The patient lies with his or her back on the table (face-up). The Supine Surgical Position used For procedures of the anterior body such as abdominal, thoracic,facial and anterior upper and lower extremity procedures.
- Most common with the least amount of harm
- Placed on back with legs extended and uncrossed at the ankles
- Arms either on arm boards abducted < 90 degrees with palms up or tucked (not touching metal or constricted)
- Spinal column should be in alignment with legs parallel to the OR bed
- Head in line with the spine and the face is upward
- Hips are parallel to the spine
- Padding is placed under the head, arms, and heels with a pillow placed under the knees
- Safety belt placed 2” above the knees while not impeding circulation
Potential Complications of Supine Positioning
- Postoperative lumbar backache: ligamentous relaxation of the back that can occur with general, spinal and epidural anesthesia.
- Nerve damage: brachial plexus, axillary, radial, ulnar, popliteal, tibial, long thoracic, and median nerves.
- Pressure ulcers: pressure ulcers of varying degrees of severity, can occur at the pressure points and bony prominences of the body, most commonly at the occiput, elbows, shoulder blades, spine, sacrum, coccyx, and heels.
Safety Considerations of Supine Positioning
- Padding to heels, elbows, kneesSpine, head alignment with hips Legs parallel, uncrossed at ankles
- Arm board at less than 90 degrees
- Head in neutral position
- Arm board pads level with OR bed
