Patient Positioning
Patient Positioning
Positioning patients correctly is important for maintaining body alignment and preventing complications
such as pressure ulcers, contractures, and foot drop. Because these complications can develop over a short
period, it is essential to position your patients properly and reposition them at least every 2 hours, or per
your facility’s policy.
Positioning Devices
When positioning patients in bed, you can use any of several support devices designed to help ensure
proper body alignment and to make the patient more comfortable. Some of these are pillows, foot
boards, trochanter rolls, and handrolls.
Pillows
Pillows help you support and maintain the patient in specific
positions. For example, place several behind the patient’s
back to help maintain a lateral position or between the
patient’s knees and ankles for comfort and to keep them
from rubbing together and possibly causing skin breakdown.
Use pillows to elevate the patient’s extremities or upper
body as well.
Trochanter Rolls
You’ll use trochanter rolls for patients who have muscle weakness or paralysis on one side of the body.
The roll keeps the
patient’s hips in a neutral
position. You can make a
trochanter roll by folding
and rolling up a bath
blanket.
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Patient Positioning
Handrolls
You’ll help prevent deformities and contractures
by placing a hand roll in the patient’s hand to
position an maintain the wrist and fingers in a
functional position. You can roll up a washcloth to
make a hand roll.
Hip Abduction Pillow
A hip abduction pillow is designed for use following hip surgery when immobilization or post-operative
positioning is required.
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Patient Positioning
Patient Positions
Supine
The supine position provides comfort in general and specifically for patients recovering from some types of
surgery. To provide support and maintain body alignment in this position, place a pillow under the
patient’s head and shoulders and a towel roll or small pillow under the small of the back and under the
thighs to keep the patient’s knees slightly flexed. You can also elevate the patient’s forearms on pillows
placed at the patient’s sides.
Prone
In the prone position, the patient lies on the abdomen with the head turned to one side. The hips are not
flexed. Sometimes, one or both arms are flexed on each side of the patient’s head. Because this position
can cause hyperextension of the lower back, difficulty breathing due to pressure on the chest, and foot
drop, it is not a position you’ll use often. If a patient does lie prone, place a pillow under the patient’s head
and a small pillow or towel roll under the abdomen just below the diaphragm. Also, place a pillow under
the lower legs to keep the toes from touching the bed.
Lateral or Lateral Recumbent
In the lateral or Lateral Recumbent position,
the patient lies on one side of the body with
the top leg in front of the bottom leg and the
hip and knee flexed. This position helps
relieve pressure on the sacrum and is
especially useful for patients who are on bed
rest and spend a lot of time supine or in
Fowler’s position. To maintain proper body
alignment in this position, place a pillow
under the patient’s head and neck, another
under the upper arm (with the lower arm
flexed), and another between the legs to
keep the hips properly aligned.
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Patient Positioning
Fowlers, Semi-Fowlers, and High-Fowlers
Fowler’s position, is a bed position wherein the head and trunk are raised 45-60 degree elevation.
Fowler’s position is used for people who have difficulty breathing because in this position, gravity pulls the
diaphragm downward allowing greater chest and lung expansion.
For Low-Fowler’s position, the head of the bed is elevated 15-30 degree elevation. This position is useful for
patients who have cardiac, respiratory, or neurological problems and is often optimal for patients who
have a nasogastric tube in place.
For High-Fowlers, the patient is elevated a full 90 degrees.
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Patient Positioning
Sims
In Sims’ position, the patient is halfway between the lateral and the prone positions. The upper arm is
flexed at the shoulder and elbow, and the lower arm is positioned behind the patient. Both legs are in a
flexed position in front of the patient, with the upper leg more flexed than the lower one. This position is
most often used when patients are receiving an enema or for an examination of the perineal area.
To keep the body in proper alignment in this position, place a pillow underneath the patient’s head and
under the upper arm to prevent internal rotation. Place another pillow between the legs.
Trendelenburg
Trendelenburg’s position involves lowering the head of the bed and raising the foot of the bed of the
patient. Patients who have hypotension can benefit from this position because it promotes venous return.
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