Quick Reference
Supine
Lying on the back, face upward.
- Uses: Rest, assessment, certain procedures.
- Pressure Points: Back of head, shoulder blades, elbows, sacrum, heels.
- Support: Maintain alignment; offload heels and support limbs as indicated.
- Watch For: Pressure injuries, aspiration risk, breathing difficulty.
Fowler’s
Lying on the back with the head of the bed elevated.
| Variation | Head Elevation |
|---|---|
| Low Fowler’s | 15–30° |
| Semi-Fowler’s | 30–45° |
| Fowler’s | 45–60° |
| High Fowler’s | 60–90° |
- Uses: Breathing comfort, meals, personal care.
- Pressure Points: Sacrum, coccyx, elbows, heels.
- Support: Pillows for arms and legs; support feet and offload heels as appropriate.
- Watch For: Sliding, shear, poor alignment, discomfort.
Lateral
Lying on the left or right side.
- Uses: Pressure redistribution, personal care, rest.
- Pressure Points: Ear, shoulder, hip, knees, ankles.
- Support: Pillows behind back, between knees, and under head as appropriate.
- Watch For: Pressure on hips and shoulders, joint alignment.
Sims’
Semi-prone side-lying position, typically on the left side with the upper leg flexed.
- Uses: Enemas, rectal procedures.
- Pressure Points: Shoulder, hip, knee, ankle.
- Support: Pillows under head, upper leg, or other areas as needed.
- Watch For: Joint strain, pressure, discomfort.
Prone
Lying face down.
- Uses: Specific treatments, examinations, or prescribed positioning.
- Pressure Points: Face, ears, chest, pelvis, knees, toes.
- Support: Pillows or positioning devices according to the care plan.
- Watch For: Airway obstruction, breathing difficulty, pressure injuries, medical restrictions.
Tripod
Seated upright, leaning forward with arms supported.
- Uses: May improve comfort and breathing mechanics during respiratory difficulty.
- Support: Support forearms on a table or pillows.
- Watch For: Respiratory distress, fatigue, poor balance.
Wheelchair Positioning
Seated with the pelvis and trunk appropriately supported.
- Uses: Mobility, daily activities, social interaction.
- Pressure Points: Ischial tuberosities, sacrum, thighs, heels or feet.
- Support: Proper wheelchair size, positioning cushion, armrests, and footrests.
- Watch For: Sliding, poor alignment, pressure injuries, discomfort.
Important Considerations
- Follow prescribed positioning and mobility restrictions.
- Maintain alignment and protect bony prominences.
- Avoid friction and shear during movement.
- Support limbs without creating additional pressure.
- Reposition according to the individualized care plan.
- Monitor comfort, skin condition, and breathing.
- Fowler’s angle ranges may vary slightly by textbook.
- New or severe breathing difficulty requires immediate escalation; positioning alone is not sufficient treatment.
Related
- Repositioning in Bed
- Wheelchair Transport & Positioning
- Pressure Injuries
- Skin Integrity & Breakdown Prevention
- Limited Mobility
Sources
- CNA Module 5 — Body Mechanics
- Facility positioning guidelines
Flashcards
What distinguishes supine from prone?01-foundations / reference-guidelines
Answer
Supine is lying on the back; prone is lying face down.
What is Fowler's position generally?01-foundations / reference-guidelines
Answer
A semi-upright to upright position with the head of bed raised.