1. October 7, 2005
PTA 110
Positioning
Draping
Bed Mobility

2. Positioning
 Why do we spend time on positioning?
 Patient comfort/decrease pain
 Support and stability to pt’s trunk &
extremities
 Prevent development of pressure sores
 Prevent joint contractures
 To have easier access to area being treated
 Decrease edema
 Increased function

3. Positioning
 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
condition
 What about restraints?

4. Considerations with positioning
 Who is at risk?
 Elderly
 Those unable to change their own position
 Those with decreased sensation
 Those who may be unable to communicate
their discomfort

5. Pressure Points To Consider

6. When do we change position
 Medicare standards = common practice
standards
 Change every 2 hours
 At the conclusion of treatment
 Check with nursing on preference

7. What do we use
 Pillows
 blankets
 Heel protectors
 Splints, slings & braces
 Seat cushions
 Wedges
 Others??

8. Standard Positions
 Supine
 Prone
 Side- lying
 Semi-fowler
 Sitting

9. Standard Positions
 Supine
 Pillow under head to keep c-spine neutral
 Small pillow or towel roll for cervical support
 Support under popliteal space to ↓ lumbar
lordosis
 Ankle support to relieve pressure on
calcaneus
 Support under elbows to relieve pressure on
bony prominence

10. Supine Position

11. Standard Positions
 Prone
 Pillow under head
 Pillow under lower abdomen to ↓ lumbar
lordosis
 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

12. Prone Position

13. Standard Positions
 Sidelying
 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
rolling
 Pillow under top arm to keep chest open

14. Sidelying Position

15. Standard Positions
 Semi-fowler
 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°

16. Semi-Fowler Position

17. Standard Positions
 Sitting
 Variety of seated positions
 Straight, recumbent, semi-recumbent
 Remember to soften bony prominences
 Arms and legs supported (head if necessary)
 Elbows at 90°

18. Draping
5 minute Break

19. Draping
 Reasons for draping pt’s:
 Privacy/modesty/dignity
 Warmth
 Hygiene
How do you feel at the Dr’s office with no
clothes on????

20. Draping
 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

21. Draping
 Be sure you keep legal considerations in
mind
 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
times

22. Bed Mobility
 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?

23. Most Common Movements Of
Bed Mobility:
 Turning from supine to sidelying position
and returning.
 Supine to prone positioning and returning.
 Moving in bed-upward, downward, side to
side.
 Rolling
 Bridging exercises
 Moving from lying to sitting EOB.

24. How do you actively involve
the patient in bed mobility
instruction?

25. What are some
ways/techniques you can
use to reduce the patient’s
and your energy
expenditure during bed
mobility activities?

26. 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
that be?
 Examples of bed mobility exercises we will
cover today in lab are on pages 132-140.

27. 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.