1. cspine mobility 2. should, hip, knee mobility 3. pre-existing parethesasis 4. co-morbidities susceptible to injury? htn dm PVD smoker ETOH peripheral neuropathy

brachial plexus injury due to:

lateral displacement of head with arm abducted over 90 degrees

Most common nerve injury:

ulner nerve

risk factors to ulner nerve injury: 1 2 3

1. male 2. high BMI 3. prolonged postop bed rest

how to protect the peroneal nerve when lateral decubitus:

dependent leg bent independent leg straight pillow in between

position associated with 20% drop in cardiac output due to venous pooling:

sitting

what position is most at risk for venous air embolism

sitting

venous air embolism is dependent on: 1 2

amount speed of entrance into systemic circulation

Venous air embolism: enters Right heart>> enters Left heart>>

RIGHT: limits gas exchange in pulmonary vasculature 1> hypotension 2> arrhythmia 3> cardiac arrest LEFT: 1> MI 2> CVA

gold standard to DX venous air embolism:

TEE

signs of a venous air embolism: 1 2 3 4

1. abrupt drop in ETCO2 2. mill-wheel murmur 3. increase PAP 4. hypoxia

2 most common causes of postop vision loss:

1. ischemic optic neuropathy ION 2. central retinal artery occlusion CRAO

ischemia optic Neuropathy: mechanism> risk factors>

ischemia to portion of optic nerve risk factors: male dm htn vascular disease surgery 5 hours + anemia from blood loss Wilson frame

central retinal artery occlusion: mechanism> risk factors>

decrease blood flow to entire retina risk factors: htn CVD increase BMI open angle glaucoma sick cell anemia

biggest concern of injury when prone:

POVL

positioning: except for physical injury, what is next major hazard:

hypotension

nerves are most commonly injured by what 2 mechanisms:

stretch compression

6 standards of monitoring:

1. oxygenation 2. ventilation 3. circulation 4. temperature 5. NM function 6. positioning

best way to prevent ulnar nerve injury:

supinate arms (palm up, elbow down)