Case 17: Hasty C-Arm Positioning – A Recipe for Disaster

Abstract

You have anesthetized an otherwise healthy man for a neurosurgical procedure. He is 54 years old, weighs 110 kg, and is 6 feet in height. He is placed in a left lateral position. The surgeon is in a bit of a rush, and before the patient is appropriately secured, the surgeon moves the C-arm into position over the operating room (OR) table (Skyton 3100, John Cudia & Ass. Morgan Hill, CA 95037). Suddenly the table is now going into a full left lateral tilt without you or anybody touching the table control situated at the head of the table. You grab the patient’s head and the endotracheal tube and call for help. The surgeon and nurses, with outstretched hands, prevent the patient from hitting the floor. They call for a gurney as the table is still moving toward a full left lateral tilt.