Gotta love those Greek and Latin medical terms – dorsal recumbent. But what exactly is the dorsal recumbent position?
The dorsal recumbent position is one of the most common positions that a nurse will place her patients in. Nurses, doctors, and healthcare professionals routinely position their patients whether they are doing an assessment, performing a procedure, or simply making sure that their patient is comfortable.
Proper positioning of patients is essential not just for giving access to their bodies for examination and performing medical procedures; it’s also important for patient comfort and safety. There are several ways your patient can be situated in bed, on the examination table, or for surgery. The dorsal recumbent position provides the best access to the pelvic area, that’s why it’s commonly used for gynecological, colorectal, genitourinary, and other procedures.
We’re going to talk a little about positioning in general, then go more into depth about the dorsal recumbent position, what it is, why it’s used, how to do it, risks involved, and things to keep in mind.
5 Basic Types Of Patient Positioning
The human body only has so many ways it can be positioned in bed or on an examination table. These positions have been codified in the medical field to include five different basic positions with some variation.
The patient lays face-down on their stomach with their head in a neutral position, turned to one side. This position gives access to the spine and dorsal area of the body, commonly used for spinal surgeries.
The supine position is the opposite of prone, where the patient lays on their back, facing upward with their legs straight and arms at their side. It is the most common position for examinations, surgeries, procedures, and patients in bed.
The patient lays horizontal on one side, either right or left, often laying their head on the arm of the side against the bed.
Fowler’s position has the patient sitting upright in a slight reclining position, often with the knees slightly raised.
The patient lays in a supine position with the feet raised to a 30-degree angle above the head.
The position we’re focusing on here is a variation of the supine position with just a little twist that provides nurses and doctors better access to the pelvic region.
Your goals when positioning a patient are simple, but nonetheless very important. You want the patient in the correct position for whatever exam or procedure needs to be done while ensuring the safety, comfort, and dignity of your patient.
Here are the objectives for proper patient positioning:
Comfort And Safety
You want the patient comfortable, while at the same time safe. See that they are safely put into position to maintain their airway and blood flow. Proper positioning will also help ensure comfort throughout the procedure.
Dignity And Privacy
With many positions and the dorsal recumbent position, in particular, maintaining the patient’s dignity needs to be prioritized. Often sensitive areas like the genitals and buttocks may be exposed. A strategically placed sheet can go a long way to helping your patient maintain their privacy and dignity while still giving proper access to the body.
Accessibility And Visibility
If you have the patient properly positioned, it will afford the maximum accessibility and visibility to whoever is examining or performing a procedure on them.
Of all the goals, your primary one should be a safe positioning of your patient – look here to learn about proper lifting and patient moving techniques.
What Is Dorsal Recumbency?
Dorsal is pertaining to the back or posterior, while the word recumbent means laying down, especially in a position of comfort or rest. Add the two and we have a person, or your patient, laying on their back. But the dorsal recumbent position is more than just your patient laying on their back.
There’s a part two:
The knees are bent facing in an upward and outward position with the feet planted flat on the bed or examination table.
So the three key pieces of the dorsal recumbent position are:
- The patient is laying on their back
- Knees are bent upward and outward
- Feet are planted flat
The patient’s head is in a neutral position looking upward and the arms can lay naturally at the sides or be folded across the chest depending on what procedure or examination is being performed.
The patient’s arms, hips, or feet may be secured with straps to prevent movement during an exam or surgery.
Dorsal Recumbent Position Vs Supine
The supine position is the most common position for most patients whether they’re in bed, being examined, or on the surgical table. Many of the other commonly used body positions in healthcare are variations of the supine position.
Put simply, the supine position is the patient laying on their back with their legs straight and arms by their side. The head is in a neutral position looking up at the ceiling.
The dorsal recumbent position is a slight modification of the supine position.
Lithotomy Position Vs Dorsal Recumbent
The lithotomy position is very similar to the dorsal recumbent position. The patient is lying supine (on their back) but instead of the knees bent up and out at a general 45-degree angle, the legs are in stirrups or boot-style leg holders at a raised 90-degreee angle.
The Lithotomy position is used for a variety of procedures including gynecological, colorectal, perineal, urological or other pelvis procedures. It is the most used position for giving birth because it provides the most comfort for the mother while giving nurses, doctors and those assisting the best, safest access.
