There are quite a few ways a patient can be positioned for lots of different reasons – but there are 5 positions that are the most common. These 5 positions cover everything from the patient at rest to prepping for neurosurgery.
We’re going to give you a quick review of the five most common patient positions. We’ll tell you what the position is, a little about its benefits, and what it’s most commonly used for.
But first, let’s talk about why proper positioning of patients is such a critical task that nurses do.
Why Patient Positioning Is Important
While the patient’s comfort is important, proper positioning also has to satisfy other requirements as well. Here are 5 considerations for proper patient positioning:
1. Safety
First and foremost, the position has to be the safest one for the patient’s condition.
A patient with spinal problems isn’t going to be on his back and a patient with breathing problems needs to be sitting up or in the tripod position.
2. Comfort
The more comfortable a patient is, the easier it is for them to be in a certain position. And of course, the patient needs to be as comfortable and relaxed as possible.
3. Access
For examinations, procedures, and surgeries, nurses and doctors need the maximum amount of access to the body area they’re working on. The proper body position ensures the greatest access possible.
4. Dignity
As much as can be allowed (depending on the procedure) the patient’s dignity should be guarded. They shouldn’t be unnecessarily exposed if possible. Sheets are helpful for some positions.
5. Recovery
Some positions can help speed the recovery of the patient, taking pressure off certain parts of the body, helping reduce pain, improve alignment, and aid breathing.
Patients Positions, When Best To Use?
1. Supine
The supine position is perhaps the most common. The patient lays on their back with their legs straight or slightly bent. Their arms may be at their side or crossed on the chest.
Pillows may be placed under the head to ensure proper alignment, or under the knees (a roll may also be used here) for comfort.
A very common variation of the supine position is the dorsal recumbent position – you can learn more about it here.
The supine position is used for:
- Physical examination
- General resting
- Anterior surgeries
- Recovering from surgery
2. Prone
The prone position is the opposite of the supine position. The patient lays on their stomach with their legs staring and arms at their sides.
This position is the only one that permits full extension of the hip and knee joints.
The prone position is best for:
- Promoting drainage of the mouth – good for unconscious patients or patients recovering from surgery
- NOT good for spine problems – in fact, it’s contraindicated for patients with spinal problems
- Dorsal surgeries – most commonly neurosurgery, head, neck, and spine surgeries
3. Fowler’s Position
A very common position for patients is Fowler’s position. It’s also referred to as a semi-sitting position and has the patient on their back with their legs straight or slightly bent.
Their arms may be at their sides or resting across their lap.
The head of the bed is raised 45 to 60 degrees so that the patient is “sitting up”. Fowler’s position has three variations: Low (15 – 30 degrees), Semi (30 – 45), and High, which may be almost vertical.
This raised angle takes the pressure off the chest cavity, helping to promote lung expansion and improve breathing.
Fowler’s position is best for:
- Patients with breathing problems
- General resting or sleeping
- Patients with tubes
- Patients with neurologic, respiratory, or cardio-pulmonary problems
- To prepare a patient for walking
- Neurosurgery, head and neck surgeries
NOTE:
- Patients should be encouraged not to use a pillow as it may affect neck flexion.
- A footboard should be used to keep the patient’s feet in alignment and to prevent foot drop
4. Lateral
The lateral position (side-lying) has the patient lying on their side, either on their left or right side depending on their condition.
The top leg is flexed at the knee in front of the bottom leg which is straight. This creates a stable, triangle-shaped base of support.
Pillows are used to support the top leg, arms, chest, and head.
The lateral position is best for:
- Good spine alignment
- Relieving pressure on the heels and sacrum
- An even distribution of bodyweight
5. Orthopneic
The orthopneic position (tripod) is common for patients with respiratory problems. This position has the patient sitting up with their legs straight and their upper body leaning forward.
Their arms and headrest on support (table or platform).
Often a pillow will be used to cushion the arms and head. The orthopneic position promotes maximum lung capacity and eases breathing.
The orthopneic position is best for:
- Patients with respiratory problems
- Maximum lung expansion
- Aids exhaling
These are just the 5 most common patient positions. If you want to see a complete list of patient positions, go here.
Remember, even though you do it every day – proper patient positioning is more important than just your patient’s comfort. Proper positioning can greatly affect a patient’s health and recovery.
Also remember, you also have to make sure you use proper lifting and patient moving techniques when handling patients – you can see a quick review guide here.
