Different types of placing a patient in bed

Placing a patient in Fowler's position

Fowler's position it is intermediate between the sitting and lying.

It can be performed in both functional bed and usual low beds.

Used when there is a need in physiological movements in bed to prevent bed sores in paralyzed patients (Pic. 59).

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Picture 59.

Placing a patient in Fowler's position

The procedure:

1. Elevate the head of bed to an angle from 45-60 degrees.

High position improves ventilation of the lungs, furthermore, the conditions of comfort for the patient.

2. Put patient's head on low pillow that reduces flexion contracture of the neck muscles.

3. If the patient is not able to move his/her hands then put the pillows under them.

The presence of hand support reduces venous stagnation and warns flexion contracture of the arms and hands muscles.

In addition, the presence of support prevents shoulder injury under the influence of hands gravity, directed downward.

4. To reduce pressure on the lumbar spine put the patient under lower back cushion or foam pad.

5. Put a small pillow or cushion under the lower part of the patient's thigh to prevent crushing of the popliteal artery under the action of body gravity and hyperextension of the knee.

6. Put a small pillow under the patient's heels (for the prevention of bedsores calcaneus) and put the emphasis on the patient's foot at an angle of 90 degrees (to prevent "sagging" and keeping dorsiflexion of the feet).

Placing a patient into the Sims' position

Sims' position is an intermediate position between the position of lying on his/her belly and lying on his/her side.

It can be provided as in a functional bed and a regular bed.

Used when there is a need when a patient in forced passive position, for the prevention bedsores (Pic. 60).

Picture 60.

Placing a patient into the Sims' position

The procedure:

1. Give a headboard bed to horizontal position.

2. Give the patient the next the position, "lying on his/her side and partially lying on the stomach" (the part of the patient's abdomen is on the bed);

3. Put a pillow under the patient's head to prevent lateral flexion of the neck.

4. Put a pillow to shoulder level under the "top" of the arm bent at the elbow and shoulder joint arm at an angle of 90 degrees. His/her other hand put on the sheet without bending it (to maintain proper body mechanics). All of this contributes to proper straightening of the patient's body and prevents the internal shoulder rotation.

5. Put a pillow under the "top" bent leg so the leg at the level of the hips (to prevent rotation of the thigh inward, preventing hyperextension of limbs, the prevention of pressure ulcers in the knees and ankles);

6. Put a sandbag at the soles of patient's feet (to ensure the proper dorsiflexion of the feet and prevent their "slack"). Put the patient in one of the listed positions, make sure he feels himself comfortable. All kinds of positions can be used with one patient, who is bedrest with a high risk of bedsores, and in need of change of body position every 2 hours.

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