Patient's Positioning

• Supine or Dorsal Recumbent Position

  • patient lies flat on the back with head slightly elevated by the pillow (unless contraindicated)
  • usually for spinal anesthesia or spinal surgery
• Where can pillow in Supine position be placed?

  under the head to lumbar curvature
• A small pillow or donut should be used to stabilize the head, as an extreme rotation of the head during surgery can lead to

  occlusion of the vertebral artery.
• Fowler's Position - also known as semi-sitting position. It is also useful for NGT.
• Fowler's Position

  • Low fowler's - 15 to 30 degrees
  • Semi-fowler's - 30 to 45 degrees
  • Highfowler's - nearly vertical
• Fowler’s position is named after George Ryerson Fowler, who saw it as a way to decrease the mortality of peritonitis.
• Orthopneic or Tripod Position

  • patient in a sitting position or on the side of the bed with an overbed table in front to lean on and several pillows on the table.
  • it allows maximum chest expansion
  • helpful for patients who have problems with exhalation
• Prone Position

  • patient lies on the abdomen with their head turned to one side and the hips are not flexed.
  • opposite of the supine position
  • the only bed position that allows full extension of the hip and knee joints
  • contraindicated for spine problems (used only when there is no problem with the patient's back)
  • often used for neurosurgery in most neck and spine surgeries
• Lateral Position

  • patient lies on one side of the body with the top leg in front of the bottom leg and the hip and knee flexed
  • relieves pressure on the sacrum and heels
  • for body weight distribution
  • support pillows needed
• Sim's Position

  • patient assumes a posture halfway between the lateral and the prone positions
  • prevents aspiration of fluids
  • reduces lower body pressure
  • perineal area visualization and treatment
  • advisable for pregnant women
  • promotes body alignment with pillows
• Lithotomy Position

  • patient is on their back with hips and knees flexed and thighs apart
  • commonly used for vaginal examinations and childbirth
  • low lithotomy - 40 to 60 degrees
  • standard lithotomy - 80 to 100 degrees
  • Hemilithotomy - The patient’s non-operative leg is positioned in standard lithotomy. The patient’s operative leg may be placed in traction.
  • High lithotomy - 110 to 120 degrees
  • Exaggerated lithotomy - 130 to 150 degrees
• Trendelenburg's Position

  • involves lowering the head of the bed and raising the foot of the bed of the patient
  • patient's arm should be tucked at their sides
  • promotes venous return
  • postural drainage
• Reverse Trendelenburg's Position

  • patient position wherein the head of the bed is elevated with the foot of the bed down
  • opposite of Trendelenburg's position
  • often used for patients with GIT problems
  • prevent rapid change of position
  • prevent esophageal reflux
• Knee-Chest Position

  • can be in a lateral or prone position
  • patient lies on their side, the torso lies diagonally across the table, and the hips and knees are flexed
  • usual position adopted for sigmoidoscopy without anesthesia
  • assumed for a gynecologic or rectal examination
• Jackknife Position

  • also known as Kraske
  • patient's abdomen lies flat on the bed
  • the bed is scissored, the hip is lifted, and the legs and head are low
  • frequently used for surgeries involving the anus, rectum, coccyx, certain back surgeries, and adrenal surgery
  • requires team effort
  • increases the risk for deep vein thrombosis
• Kidney Position

  • modified lateral position wherein the abdomen is placed over a lift in the operating table that bends the body
  • access to the retroperitoneal area
  • risk for falls (unless the position is secured)
  • padding and stabilization support
• Bed boards


  • Placed under the mattress's entire surface area
  • Useful for increasing back support and body alignment
• Foot boots


  • Rigid plastic or heavy foam shoes
  • Keep the foot flexed at the proper angle
• Hand rolls


  • Maintain the fingers in a slightly flexed and functional position
  • Keep the thumb slightly adducted in opposition to the fingers
• Hand-wrist splints


  • Maintain proper alignment of the thumb in slight adduction
  • Maintain the wrist in slight dorsiflexion
• Pillows


  • Provide support
  • Elevate body parts
  • Splint incision areas
  • Reduce postoperative pain during activity
• Sandbags


  • Soft devices filled with substances
  • Can be used to shape or contour the body's shape
  • Provide support
• Side rails


  • Bars along the sides of the length of the bed
• Trochanter rolls


  • Prevent the external rotation of the legs when the client is in the supine position
• Wedge pillows


  • Made of heavy foam
  • Used to maintain legs in abduction following total hip replacement surgery