October 7, 2005
Why do we spend time on positioning?
Patient comfort/decrease pain
Support and stability to pt’s trunk &
Prevent development of pressure sores
Prevent joint contractures
To have easier access to area being treated
The most comfortable for the pt may not
be the best for them
May need to be positioned to aid in the
treatment of a specific diagnoses or
What about restraints?
Considerations with positioning
Who is at risk?
Those unable to change their own position
Those with decreased sensation
Those who may be unable to communicate
Pillow under head to keep c-spine neutral
Small pillow or towel roll for cervical support
Support under popliteal space to ↓ lumbar
Ankle support to relieve pressure on
Support under elbows to relieve pressure on
Pillow under head
Pillow under lower abdomen to ↓ lumbar
Rolled towel under anterior shoulder to
adduct (retract) scapula
Towel roll/pillow/bolster under ankles to
relieve stress on hamstrings, also allows
pelvis and lumbar spine to stay relaxed
Pt in center of bed – not near edge
Head, trunk, pelvis in alignment
LE’s are flexed at hip & knee with pillows btwn
legs & top Le slightly forward of bottom LE
Pillow at chest &/or back for to prevent pt from
Pillow under top arm to keep chest open
Head of bed is lifted 30° - can use pillow,
wedge or bolster as well
Pillow under popliteal space
Used for breathing, eating, visiting
For a Fowler position head of bed is 45°
Reasons for draping pt’s:
How do you feel at the Dr’s office with no
If you need pt to change to gown – leave room –
knock before re-entering
If pt needs assistance suggest it, ask permission
before helping them
Only area being treated is exposed, the rest of
the pt is covered
Gown, blanket, sheet, towel
Pt comfort is the key to working on difficult areas
Be sure you keep legal considerations in
What is the policy of the facility on door being
closed, slightly open? Curtains?
Inappropriate comments or touch mean
different things to different people
Protect yourself by being professional at all
What are the goals of bed mobility?
How do we define bed mobility?
How will patients benefit from bed
mobility prior to a transfer activity?
Why do we teach bed mobility?
Most Common Movements Of
Turning from supine to sidelying position
Supine to prone positioning and returning.
Moving in bed-upward, downward, side to
Moving from lying to sitting EOB.
How do you actively involve
the patient in bed mobility
What are some
ways/techniques you can
use to reduce the patient’s
and your energy
expenditure during bed
Bed Mobility Exercises
Bed Mobility exercises don’t always have
to be done in bed.
A patient can greatly benefit from bed
mobility work on a mat table. Why would
Examples of bed mobility exercises we will
cover today in lab are on pages 132-140.
Modifications to bed mobility
On Wednesday Jamie will cover bed
mobility for the orthopedic patient and how
precautions alter how bed mobility is
instructed for these types of patients.