Patient Positions 

1. Supine 
Description: Lying flat on the back, face up 
Uses: Physical examinations, imaging, postoperative care 
Risks: Aspiration (if unconscious), pressure injuries to sacrum/heels 
 
2. Prone 
Description: Lying flat on the abdomen 
Uses: Spinal surgery, ARDS ventilation (promotes ventilation to lung bases – improves VQ) 
Risks: Airway compromise, neck strain 
 
3. Lateral (Side-lying) 
Description: Lying on one side 
Uses: Recovery position, pregnancy, pressure relief 
Special case: 
Left lateral → improves venous return in pregnancy 
 
4. Fowler’s Positions 
Low Fowler’s: 15–30° 
Semi-Fowler’s: 30–45° 
High Fowler’s: 60–90° 
Uses: Breathing support, eating, NG tube insertion 
Benefits: Improves lung expansion 
 
5. Sims’ Position 
Description: Semi-prone, left side with right knee flexed 
Uses: Rectal exams, enemas, unconscious patients 
 
6. Trendelenburg 
Description: Head lower than feet 
Uses: Hypotension, central line insertion (limited use now) 
Risks: Increased ICP, respiratory compromise 
 
7. Reverse Trendelenburg 
Description: Head higher than feet 
Uses: GERD, increased intracranial pressure 
 
8. Lithotomy 
Description: Supine with legs in stirrups 
Uses: Gynecologic exams, childbirth, urologic procedures 
Risks: Nerve injury, hypotension if prolonged 
 
9. Knee-Chest (Genupectoral) 
Description: Knees and chest on bed, buttocks elevated 
Uses: Rectal procedures, spinal exams 
 
Key Principles of Safe Positioning 

Maintain body alignment 
Protect pressure points 
Ensure airway patency 
Reposition every 2 -4 hours if immobile 
Use pillows, wedges, and supports 
Ensure sufficient staff to support repositioning; dynamic assessment of risk 
 
Key Points:

Pregnant + hypotension → Left lateral 
ARDS → Prone 
Raised ICP → Head elevation / Reverse Trendelenburg 
Aspiration risk → Lateral or semi-Fowler’s 
Spinal anesthesia → Sitting or lateral 
 
Nerve Injuries to Remember (from poor positioning):