POSITIONS IN PATIENT CARE IN ENGLISH

                                                  

                                  POSITIONS IN PATIENT CARE IN ENGLISH

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POSITIONING-

Positioning is an important aspect of patient care. Special positions are provided for comfort and safety of the patient. These are also known as therapeutic positions. Some special positions are used for some therapeutic or diagnostic procedures. Principles of body mechanics should be used while providing any type of position.

PRONE POSITION-

Ø In the prone position, the person lies on the abdomen with the head turned to the side. A small pillow should be placed under head. The body is straight in the prone position. The knees are prevented from  hyperextending by placing a pillow under ankles.

Ø This position helps to prevent flexion contractures of the hips and knees.

Ø Prone position is used for –

Ø Providing comfort.

Ø Assessing posterior thorax.

Ø Patients with injury, burns or surgery on the back.

Ø Relieving pressure from the pressure sores present on dorsal surface of the body and providing change of position to prevent pressure sore.

Ø This position is contraindicated in the patients

Ø with respiratory

Ø spinal problems and

Ø Surgical procedures on chest and abdomen

SUPINE POSITION-

Ø In the supine position the person lies on the back. A small pillow should be placed under head, knees and calves. Cotton rings should be placed under elbow and heels to prevent pressure sore.

Ø Air cushion should be placed under buttocks to take off the pressure and prevent pressure sore. Foot rest should also be provided to prevent foot drop. For unconscious patients, trochanteric rolls are used to prevent outer rotation of hip joint.

Ø This position is used for-

Ø comfort of the patient.

Ø Assessment of vital signs.

Ø Assessment of vital signs.

Ø Physical examination of forehead, mouth, neck, anterior thorax and abdomen.

Ø Physical examination of hand and legs.

Ø Auscultation of lungs and heart.

Ø After surgery on anterior surface of body.

DORSAL RECUMBENT POSITION-

Ø In the dorsal recumbent position the person lies on the  back and legs are flexed at hip and knees are separated. It is a modified supine position.

Ø This position is used for

Ø Vulval and vaginal examination.

Ø Rectal examination.

Ø Operative procedures on perineal area.

Ø Catheterization of urinary bladder

LATERAL POSITION-

Ø In the lateral or side lying position the person lies on the side (right lateral or left lateral). A pillow should be placed under head and neck. 

Ø One large pillow should be placed on back to stabilize the patient. Upper leg should be slightly flexed and a pillow is placed under knees of this leg to increase comfort for the leg.

Ø Both hand should be extended in front of the body and a pillow should be placed under upper hand and in front of the chest to support the body.

Ø This position is used as a position change option and to alleviate pressures from pressure points situated in the back and front to prevent pressure ulcers.

Ø This position is used for rectal examination and temperature.

Ø Left lateral position is used for giving anemas, inserting suppositories etc.

Ø Lateral position is contraindicated in hip surgery, supine surgery or other orthopedic surgeries.

SIMS POSITION-

    This is variation of the lateral position. It is also known as semi prone position. In this position, the patient  lies on the side, but the lower arm is behind the patient and the upper arm is flexed at both the shoulder and the elbow.  This position is used for vaginal and rectal examination.

FOWLER’S POSITION-

Ø In the Fowler’s position the person is placed in semi sitting position with back support or head end elevated at 45 to 60 degrees.

Ø In Fowler’s position, the buttocks bear the main weight of the body. In this position, the heels, sacrum, and scapulae are at risk for skin breakdown and require frequent assessment and skin care.

Ø Air-cushion should be placed under the buttocks. The arms should be supported by pillows. Knees should be slightly flexed with the help of a pillow.

Ø This position is often used to promote cardiac and respiratory functioning because abdominal organs are displaced downwards due to gravity, thereby providing maximal space in the thoracic cavity.

Ø Variations of Fowler’s position include low Fowler’s (semi-Fowler’s) position and high Fowler’s position . In the semi Fowler’s position, the head of the bed is kept at 30 degrees

Ø In the high Fowler’s position, the head of the bed is elevated 90 degrees.  It is also known as cardiac position hen a bedside table (cardiac table) with a pillow on top of it is placed in front of the patient in high Fowler’s position. the patient can lean forward and rest the arms on the pillow.

Ø A sputum mug can be placed on cardiac table so that patient can use it to cough up during deep breathing and coughing exercises.

LITHOTOMY POSITION-

Ø In the lithotomy position the patient is in the dorsal recumbent position with the buttocks at the edge of the examining table and the legs flexed at hip and knees and feet are placed at padded foot rest and legs are separated to visualize perineal area.

Ø lithotomy position is used for –

Ø gynecological examination.

Ø Assessment of female genitalia and rectum.

Ø Surgical procedures such as D&C.

Ø Lithotomy (removal of bladder stones).

Ø Delivery and suturing of episiotomy wound.

KNEE CHEST POSITION-

Ø In the knee chest position the patient lies prone on the knee and chest. The head is turned to one side and cheek rests on a pillow. The arms are above the head and flexed at elbow, supporting the head.

Ø A small pillow should also be placed under the chest.

Ø  This position is used for-

Ø Examination of rectum, vulva and vagina.

Ø Sigmoidoscopy examination

Ø Stretching exercises during post partum period.

Ø Spine surgery

 

TRENDELENBURG POSITION-

Ø In Trendelenburg position the patient lies in supine position with the head 30 to 40 degree lower than the feet.  Normally this position can be provided by elevating foot end of the bed.

Ø The trendelenburg position is used in surgery, especially of the abdomen and genitourinary system. It allows better access to the pelvic organs as gravity pulls the intra-abdominal organs away from the pelvis. It is also used for the patients to insert central IV catheters, for postural drainage, to reduce leg swelling and to help move heavy patients up in bed.