Technique of positioning patients.

2. OBJECTIVES
• Is crucial for maintaining body alignment and
comfort, preventing injury to the musculoskeletal
system, and providing sensory, motor, and cognitive
stimulation.
• It is important to maintain proper body alignment for
the patient at all times, this includes when turning or
positioning the patient.
– Aim – least possible stress on patient’s joints & skin.
Maintain body parts in correct alignment so they remain
functional and unstressed.
– Patients who are immobile need to be repositioned in 2
hrs.

3. • Body alignment:
– Maintaining a person in a position in which the
body can properly function
POSITIONING

4. ASSESSMENT
• Comfort level & alignment while lying
down
• Risk factors - Ability to move, paralysis
• Level of consciousness
• Physical ability/motivation
• Presence of tubes, incisions, equipment

5.  IF THE PATIENT IS UNABLE TO CHANGE
POSITION INDEPENDENTLY , YOU WILL NEED TO
ASSIST .
 PATIENTS NEED TO BE TURNED EVERY TWO
HOURS.

6. • Occurs when body alignment is not
maintained or when the patient’s position is
not changed often enough
– Pressure ulcer (bedsores) result when unrelieved
pressure on a bony prominence interferes with
blood flow to the area
– Contractures occurs when a joint is allowed to
remain in the same position for too long
COMPLICATIONS

7. • Used to maintain body alignment and position
– Pillows
– Splints (orthotic devices)
– Special boots/shoes
– Bed cradles
– footboards
Supportive devices

8. • Prone – on the abdomen
• Supine – on the back
• Lateral – on either side
• Sims’s – left lateral (slight variation)
• Fowlers – upright; variation include high
fowlers (90°) and semi-fowlers (45°)
POSITIONING

9. Lateral position

10. SUPINE POSITION
 •• Pillow of suitable thickness under head and shoulders to preventPillow of suitable thickness under head and shoulders to prevent
hyperextension of neck in if thick-chest person.hyperextension of neck in if thick-chest person.
 •• Roll or small pillow under lumbar curvature to prevent posteriorRoll or small pillow under lumbar curvature to prevent posterior
flexion of lumbar curvature.flexion of lumbar curvature.
 •• Roll or sandbag placed laterally to trochanter of femur to preventRoll or sandbag placed laterally to trochanter of femur to prevent
external rotation of legs.external rotation of legs.
 •• Small pillow under thigh to flex knee slightly and preventSmall pillow under thigh to flex knee slightly and prevent
hyperextension of knees.hyperextension of knees.
 •• Footboard or rolled pillow to support feet in dorsiflexion and toFootboard or rolled pillow to support feet in dorsiflexion and to
prevent plantar flexion (foot drop).prevent plantar flexion (foot drop).
 •• Pillow under lower legs to prevent pressure on heels.Pillow under lower legs to prevent pressure on heels.

11. FOWLER’S POSITION
--A pillow is under the head,neck and upper
back.
– A pillow support both arms.
– Head raised 90⁰.

12. SEMI-FOWLER’S POSITION
 •• Pillow to support head, neck, and upper back to preventPillow to support head, neck, and upper back to prevent
hyperextension of neck.hyperextension of neck.
 •• Pillow under forearms to eliminate pull on shoulder andPillow under forearms to eliminate pull on shoulder and
assist venous blood flow from hands and lower arms.assist venous blood flow from hands and lower arms.
 •• Small pillow under thighs to flex knees to preventSmall pillow under thighs to flex knees to prevent
hyperextension of knees.hyperextension of knees.
 •• Trochanter roll lateral to femur to prevent external rotationTrochanter roll lateral to femur to prevent external rotation
of hips.of hips.
 •• Footboard to provide support for dorsiflexion and preventFootboard to provide support for dorsiflexion and prevent
plantar flexion of feet (foot drop).plantar flexion of feet (foot drop).

13. LATERAL POSITION
--A pillow is under the head and neck.
– The upper leg, ankle, and thigh are supported with
pillows.
– A pillow is positioned against the person’s back.
– A small pillow is under the upper arm and hand.

14. PRONE POSITION
-- The person lies on the abdomen with the head turned
to one side.
– The bed is flat.
– Small pillows are placed under the head, abdomen,
and lower legs.
– Arms are flexed at the elbows with the hands near the
head.

15. SEMI PRONE POSITION
-- A pillow is under the head and neck.
– The upper leg, ankle, and thigh are supported with
pillows.
– A small pillow is under the upper arm and hand.
– A rolled towel support lower foot.

16. ORTHOPNEIC POSITION
FREQUENTLY USED BY PATIENTS WITH RESPIRATORY PROBLEMS
HELPS EXPAND THE CHEST AND LUNGS TO ALLOW MORE OXYGEN TO ENTER

18. MOVING PERSONS IN
BED
• Protect the skin when moving the person.
– Friction is the rubbing of one surface against
another.
– Shearing is when the skin sticks to a surface while
muscles slide in the direction the body is moving.
• To reduce friction and shearing:
– Roll the person or use assist devices.
– Use a lift sheet (turning sheet), turning pad, large
incontinence product, slide board, or slide sheet.

19. THE SKIN STICKS TO THE SURFACE
BUT THE INTERNAL STRUCTURES
( BONE AND MUSCLE ) SLIDE IN THE
DIRECTION THE BODY IS MOVING
OCCURS WHEN THE PATIENT SLIDES
DOWN IN BED

22. IF THE PATIENT CAN ASSIST:
HAVE THE PATIENT GRASP THE
HEADBOARD AND BEND HIS KNEES
PLACE YOUR FOREARMS UNDER HIS
SHOULDERS AND KNEES
LIFT AT THE COUNT OF THREE

23. A LIFT SHEET MAKES LIFTING EASIER
HELPS PREVENT FRICTION AGAINST
THE PATIENT’S SKIN
TAKES TWO WORKERS TO LIFT
IF PATIENT CAN HELP HAVE HIM
BEND HIS KNEES
USE FOR PERSONS WHO CAN NOT
HELP WITH THE MOVE

24. THE PERSON IS MOVED IN SEGMENTS

26. PROPER POSITIONING FOR LATERAL POSITION

27. A PATIENT WHO HAS A SPINAL INJURY OR SPINAL SURGERY MUST BE KEPT IN
GOOD BODY ALIGNMENT WHEN TURNING.
USING A LIFT SHEET THE PERSON IS TURNED IN ONE MOTION.
IT TAKES 2 OR 3 PERSONS TO SAFELY LOGROLL A PATIENT.

28. DANGLING
REFERS TO
SITTING ON THE
SIDE OF THE BED
WITH THE FEET
HANGING DOWN

31. THE WHEELCHAIR IS
PLACED AT A RIGHT
ANGLE TO THE
TOLIET

32. TAKES 4 OR MORE STAFF
USE A LIFT SHEET OR SLED TO PULL
PATIENT OVER ONTO CART

34. o ALWAYS LOCK THE BRAKES WHEN
TRANSFERRING
o CLEAN THE WHEELCHAIR ON A
REGULAR BASIS
o MOVE THE FOOTRESTS OUT OF
THE WAY WHEN TRANSFERRING