Step 2. Installing and draping the patient

 


In order to obtain an optimal workflow or ESY OR Pulse, it is important that the tasks of the different team members the team members are perfectly attuned to each other. During parallel processing, different team tasks are performed at the same time. While the patient is installed by the surgeon and the circulating nurse, the sterile scrub nurse is simultaneously installing the instrument tables. The surgeon will scrub after installing the patient so that the prep can dry. When the surgeon is sterile, the scrub has finished installing the instrument tables and they can both cover the patient. This is an example of a positive ESY OR Pulse, where the teams are alligned to each other and there is no delay in conducting the different steps of the OR process.

This parallel proces of installing and draping the patient consists of 4 steps:

1. Patient Installation

2. Installation fixation poles

3. Prepping the patient

4. Draping the patient


 

Patient Installation 

 

The ipsilateral arm is folded over the chest. This prevents the arm from being in the way during femoral preparation when the surgeon is standing at the level of the chest of the patient. The contralateral side table at the level of the mid – tibia is important for external rotation during the femoral elevation maneuver.  The contralateral support is attached to the greater trochanter and stabilizes the body during femoral adduction for optimal femoral exposure.

 

 

 

 

 

 

 

 

 Installation fixation poles 

 

 

The Gripper fixation poles are attached to the side bar of the OR table. The long fixation poles are at the contralateral side and the short ones on the ipsilateral side, just opposite the longer ones. The poles are positioned opposite to each other. The distal ones are just proximal to the patella and the cranial ones are at the level of the kidneys.

 

 

 

 

 

 

 


 

 

Prepping the patient 

 

A schematic overview of the chlorhexidine patient prepping for a right THA . The contralateral leg is also prepped on the anterior side to minimize the risk of contamination of the EsySuit during application.  The legs are put on a soft leg holder and prepped on the anterior side. This allows for an easy preparation and lifting with a minimum of energy expenditure and optimized staff ergonomics.

 

 

 

 

 

 

 


Draping the patient