Various patient positions while in medical care include Fowler’s position, dorsal recumben, knee chest, lateral, lithotomy, sims and trendelenburg. The position of the patient is important to note to support the healing process. There are several patient positions used in hospitals, depending on the health conditions of each individual. A good sleeping position will help support recovery. In addition, various patient positions can also make it easier to access certain anatomical locations during treatment or surgical procedures.
Several factors also need to be considered in selecting the patient’s position. This includes the patient’s age, weight, and size and past medical history, such as respiratory or circulatory disorders.
The following are various patient positions in bed including:
1. Fowler’s position
Fowler’s position is the most common patient position for both inpatients and emergency room patients. To perform the Fowler’s position, the patient is positioned in a semi-sitting position with the head of the bed at an angle of between 45 and 60 degrees and the knees straight or slightly bent.
- This patient position can be used in patients with mild to moderate respiratory distress and placement of orogastric and nasogastric tubes.
- Can maximize chest expansion, minimize abdominal muscle tension, minimize the effect of gravity on the chest wall
2. Dorsal recumben position
The patient is in a supine position with both legs bent and slightly stretched while both feet are flat on the mattress.
- This patient position can be used during gynecological or urological examinations, treatment of the urethra and bladder and during childbirth.
- The dorsal recumbent position is useful for providing a sense of comfort and facilitating the examination and implementation of procedures such as digital rectal examination, abdominal palpation or vaginal irrigation.
3. Knee chest position
This is the patient’s position with the supine position where the legs are bent and the chest is against the mattress.
- This position is useful for facilitating examination of the rectum and sigmoid area
- This position can be applied to patients who require sigmoidoscopy and rectoscopy.
4. Lateral position
Position the patient lying on his side with the thighs and knees bent forward.
- Its use is to facilitate treatment, facilitate the flow of mucus or mucus from the mouth to the esophagus, and prevent pressure on the sacrum in the lower back and heel area.
- This position can be applied to patients who have been lying in one position for too long, or to facilitate eating or bathing without leaving the bed. The lateral patient position also supports patients whose one side of the body should not be crushed or experiencing sensory and motor disturbances.
5. Lithotomy position
Position the patient supine with the legs raised about 30 to 45 degrees above the abdomen with the knees bent. The knee will usually rest on the end of the mattress. This position is usually used for genital examinations, insertion of an intrauterine device (IUD), during labor or during gynecological, rectal and urological operations.
6. Sims position
This is a semi-prone position with one leg bent forward and the other straight.
- This patient position is useful for facilitating procedures or examinations in the perineal area which is the area between the genitals and the anus.
- Can be done to facilitate the drainage of fluid from the esophagus.
- This position can be applied to various conditions including patients who are unconscious, paralyzed, or about to perform a perineal examination.
7. Trendelenburg position
Next is the Trendelenburg position where the patient’s head is lower than the legs or body.
- This position is useful to improve blood circulation to the brain and facilitate operations on the abdomen.
- This condition can be applied to clients who are in a state of shock, hypotension and require certain actions such as bronchoscopy.
Things to consider when changing the patient’s position
When changing the patient’s position, pay attention to the following steps:
- Explain to the patient what you intend to do, so that the patient can anticipate what will happen.
- If possible, raise the bed to a level that reduces back strain.
- Get as close to the patient as possible. You can put your knees on the bed if needed.
- Place one hand on the patient’s shoulder and the other on the patient’s hip.
- Stand with one foot forward. Transfer weight to the front leg while gently pulling the patient’s shoulder toward you.
- Transfer weight to the back leg while gently pulling the patient’s hip toward you.
Steps 4 and 5 may need to be repeated several times until the patient is in the correct position. To ensure the patient’s position is correct, pay attention to the following:
- Ensure that the patient’s ankles, knees, and elbows are not resting on each other.
- Make sure your head and neck are in line with your spine, not stretched forward, backward, or sideways.
- Return the bed to a comfortable position with the side rails facing up. Use pillows as needed and make sure the patient is comfortable.