BED POSITION

These are different methods of positioning the patients

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BED POSITIONING OF PATIENTS .

By NDYAMUHAKYI ELISA
BNS IV BUSITEMA UNIVERSITY 2019/2020.

Disclaimer - This article is for informative and educative purposes only and does not in any way
attempt to replace the advice offered by an expert on the subject.

1. Supine
Lying on the back with arms at sides.
Purposes: For physical examination, resting in bed, undergoing anaesthesia.




2. Dorsal recumbent
Lying on the back with arms at sides, legs apart, knees bent, and feet flat on the bed.
For physical examination of abdomen and genitalia, perineal care, examination during
labour

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3. Trendelenburg
Lying on back with arms at sides, bed positioned so foot is higher than the head.

Purposes: During some abdominal surgeries to shift abdominal contents upward.

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4. Reverse Trendelenburg
Lying on back with arms at sides, bed positioned so that head is higher than foot, but no
flexion at waist.

Purposes: After certain angiography procedures, allows head of bed to be elevated
without causing pressure on the femoral artery. During certain abdominal surgeries to
shifLatwrt abdominal contents downward.




5. Lateral
Lying in the left or right side, supported behind back and between knees and ankles
with pillows, in good body alignment.

Purposes: For patient comfort and to promote lung and cardiac function. To relieve
Pressure on bony prominences of the coccyx and sacrum.

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6. Sims'
Lying on the left side in semi-prone position with right leg flexed and drawn up toward
the chest; the left arm is positioned along the patient's back
Purposes: For rectal examinations and administering enemas.

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7. Orthopneic
Sitting upright with head of bed elevated 90 degrees or on the side of the bed with feet
flat on the floor, patient leaning slightly forward with arms raised and elbows flexed,
supported on an overbed table.

Purposes: To assist patient in severe respiratory distress, by allowing chest to
expand to maximum capacity for moving air in and out of the lungs.




8. Prone
Lying on stomach with head turned to the side.

Purposes: To improve oxygenation in patients with acute respiratory distress. To
relieve pressure on the back, coccyx, and hips

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9. Lithotomy
Lying on back with knees flexed above the hips and legs supported in stirrups.

Purposes: For vaginal and gynaecological surgery and examination, delivery of
neonate, pelvic and gynaecological surgery and procedures.

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10. Fowler's
Semi-sitting position with various degrees of head elevation with knees slightly elevated.

Purposes: vary based on elevation.

(i). Low fowler's
Head of the bed elevated 30 degrees
Purposes: to prevent aspiration during tube feeding.

(ii). Semi-Fowler's
head of the bed elevated 45 degrees
purposes: To comfortably watch television or converse with visitors. After abdominal
surgeries to relieve tension on incision. To assist patients who have difficulty breathing.

(iii). High Fowler’s
head of bed elevated 90 degrees
Purposes: To eat and drink without risk of choking. To assist patients who have difficulty
breathing.





Fowler's Position
Fowler's position is a characteristic position that is used in nursing which helps ease the
discomfort of patients. Let us study this concept in more detail. ( Rujuta Borkar)

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Did You Know?
This position is named after George Ryerson Fowler. He served as a surgeon in the
Spanish-American War in 1898. He was the first president and founder of the Brooklyn
Red Cross in 1884 and also introduced first-aid instruction to the New York National
Guard.

Here's something that will help you understand what this entails. Let's say that you just had a
very heavy meal and have come into the living room to watch a film. You sit with your legs
crossed because there is no room left on the couch. After sometime, someone leaves for a nap
and there is some space created. So what do you do? You spread out your legs and release them
to feel more comfortable. Doing that gives you an instant feeling of comfort and your legs feel
better after being released from their confined, cramped position. Thus the position of legs
sprawled is more comfortable and puts you at instant ease than sitting in a cramped, crossed-
legged position. Correct?
The Fowler's position is something like that. It is a specific position that is adjusted on the
patient's bed in a hospital and is used to put patients at ease and to make them more comfortable.
This eases their stress and brings instant comfort to them. The Fowler's position was named after
the renowned surgeon George Ryerson Fowler for inventing this particular position that helped
in patient aftercare. What is the Fowler's position in nursing and how does it help patients is what
we will see in the sections that follow?
The Characteristics
The Fowler's position is a standard position that is used as a part of patient care. In this, the head
of the bed (on which the patient is placed) is raised in a range of 15 - 90 degrees from the
original, flat position, depending on the ailment of the person. Along with that, the knees of the
patient are slightly elevated as well. This is done so that the patient feels comfortable and is able
to recover faster. Placing pillows behind the patient's head, lower back and under the forearms,
ankles, and thighs for support is also standard procedure and is known to lead to a lot of comfort.
The bed might also be equipped with a footboard in order to keep the patient's feet in proper
alignment and to prevent footdrop.
Other than that, the other reasons for which this position is used is for improving breathing in
patients who cannot move at all, relaxing the abdominal muscles―especially after surgery, to
improve uterine drainage of women post delivery, and for lending comfort while eating.
There are varied other positions that fall under this category. These have to do with the varying
degrees of position types. Here are some of the ones that are used in nursing homes.

