Patient positioning is one of the most essential skill sets to master as a Certified Nurse Assistant. Patients that are constrained to a bed for health concerns must be repositioned regularly in order to provide optimal blood flow, muscle regeneration, and overall physical and physiological recovery.

CNAs must be aware of the common positions to place patients in while they are confined to a bed.

Repositioning Bedbound Patients:

Fowler’s Position: This position is used for patients that are having difficulty breathing. The head and trunk of the patient are raised 40 to 90 degrees to allow gravity to pull the diaphragm down, signaling the chest and lungs to expand. Semi sitting, the feet are also raised to allow good circulation. Fowler’s is a common position for patients with heart and respiratory disorders.

Supine or Dorsal Position: This position is used for immediate surgery recovery. The bed is completely flat and the patient is lying on their back. Options include possible head and neck elevation, but it is case dependent.

Prone Position: In this position the patient is lying on their abdomen with their head turned to one side and hips relaxed. This is the only position that allows the full extension of the hips and knee joints, a needed position after knee or hip replacement surgery. Prone position also is used for patients that are unconscious after surgery, as it allows drainage from the mouth.

Lateral Position: In lateral or side position, the patient lies on one side of the body with the top leg in front of the bottom leg and the hip or knee flexed. This triangular base of support allows for stability and strength as the body recovers. This position is also used to relieve pressure on the sacrum, for those patients confined to long term bedrest.

Sims’ Position: This position is used most commonly for paralyzed patients, or for those receiving enemas and other treatments of the perineal area. In Sims’ the patient is halfway positioned between lateral and Prone position. The legs are flexed out in front, the lower arm is positioned behind the patient and the upper arm is flexed at the shoulder and elbow. Pillows are used to allow for proper body alignment in this position, and can be seen under the head, between legs, and under the upper arm.

Tripod Position: This position is used most commonly for patients that are having trouble breathing. With this position patients are placed in a sitting position on the side of the bed with their head leaning on a oversized table. The table is often padded with pillows to allows maximum relief and avoid neck strain.

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