1. Patient Positioning

2. Purpose of Positioning in PT
patient comfort
prevent pressure ulcers
prevent joint contractures
provide treatment.

3. Frequency of Positioning
When patient are confined to bed they should be repositioned every 2 HOURS. If they have frail skin, poor circulation or decreased sensation positions should be changed more often.
Patient confined to WC should be taught to relieve pressure on buttocks and thighs every 15 minutes.

4. Positions

5. Preparing The Environment
Preparing the environment assists in safe and effective turning and positioning.
Preparing the environment includes having a clear area for movement and having all necessary supplies i.e. sheets, pillows, and towels.
Additional personnel if necessary

6. 1. Smooth all sheets, towels and patient clothing to avoid increase of pressure and/or irritation on skin.
2. Pillows, rolled blankets, or towels are used to support body parts and to avoid strain or pressure on ligaments, nerves and muscles.
Ensure that enough clear area exists and equipment is ready to move safely.

7. 4. Ensure that sufficient personnel trained in moving and positioning patients is present and ready to assist.
5. Draping should allow appropriate positioning, while maintaining patient modesty and warmth.
6. Whenever possible, patient should participate actively during moving and positioning.

8. Supine (fig 13-1, p 218)
Place small pillow under head to keep head and neck neutral, small pillow under popliteal area and small roll under ankle to relieve pressure under calcaneus.

9. Bony Prominences susceptible to developing pressure sores in supine:
Occipital Tuberosity
Medial Epicondyle of the Humerus
Spine and Inferior Angle of Scapula
Vertebral Spinous Processes
Posterior Iliac Crest
Sacrum
Greater Trochanter of Femur
Head of Fibula
Lateral Malleolus
Posterior Calcaneus

10. Sidelying (fig 13-2, p 218)
lying in lateral recumbent position resting on (L) or (R) side, hips and knees flexed. Head should be supported with 1-2 pillows. The uppermost UE should be placed forward with a pillow supporting. The uppermost LE should be placed slightly forward with folded pillow between the knees.

11. Bony Prominences susceptible to developing pressure sores in sidelying:
Lateral ears, ribs and acromion process
Lateral head of humerus,
Medial and lateral epicondyle of humerus
Greater Trochanter of Femur
Medial and lateral condyles of femur
Malleolus of fibula and tibia

12. Prone (fig 13-3, p 219) Horizontal with face down.
Place pillow or towel roll
under head, instruct pt. to turn
head (R) or (L).
Place a pillow under the lower
abdomen to lordosis.
A rolled towel can be placed
under each anterior shoulder.
Elbows can be bent to 90
degrees. A pillow can be placed
under anterior ankle

13. Bony Prominences susceptible to developing pressure sores in prone:
Forehead, lateral ear, and tip of the acromion process
Anterior head of humerus
Strenum
Anterosuperior iliac spine
Patella
Dorsum of foot

14. Sitting (fig 13-4, p 219) patient should sit with adequate support.
Feet should be on a footstool or footrest.
Hips and knees should be bent to 90 degrees and ankle neutral.

15. Bony Prominences susceptible to developing pressure sores in sitting
Scapula
Vertebral Spinous Processes
Ischial Tuberosities