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Comorbidities and Positioning: Morbid Obesity and Multiple Trauma

  • Emily P. Sieg
  • Shelly D. Timmons
Chapter

Abstract

Neurosurgical positioning is challenging even in a controlled environment. Comorbidities such as morbid obesity and polytrauma make operative positioning even more challenging. Prone positioning requires extra thought and preparation, especially in the obese patient. Extensive preoperative workup may be required. Intra-abdominal pressure should be minimized. Great care must be taken when positioning to avoid peripheral nerve injury, pressure points sores, and ischemic optic neuropathy. Positioning of the polytrauma patient is equally challenging and requires cooperation between the anesthesia team and multiple surgical teams in time-pressured emergency situations. Protection of the spine during intubation and positioning is key.

Keywords

Polytrauma Concurrent cranial and abdominal surgery Morbid obesity Complications Comorbidities Prone positioning Neurosurgical positioning 

Notes

Conflict of Interest

The authors declare no conflict of interest.

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Copyright information

© Springer International Publishing AG 2018

Authors and Affiliations

  • Emily P. Sieg
    • 1
  • Shelly D. Timmons
    • 1
  1. 1.Department of NeurosurgeryMilton S. Hershey Medical Center, Penn State University College of MedicineHersheyUSA

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