library/

      Regarding certificates, please note the following for our live webinars and courses respectively:

      If you attend a Cybersight webinar for at least 80% of the scheduled time, and you have a Cybersight account, you will automatically receive a certificate of attendance within 24 hours.

      If you complete a Cybersight Online Course and pass the examination with a score of 80% or higher, you will receive a certificate of completion.

      Instructions to access your certificates are available here: https://cybersight.org/accessing-webinar-certificates/

      Should there be any questions, please do not hesitate to contact us at [email protected].

      Reply

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