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When transporting a patient to the operating room using an elevator, the stretcher should be oriented so that the patient enters head first and exits feet first. This positioning is crucial for several reasons.

First, it allows for better visibility and access to the patient for healthcare staff as the stretcher is wheeled into the elevator. When the head of the stretcher is facing the elevator doors, the healthcare team can more easily monitor the patient's condition and manage any necessary equipment, such as IV poles or monitoring devices.

Second, entering head first ensures the patient's safety and comfort. This orientation minimizes the risk of injury during transfer, as the patient's head and torso remain supported until they are secured in the operating room.

Lastly, exiting feet first allows for a smooth and organized transition from the elevator to the operating room, streamlining the workflow and ensuring that the patient is moved efficiently and safely.

In contrast, other orientations may hinder visibility, increase the risk of accidents, and complicate the transfer process, making head-first entry and feet-first exit the most sensible approach when using an elevator for patient transport.