The lateral position is used for surgical access to the thorax, kidney, retroperitoneal space, and hip. Depending on the side of the body on which the patient is being operated, the patient will lie on their left or right side. Before being placed in the lateral position, the patient is induced in the supine position. A team of Operating Room staff will then lift and turn the patient onto their nonoperative side. The patient is placed into the supine position toward the edge of the operative side of the surgical table and then turned onto the side toward the center of the table.
When positioning a patient in the lateral position, surgical staff should use safe practices and guidelines.The following are to be used as appropriate based on individual patient variables and the procedure. Surgical staff should refer to their facility’s positioning policies and procedures for the safe positioning of patients.
- Place a pillow or head positioner under the patient’s head with the dependent ear assessed after positioning.
- Support and secure the patient’s arms on parallel armboards with one arm on each armboard and both arms abducted less than 90 degrees.
- Place an axillary roll under the patient’s dependent thorax, distal to the axillary fold, at the level of the seventh to the ninth rib.
- Verify the patient’s bilateral radial pulses after placement of the axillary roll.
- Maintain the patient’s physiologic spinal and neck alignment.
- Flex the patient’s dependent leg at the hip and knee. (This is done for extra support during the procedure, to reduce the risk of the patient tilting and falling.)
- Position the patient’s upper leg straight and support it with pillows between the legs.
- Place safety straps across the patient’s hips.
- Use lateral braces, kidney braces and bean bag positioners as needed.