Therapeutic Positions

1. Fowler's Position - The head is up approximately 45 degree. The knees aare not elevated to avoid putting pressure on the popliteal areas. This position promotes lung expansion. This position also decreases intracranial pressure for the patients with neurological problems. It is used to relax tension of the abdominal muscles, allowing for improved breathing in immobile patients, and to increase comfort during eating and other activities. We have different form of fowler's position - low, semi and high fowler's position. High - above 45 degrees; semi - 20-30 degrees; low - 10-15 degrees.
2. Trendelenburg position - the body is laid flat on the back (supine position) with the feet higher than the head with approximately 30 degree below horizontal level. This is a standard position used in abdominal and gynecological surgery. It allows better access to the pelvic organs as gravity pulls the intestines away from the pelvis. This position also use for postural drainage, which is a procedure for draining secretions from certain segments of the lungs. It promotes venous return in patients with problems in tissue perfussion. Use pillow to protect the head from the bed's headboard. It was named after the German surgeon Friedrich Trendelenburg.
3. Orthopneic position - is the sitting position that permits maximum lung expansion for gaseous exchange, because the abdominal organs do not provide pressure against the diaphragm. This position is used to promote lung expansion for the patients who have difficulty of breathing and who is unable to lie flat. the patient rests on a pillow on the overhead table. It is also used to perform a thoracentesis.
4. Dorsal Recumbent Position - Patient is on his back with knees flexed and soles of feet flat on the bed. Fold sheet once across the chest. Fold a second sheet crosswise over the thighs and legs so that genital area is easily exposed. It is used to give comfort to patients with back strain.
5. Sim's Position - Used for rectal examination. It is used for administering enemas or for examination of the rectal area. Patient is on left side with right knee flexed against abdomen and left knee slightly flexed. Left arm is behind body; right arm is placed comfortably.
6. Prone Position - Used to examine spine and back. Patient lies on abdomen with head turned to one side for comfort. Arms may be above head or alongside body. Cover with sheet or bath blanket.
7. Knee-Chest Position - also known as genupectoral position. Used for rectal and vaginal examinations and as treatment to bring uterus into normal position. Patient is on knees with chest resting on bed and elbows resting on bed or arms above head. Head is turned to one side. Thighs are straight and lower legs are flat on bed. The patient is draped to allow visibility of the rectal area and coverage of the rest of the body warmth and modesty.
8. Lithotomy Position - Used for examination of pelvic organs, perineaal or vaginal examination and vaginal douche. Similar to dorsal recumbent position, except that the patient's legs are well separated and thighs are acutely flexed. Feet are usually placed in stirrups. Drape the patient properly. Fold sheet or bath blanket crosswise over thighs and legs so that genital area is easily exposed. Keep patient covered as much as possible to provide privacy.