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Patient Positioning

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John Dinesh
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31 views29 pages

Patient Positioning

Uploaded by

John Dinesh
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PPTX, PDF, TXT or read online on Scribd
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Key points

• What is positioning?
• What are the purposes and principles in
positioning?
• What are the different positions?
• Techniques, pressure points in different
positions?
• Documentation of positioning
• Positioning is defined as placing the
person in a proper body alignment for
the purpose of preventive, promotive,
curative and rehabilitative aspects of
health and well being
PURPOSES
• To promote comfort to the patient
• To relieve pressure on various parts
• To stimulate circulation
• To provide proper body alignment
• To carry out nursing intervention
• To perform surgical and medical
interventions
• To prevent complications caused by
immobility
• To promote normal physiological
functions
PRINCIPLES
• Maintain good body mechanics
• Wash hands before and after procedure
• Ensure patient’s comfort
• Obtain assistance as required
• Ensure that mattress is firm and level of bed is
at working level
• Follow safety measures to prevent accidents
• Follow the systematic and orderly way of
doing
• Use right technique at right time
1. SUPINE POSITION
• The patient lies on his back with his head and
shoulders are slightly elevated
Pressure points in supine
position

Occiput
Scapulae
Sacrum and coccyx
Olecranon process
Calves and calcanae
PROCEDURE
• Place the patient on back with one pillow
under the head, arms and hands at the
sides, knees flexed and separated.
• Place the air cushion under the hips and
cotton or foam pads under the heels to
reduce the pressure.
• Place footboard under bottom of feet
• If the patient is a paralyzed, place hand
role in hand.
• Align the patient’s body in good
position.
Moving a patient up in bed
• Perform hand hygiene
• Explain to the patient and the family
members
• Ensure tubes and attachments are
properly placed prior to the procedure
• Ensure patient has a draw sheet or a
friction-reducing sheet on the bed prior
to repositioning
• Make sure an additional health care
provider is available to help with the
move
• Explain to the patient what will happen
and how the patient can help
• Assess patient, environment and the
health worker for readiness and safety
• Raise bed to safe working height and
ensure that brakes are applied
• Lay patient supine; place a pillow at the
head of the bed against the headboard
• Stand between shoulders and hips of
patient. Keep your feet apart
• Fan-fold the draw sheet toward the
patient with palms facing up.
• Ask patient to tilt head toward chest, fold arms
across chest, and bend knees to assist with the
movement. Let the patient know when the
move will happen
• Tighten your gluteal and abdominal muscles,
bend your knees, and keep back straight and
neutral
• On the count of three by the lead person,
gently slide (not lift) the patient up the bed
• Replace pillow under head, position patient in
bed, and cover with sheets.
• Raise side rails as required
2. LATERAL POSITION
• The client lies on the side with weight on hip
and shoulder or the patient lies on his side
with both arms forward and his knees and hips
flexed.
• The upper leg is flexed more than the lower
leg.
• The upper knee and hip should be at the same
level.
• A pillow is given under the head, back and
front to support the arms and abdomen.
• A small pillow is given in between the knees.
INDICATIONS
• Patients who requires periodic position
changes
• In immediate post-operative patients
• Used for examination of perineum
• Inserting suppositories.
• For taking rectal temperature.
• Giving back care
• For giving enema and colonic irrigation
Pressure points
2. PRONE POSITION
• Position in which the patient lies on the
abdomen with the head turned to one side with
one small pillow under the ankle.
Indications
• Post operatively (spinal surgeries if indicated)
• Patient with pressure sores, burns, injuries and
operations on the back.
• To relieve abdomen distension
• Renal biopsy.
• Examine the back
• For patients after 24 hours of amputation of
lower limbs
PROCEDURE

• Explain the procedure


• Provide privacy
• Place the patient flat on abdomen with one
pillow under the head
• Turn patients head to one side and align the
patient in good position
• Place both arms at the side of the head and
support arm in flexed position at level of
shoulder.
• Support lower legs with pillows to elevate toes.
LITHOTOMY POSITION
• The client lies supine with hips flexed. The legs
are separated and thighs are flexed.
• The patient’s buttocks are kept at the edge of
the table and legs are supported by stirrups.
INDICATIONS
• For delivery of baby
• For rectal examination & surgeries
• For vaginal examination & hysterectomy
PROCEDURE
• Explain the procedure to the patient
• Provide privacy
• Position the patient to lie on his back with one
pillow under the head
• Keep the legs well separated and the thighs
well flexed on the abdomen and the legs on the
thighs
• Buttocks are kept on the edge of the table and
the legs are supported on stirrups
FOWLER’S POSITION
• It is a sitting position in which the head
is elevated at 45˚ to 60˚, and the client
knees are slightly elevated, avoiding
pressure on the popliteal vessels.
• Backrest and two pillows are used for the
back and head.
• Pillows can be used to maintain natural
alignment of the hands wrist and
forearms.
INDICATIONS
• To relieve dyspnea
• To improve circulation
• To relax the muscles of the abdomen,
back and thighs.
• To relieve tension on abdominal stature.
PROCEDURE
• Explain the procedure
• Elevate the head of the bed
• Rest the head against mattress or small
pillow.
• Use pillow to support arm.
• Place a small pillow at lower back.
• Place foot board at bottom of patient’s feet.
• Place the patient in sitting position with
arms at sides and knees raised with pillow.
SIMS POSITION
• In this position the client lies on either the right
or left side.
• The lower arm behind the body and upper arm
is bent at the shoulder and elbow.
• The knees are both bent, with the upper most
leg more acutely bent.
• These positions similar to the lateral position
except that the patient’s weight is on the
anterior aspect of the patient’s shoulder girdle
and hip
INDICATIONS
• Vaginal and rectal examination
• Administration of enema and
suppository
• Used for relaxation in antenatal exercises
• Position for sigmoidoscopy and
proctoscopy
TREDLENBERG POSITION
• In this the patient lies on the back with the
head low.
• The foot of the bed is elevated at 45˚ angle.
Entire frame of bed is tilted with head of bed
down.
INDICATION
Used in emergency situations like shock,
hemorrhage and hypotension Postural drainage
Patients with deep vein thrombosis
PROCEDURE
• Explain the procedure to patient
• Place the patient in supine position
• Lower the head end of the bed or if it is not
adjustable type, use bed block at foot end and
tilt entire frame of bed down. OR elevate the
foot end at 45˚angle.
• The patient is carefully supported to prevent
from slipping.

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