PCDF Dr. Ahn

Indications

Complications

Preop Imaging

Equipment

Position

Surgical pause
Move patient to Jackson Supine
Intubate/ Arterial Line/ Foley
Pneumatic TEDS on
Pillows over shins
Mayfields
- Loosen to max first
- Dock double prongs first
  - Prong 1
    - Put one finger below to guide
  - Prong 2
- Ratchet slowly until contacting
- Single prong 1cm above pinna in line with EAMeatus
- Tighten using hand tighten (each line is 20N of force- so 60N total max)
Mayfield Frame Attachment
- Lock the distal two elbows first so it doesn’t hit patient in face
- Bottom hooks on first
  - Tighten top two
- Loosen distal two
- Attach to Mayfield
- Control rotation and extension to desired
- Lock (total = 7?)
Bed Top time
- Bottom H frame in (3 pins)
- Bed top slides in
- Large Bolsters at ASIS
- Smaller Bolsters over thighs
- Chest pad at sternum (make sure nipples are free
- Top H frame in and slight compression (tell anesthesia that Pressures wil change)
  - So that it will slope AWAY from head after the flip)
- Top H 4 pins all in
- Bottom H 4 pins all in
- Strap in x4
- Systems check
  - 4 pins all in, Mayfield is locked at all points (7?)
Flip
- Stand at head
- Test swing toggle (mech lock, e-lock)
- Anesthesia disconnect tube and check all lines free
- Swing
- Confirm C02 on anesthesia machine
- Lock up
- Release and remove extra table piece
Final details
- Arms in yellow to skin gel pad
- Hockey tape shoulders gently
- Central tape for skin fold
- Haircut – French Montana

Special Considerations

Localize

Marking

Prep and Drape

Approach

**cautery is 40 40 20 for CERVICAL

Instrumentation

Closure

Post Op Care