[...]... cardiovascular depression or allergies to skin 3 4 4 Use of X-rays in the operating suite General aspects and X-ray Ordinance, radiation generation and radiation protection H Kreienfeld, H Klimpel, V Böttcher 4 .1 Radiation protection in the operating suite – 20 4 .1. 1 4 .1. 2 4 .1. 2 .1 4 .1. 7 4 .1. 8 4 .1. 9 Introduction – 20 Legal principles for the use of X-rays in medicine – 21 X-ray Ordinance, Atomic Energy Law, Euratom... – 14 Positioning for the operation – 15 Positioning on the operating table – 15 Changes in position – 15 The postoperative phase – 15 3.3 Cooperation between doctors and nurses in positioning the patient – 15 3.4 Burden of proof – 16 3.5 Documentation of patient positioning – 16 14 Chapter 3 · Legal aspects 3 .1 3 Legal principles A patient is to be positioned before, during and after an operation in. .. 4.2 .1 4.2.2 4.2.3 4.2.4 4.2.5 4.2.6 4.2.7 Expert inspection – 36 X-ray radiation – 36 Radiation protection – 36 Structure and technique of a surgical image intensifier Application – 38 Use of the surgical image intensifier – 38 Tips and tricks for daily routine – 38 4 .1. 2.2 4 .1. 2.3 4 .1. 2.4 4 .1. 2.5 4 .1. 2.6 4 .1. 2.7 4 .1. 2.8 4 .1. 2.9 4 .1. 3 4 .1. 4 4 .1. 5 4 .1. 6 References – 39 – 37 ... using shaving soap or cream to prevent any injuries to the skin as far as possible UCH-MHH: patients are not bathed or shaved on the evening before the operation Surgical preparation room: fine down and short hair is left; interfering long hair in the immediate operating site is cut with scissors; gentle shaving is only carried out in a 2-cm strip in the case of thick hair Skin disinfection The disinfectants... Hygienikers In: Hansis ML (Hrsg) Perioperative Infektionsprophylaxe in der Unfallchirurgie Traumatologie aktuell, Bd 12 Thieme, Stuttgart, S 31 38 13 Heeg P (19 95) Beitrag zur Hygiene: Gesichtsmasken Operat -Orthop Traumato 7: 14 1 14 2 14 Hierholzer G, Hierholzer S (Hrsg) (19 90) Hygieneanforderungen an operative Einheiten – Aus traumatologischer Sicht Springer, Berlin Heidelberg New York Tokyo 15 Hingst V,... HG (19 92) Evaluation of the efficacy of surgical hand disinfection following a reduced applikation time of 3 instead of 5 min J Hosp Infect 20: 79–86 16 Riese J (19 36) Stummes Operieren und seine Bedeutung im Vergleich zu anderen Faktoren der Aseptik Zbl Chir 32: 18 74 18 90 und 33: 19 22 19 39 17 Rotter ML., Larsen SO, Cooke EM et al (19 88) A comparison of the effects of preoperative whole-body bathing... and with detergent containing chlorhexidine gluconate in the frequency of wound infections after clean surgery The European Working Party on Control of Hospital Infections J Hosp Infect 11 : 310 –320 18 Sander J, Sander U (Hrsg) (19 92) Praxis der Krankenhaushygiene – Umsetzungen von Gesetzen, Verordnungen und Empfehlungen Schliehe, Osnabrück 19 Seropian R, Reynolds BM (19 71) Wound infections after preoperative... Mobile Operating Tables Kehler Straße 31, 76437 Rastatt Trauma Department, Hannover Medical School Carl-Neuberg-Straße 1, 30625 Hannover Dr Becker, Armin, MD Klimpel, Herbert, graduate engineer Neurology Clinic with Clinical Neurophysiology, Hannover Medical School Carl-Neuberg-Straße 1, 30625 Hannover Urological Clinic, Hannover Medical School Carl-Neuberg-Straße 1, 30625 Hannover TÜV Nord X-Ray Technology... risk involved with a certain positioning method, e.g the knee-elbow position (so-called »rabbit position«) such as permanent injuries to nerves compressed by the position, the patient must be informed about this specific risk before the operation (according to the Federal Supreme Court in its judgement pronounced on 26.2 .19 85 – VI ZR 12 4/83 – ArztRecht 19 85, 214 ) 3.2 Interdisciplinary cooperation in positioning. .. of positioning injuries, he shall inform the surgeon accordingly The surgeon’s decision regarding positioning is part of his medical and legal responsibility for the operative procedure itself justifying the increased risk of the stipulated operative procedure (loc cit p 65) 3.2.3 Positioning on the operating table Responsibility for positioning the patient on the operating table is fundamentally part . . . . . . . . . . . 11 6 10 .1. 2 Occurrence of positioning injuries . . . . . . . . 11 6 10 .1. 2 .1 Frequency . . . . . . . . . . . . . . . . . . . . . . . 11 6 10 .1. 2.2 Kind of injuries . . . . . Heidelberg Typesetting and reproduction of the illustrations: Fotosatz-Service Köhler GmbH, Würzburg Printing and binding: Universitätsdruckerei Stürtz, Würzburg SPIN: 11 42 019 4 Printed on acid-free paper 211 1/BF. 18 5 15 .1 Cervical spine . . . . . . . . . . . . . . . . . . . . . 18 6 15 .1. 1 Supine position/CRP horseshoe headrest. . . . 18 6 15 .1. 2 Supine position/skull clamp . . . . . . . . . . . . 18 8 15 .1. 3