Position Degree
High 80 - 90º
Standard 45 - 60º
Semi 30 - 45º
Low 15 - 30º

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High Fowler's Position

In this, the patient is put on the bed and the bed is raised to an 80 - 90º angle. Usually, the knees
of the patient are slightly raised as well―either by adjusting the bed or by placing pillows under
the knees. However, depending on the specific condition that the patient is being treated for, the
knees may or may not be elevated.

This position may be used for the treatment of these conditions.

• This position is usually used when there is feeding of the patient involved. The position allows
for proper feeding of the patient without it causing any complications, like the food entering the
nasal pipe (which is a possibility when the patient is in a supine position).
• The high position is also used when a patient is facing breathing problems and a treatment for
the same is being administered.
• So also, when there is a need to take particular type of x-rays, this position is used.
• A patient is placed in this position after an abdominal procedure is conducted because it
promotes dependent drainage.
• Another reason for using this position is for the purpose of grooming a patientt.

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Standard Fowler's Position

In this position, the head of the bed is raised at a 45 - 60º angle and the person is in a position
that is half-sleeping, half-straight. This position is maintained for the treatment of the following
conditions. This position is maintained for the treatment of the following conditions.
• This position is often used during surgeries that are performed on the nasal and oral cavities.
• This position especially helps in promoting drainage and preventing aspiration―which is,
inhaling substances from the stomach into the respiratory tract.
• The standard Fowler's position is also used as the perfect means to increase comfort of the
patient.
• It also improves the ventilation and promotes relaxation after a thoracic surgery, or for patients
who experience cardiovascular problems.


Semi-Fowler's Position

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In this position, the head of the bed is raised at a 30 - 45º angle and the patient is made to lie in a
supine position. A supine position is one in which the person lies on his back with his legs
completely flexed and hands straight. This position may be used for the treatment of these
conditions.
• This position is ideally used for patients who are being fed with the help of feeding tubes, as
well as for patients who have a nasogastric tube in place for the purpose of administering drugs.
This is because, if a patient lies at a straight angle, the feeding tube contents can run into his
lungs and cause complications.
• It is also used for shoulder, cranial, nasal, breast reconstruction, and/or abdominoplasty
procedures.
• This position releases the tension of the abdominal muscles, thereby improving the breathing of
the patient.
• This position is also used to improve the uterine drainage in postpartum women.
• This is a helpful position for patients who have respiratory, cardiac, or neurological problems.

Low Fowler's Position


In this position, the head of the bed is raised at a 15 - 30º angle and the patient is just about raised
from the flat position on the bed. This position is used in these situations.

• This position is used for administering drugs, for example, putting eye drops.
• Many times, lying down flat on the bed can lead to a strain on the lower back. Raising the bed
to the low Fowler's position is known to bring some relief to the patients.
The Fowler's position is a very important position in nursing and the medical field because of the
way in which it helps in caregiving to the patients. It makes the process extremely easy and
relaxing for the patient and thereby helps in faster and better recovery.

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OR. Positioning Patients in Bed
Positioning a patient in bed is important for maintaining alignment and for preventing
bed sores (pressure ulcers), foot drop, and contractures. Proper positioning is also vital
for providing comfort for patients who are bedridden or have decreased mobility
related to a medical condition or treatment.
When positioning a patient in bed, supportive devices such as pillows, rolls, and
blankets, along with repositioning, can aid in providing comfort and safety (Perry et
al., 2014).
Patient Positions in Bed
Positioning a patient in bed is a common procedure in the hospital. There are various
positions possible for patients in bed, which may be determined by their condition,
preference, or treatment related to an illness. Table 3.6 lists patient positions in bed.
Table 3.6 Patient Positions in Bed
Position Description
Supine position
Patient lies flat on back. Additional supportive devices may be added for comfort.
Supine position
Prone position Patient lies on stomach with head turned to the side.

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Prone position
Lateral position
Patient lies on the side of the body with the top leg over the bottom leg. This position helps relieve pressure on
the coccyx.
Lateral position
Sims position
Patient lies between supine and prone with legs flexed in front of the patient. Arms should be comfortably placed
beside the patient, not underneath.
Sims position
Fowler’s position
Patient’s head of bed is placed at a 45-degree angle. Hips may or may not be flexed. This is a common position to
provide patient comfort and care.

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Fowler’s position
Semi-Fowler’s
position
Patient’s head of bed is placed at a 30-degree angle. This position is used for patients who have cardiac or
respiratory conditions, and for patients with a nasogastric tube.
Semi-Fowler’s position
Orthopneic or tripod
position
Patient sits at the side of the bed with head resting on an over-bed table on top of several pillows. This position is
used for patients with breathing difficulties.
Trendelenburg
position
Place the head of the bed lower than the feet. This position is used in situations such as hypotension and medical
emergencies. It helps promote venous return to major organs such as the head and heart.
Trendelenburg position

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