To the Editor:—
In an era of increasing cost containment and occasional equipment shortages, we are sometimes forced to “make due” with items at hand. Although these conditions most commonly contribute to frustration, they occasionally bring about creative inspiration. While administering anesthesia to children with leukemia for painful procedures several years ago, I replaced a soiled foam anesthesia pillow with a towel roll. By taking an 18 x 36 inch terry-cloth towel, rolling it lengthwise, and folding it into an α-shaped configuration (fig. 1),
I fashioned a simple pediatric headrest which I continue to use today.
Terry-cloth towel rolls are especially useful for pediatric cases because they allow a large occiput to flatly rest on the operating table and they minimally elevate the neck and shoulders. Towels are ubiquitous items, available on most every ward and in most every country, and they are infinitely adjustable: roll tightness, central loop hole size, and number of towels included in the wrap may all be customized. For adults, extra towels stacked below the circular portion may better promote the “sniffing position.” Alpha-shaped towel rolls provide excellent stability and reduce unwanted side-to-side head motion. Furthermore, the towel ends may be freed from underneath the shoulders to wipe up secretions during the case and, of course, the whole towel may be used for clean up at the completion of the case. Lastly, towels are inexpensive (institutional cost, $ 1.00) and may be reused after laundering, thereby saving some foam headrests ($ 0.74 to $2.06) and plastic covering from the refuse bin.