Supine with Mayfield Tongs

DESCRIPTION:            

While supine, the head is placed in Mayfield tongs by the surgeon to facilitate surgical access to the neck or cranium.

USED FOR:  
Procedures of the anterior body such as:

  • Neurosurgical Procedures

  • Posterior Cervical Spine Procedures


POSITIONING STEPS:

1.  The patient is transferred from the cart to the bed with assistance and lays with his or her back resting on the OR table.

2.  Legs are maintained in the long axis of the body.  A blanket or pillow may be placed under the knees to relieve lumbar strain.

3.  The surgeon will place the Mayfield tongs and hold the head while the head section of the bed is removed and the stabilization equipment for the Mayfield’s are secured to the bed.  The surgeon will then attach the Mayfield’s to the equipment and position the head.  Make sure that 2-3 fingerbreadths exists between the chin and chest, and that no portion of the head is striking the bed.  During this movement, ensure ETT stability.

4.  The arms are padded and positioned to prevent nerve stretch or compression.

5.  The patient is secured to the table with tape or belt across the hip between the iliac crest and the head of the femur so not to cause aseptic necrosis of the femur head.  Tape or belt can also be placed across the thighs for lower abdominal or groin surgery.


EQUIPMENT: POTENTIAL COMPLICATIONS: 
    REQUIRED

POSSIBLE

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Mayfield Tongs

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Mayfield Headrest

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Safety Belt

Arm boards

Blankets

Towels

Pillows

Egg Crate Padding

3 Inch Tape

  • Postoperative lumbar back ache:  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.

  • Slipping of the head from inadequate tong placement or fixation of tongs to support, or equipment failure.

   

SUPINE ARM POSITIONS: POSITIONING VARIATIONS: