Although often overlooked, the importance of proper patient positioning shouldn’t be ignored.
Patient positioning is vital for three main reasons:
- Access and exposure to a patient’s body
- Preventing injury to the patient
- Maintaining the patient’s dignity
While those are the three main goals of patient positioning, positioning is also equally important to the patient’s comfort, ABCs (airway, breathing, circulation, and recovery.
We’ve collected the 10 most commonly used patient positions and abbreviated their descriptions and included some of their most common uses for you to review.
In the supine position or dorsal decubitus, the patient lays on their back with their legs straight and arms at their sides or folded across their chest.
This is overall, the most common patient position and used for examinations, anterior surgeries, rest, and recovery.
Depending on the need, pillows or other supports may be used under the head or legs.
A common variation of this position is the dorsal recumbent position where the legs are bent with the knees pointed upward. It’s used for childbirth, genital examinations and procedures, heart issues, and for running IVs and catheters.
The reverse of the supine position is the prone position (or ventral recumbent position), which has the patient lying on their stomach. The patient’s legs are straight with their arms resting at their sides or bent at the elbows facing forward.
The prone position is the only position to allow for full extension of the hips and knees. Commonly used for dorsal surgeries, such as spinal surgeries and drainage of secretions (especially for patients recovering from sedation or who are unconscious).
The prone position IS NOT indicated for patients with spine injuries as it causes forward curvature of the spine.
In Fowler’s position or a semi-sitting position, the patient is in varying degrees of a sitting position. Depending on the position, the patient’s torso may be elevated anywhere from 15 to 45 degrees (known as a low or high Fowler’s position).
Fowler’s position is indicated for patients with respiratory, cardiac, or neurological problems and for patients who are intubated. The raised position takes the pressure off the chest cavity and helps to promote breathing. Also indicated for preparing a patient to walk.
Patients in Fowler’s position should be encouraged against using pillows as it can result in over flexion of the neck. Footboard should be used to keep the patient’s feet properly aligned and prevent foot drop.
Patients in a lateral position lay on their side (either right or left) with the top leg bent at the knee, on top of the bottom leg which remains straight creating a stable triangle-shaped support base. Pillows or other supports are placed beneath the top leg for support.
The lateral position promotes proper spinal alignment, relieves pressure on the heels and sacrum while evenly distributing the patient’s body weight.
The orthopneic position (or tripod position) has the patient sitting upright with their legs straight and torso leaning forward resting on support (table or platform). Often used for patients with respiratory issues, the orthopneic position promotes the maximum expansion of the chest cavity and lungs making respiration and exhalation easier. Pillows or other cushions are used to support the patient’s upper body. For the best patient positions to promote oxygenation, look here.
Sim’s position (or semi-prone) is a combination of the lateral and prone positions where the patient lays on their left side with their right knee slightly flexed and tilted. The right arm lays comfortable in front of the patient while the left arm rests behind the body. Pillows or other supports are used to support the head and right leg.
Commonly used for gynecological, childbirth, and rectal examinations and procedures.
The lithotomy position is commonly used for childbirth, vaginal examinations, and any surgery or procedure involving the pelvic region.
In this position, the patient lays on their back with their hips flexed to a 90-degree angle and their knees at an 80 – 90-degree angle. The legs will be supported by footrests, stirrups, or boot-style leg holders.
The Trendelenburg position has the patient lying on their back with their legs straight and arms at their sides in the basic supine position. The patient’s body is at a descending angle with the head lower than the feet. Often the patient must be secured to the bed or table to prevent slips or falls.
A variation is the reverse Trendelenburg position where the patient’s head is higher than their feet.
The knee-chest position is a variation of the lateral position where the patient lays on their side with their arms folded comfortably in front of them and both knees flexed greater than 90 degrees, drawn into the chest.
Often used in gynecological or rectal examinations to help better preserve patient dignity (some patients may find the prone knee-chest position embarrassing or uncomfortable).
The jackknife position (or Kraske position) is a variation on the prone position where a patient lays on their stomach with their legs straight and arms either at their sides or out to the side on supports. The bed or table is bent or “jackknifed” in the middle to lift the hips while lowering the head and feet.
It’s commonly used for surgeries on the rectum, coccyx, anus, or some spinal surgeries.
This list covers not only the most commonly-used patient positions but gives you a few more you may not see on a daily business. Remember, patient positioning is crucial, not just for ease of access to a patient’s body, but it also greatly influences a patient’s recovery, comfort, and dignity.