Thomas E Szymczak, PT. Vortek Surgical.
INTRODUCTION
Achieving and maintaining the desired position during endoscopic GI procedures including colonoscopy, EGD, ERCP, TIF, and similar procedures is a critical first step in performing a successful, complication-free procedure.
Given the variety of patient types that may present for a procedure, a number of factors can present unique positioning challenges, including:
- History of neck, back, or shoulder pain
- Shoulder injury or contracture (adhesive capsulitis or compression injury)
- Obesity
- History of sleep apnea
- Structural airway abnormality
- Many others
Even after establishing a desired position, dramatic or subtle changes can readily occur upon administration of sedation or anesthesia. A seemingly routine procedural course can be disrupted by airway compromise resulting from a change in head position that results in desaturation or other airway alignment restriction. Inadequate positioning also presents other patient safety concerns that can include procedure-related shoulder compression, risk of pressure points, risk of corneal abrasion, risks if inadvertent or unanticipated rolling or falls, and exacerbation of pain any cervical or low back positional pain that can be felt for days or weeks post-procedure. In the case of endoscopy patients, who often require repositioning during the procedure, the pillows or wedges commonly employed in positioning must all be moved and adjusted prior to resuming the procedure.
DESCRIPTION
Historically, positioning tools available for use during endoscopic procedures have been limited, and usually consist of a combination of multiple pillows and wedges to seek the desired patient position. These can be cumbersome to manage, especially during repositioning, and the multitude of components required can block or limit visibility and access to the patient during the procedure.
The EPS-30 Endoscopy Positioning Systems (Vortek Surgical, Indianapolis, IN) are specificially designed to meet the needs (and eliminate the challenges) of achieving a consistent and desired position for both upper and lower endoscopic GI procedures. The versatile EPS-30 positioners are ergonomically designed to provide the necessary and consistent support in lateral, prone, and supine positions. The patented EPS-30 Positioners are comprised of a molded foam base and feature a durable latex-free vinyl coating for ease of cleaning and disinfection between uses. The EPS-30 Positioners are configured to maintain the relative elevation necessary for reducing risk of reflux or aspiration while under sedation. They incorporate a number of components including:
- Head Support with bolsters to maintain head and cervical alignment
- Arm/Shoulder recess to eliminate pressure and compression in sidelying
- Front and rear bolsters to provide support and eliminate risks of inadvertent rolling
- Chest Support to assist in maintaining support and elevation, and maintaining support of the left lower quadrant, often reducing the need for external counterpressure during scope advancement
- Recovery Head Supportfor maintained cervical position and promotion of airway alignment in supine
- Radiology compatible for use in ERCP and TIF
- Durable, and latex-free coating for ease of cleaning and disinfection between patients
CONCLUSION:
The EPS-30 Endoscopy Positioners provide a comfortable, safe, and consistent positioning platform for the multiple positioning needs of GI endoscopy.
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