Ventral Recumbent Position Vs Dorsal Recumbent
If you hear the term ventral recumbent position, it’s just another way of saying the prone position, which we mentioned above. The patient in this position is laying face down, head in a neutral attitude facing down with their arms at their sides.
The ventral recumbent position is commonly used for examining the back and performing spinal procedures.
Semi-Recumbent Position or Dorsal Recumbent?
Like the supine position, the patient lays on the back with their legs out straight and arms at their sides or folded on their chest. However, using pillows or a pad for support or by simply raising the bed, the patient’s upper torso is lifted to around 45 degrees.
This position is often used for critically ill patients to ensure normal blood flow, pressure and aid lung function.
What Is The Dorsal Recumbent Position Used For?
The dorsal recumbent position is one of the most common patient positions because it grants access to most of the major areas of the body including the head, neck, chest, abdomen, hips and pelvis, genitals, and rectum.
Many examinations and procedures to diagnose and treat medical issues deal with these areas of the body.
In addition to being the one of the positions providing the best access to major areas of the body (especially the pelvic region), the dorsal recumbent position is preferred for:
- Physical examinations (especially vaginal, genital, rectal)
- Running IVs
- Giving birth
- Inserting catheters
- Drawing blood
- Treating heart issues
- Diagnosing and treating genital issues
- Performing certain surgeries
How To Perform The Dorsal Recumbent Position
For all its usefulness, getting a patient into the dorsal recumbent position is simple and straightforward.
Here is what you do:
- Ask your patient to lay on their back. If the patient has any abdominal pain or mobility issues, you can help to ease them onto their back by locking arms with them and slowly lowering them down.
- Tell them to bend their knees upward and outward, toward the ceiling while leaving their feet flat on the bed or examination table. Again, if your patient is having weakness or difficulty moving, you can help them.
- To protect your patient’s privacy and dignity, drape a sheet over their lower body from the abdomen to the feet to cover the pelvic and genital areas.
- Unless it would interfere with the examination or procedure, a pillow or rolled towel can be placed beneath the patient’s head for proper spinal alignment and comfort.
The patient should leave their head in a comfortable, neutral position as they look toward the ceiling. Their arms can lay alongside their body to keep the head, neck, chest and abdomen free can accessible during the examination or procedure.
If the patient is being prepared for surgery, often the arms and legs may be supported by boards and secured with straps to prevent movement during the procedure.
Points To Remember:
When you’re putting a patient into any body position, here are a few points to follow and keep in mind:
- Talk to the patient, explaining the procedure so they understand what you’re doing
- Encourage your patient to help as much as they are able
- Raise the bed
- Use aids such as handrails, slings, pillows, and bed boards
- Enlist the help of a fellow nurse
If you have to lift or partially lift a patient to get them into position, remember the keys to proper lifting:
- Get close to the patient
- Don’t twist – keep your body in alignment
- Keep your chest out and back straight
- Widen your stance
- Tighten your abs and glutes
- Lift with your legs and arms, not your back
- Exhale as you lift
Risks Of The Dorsal Recumbent Position
Each position of the body poses its own risks dependent on the health issues the patient is facing because of these factors:
- Duration of time in position
- Pressure on body
- Effects of anesthesia
- Respiratory problems
- Heart and circulatory problems
- Body size (especially in obese patients)
With any patient lying in the supine position, the most serious risks are often linked with duration of time spent in the position. This mainly applies to patients who are bedridden and includes bed sores, circulation, and nerve issues. These are remedied with daily movement and physical therapy in conjunction with constant monitoring.
More commonly, patients in the dorsal recumbent position are being examined or having a procedure or surgery done – so they’re not going to be in that position for an extended period. The main concern then is watching the patient to make sure they’re comfortable, their legs don’t fall, or if they’re covered with a sheet that it stays in place. If they have a breathing or circulatory problem, monitor them for any discomfort or difficulties.
The Orthopneic Position And What It’s Used For
The orthopneic position has the patient sitting upright or leaning over a table, pillows, or a support structure. Also called the tripod position, it eases pressure on the chest cavity allowing for the maximum amount of lung function. This is why it’s commonly used with patients who are experiencing difficulty breathing or exhaling.
Hope we helped you further understand what dorsal recumbent position and furthermore guide you as to-dos’ and don’ts when administering to your patients,