IV cannula and ECG electrode positioning

• Confirm the specialty, procedure, operative side and planned position.
• Check whether the arm will remain accessible or whether an extension and intermediate stopcock are required.
• Verify that the IV cannula and electrodes will not enter the surgical field.
• Reconcile the plan with the anaesthetist's directions and the local protocol.

• For lateral or flank procedures, use the side opposite the incision when appropriate.
• For breast, shoulder and limb surgery, use the contralateral side when required.
• For robotic surgery, check the side, site and need for two access points in advance.
• For spinal surgery and prone positioning, assess hand access before final positioning.

• In the lateral position, consider placing the lower electrode opposite the incision.
• In head and neck surgery, upper electrodes may be placed posteriorly on the shoulders.
• In the supine position, keep anterior electrodes outside the operative site.
• For shoulder or humeral procedures, check whether the electrode on the operative side should be moved to the forehead.

• Carotid endarterectomy: do not place the IV cannula in the hand without checking the procedure-specific guidance.
• Inguinal hernia with arms tucked: an extension with stopcock may be needed.
• Robotic gynaecology: verify the local procedure for right-arm placement and required access.
• Before sterile draping, reconfirm that access points and electrodes remain reachable.

This checklist supports preparation. Actual directions depend on the procedure, patient, anaesthetist and local protocol.