Patient Positions HSTP

Sitting

The patient sits unsupported with her feet flat on the floor.

used for physical exams of the head, neck, chest, back, eating or swallowing, and to ease difficulty breathing.

Supine

The patient lies flat on his back with extended legs and arms at sides. 

The position is used for physical assessments of the head, neck, chest, abdomen, and extremities, diagnostic imaging, and procedures requiring access to the anterior body.

Prone

The patient lies flat on his stomach with hips flexed, legs extended, and head turned to one side. 

The position is used for neck, back, and spinal surgeries, and to improve oxygenation in critically ill patients with severe respiratory failure.

Lithotomy

The patient lies on her back with hips and knees flexed, legs elevated and supported in stirrups, and thighs apart. 

The position is commonly used for gynecologic reasons like pelvic exams, vaginal ultrasounds, hysterectomies, and childbirth, but it can also be used for urologic procedures.

Lateral

The patient lies on one side of his body with hip and knee flexed. 

This side-lying position is used to relieve pressure on the back and heels, to prevent choking while unconscious, to allow access for hip surgeries, and for comfort.  Pregnant women are advised to sleep in the left-lateral position.

Sim’s

This is a left-side lying position where the patient’s lower arm is extended behind the patient, and the upper arm is flexed in front of the patient at the shoulder and elbow. Both legs are flexed at the hip and knee, but the upper leg is more acutely flexed at the knee.

The position is used for rectal exams and procedures, perineal exams, to prevent choking while unconscious, and for comfort.

Semi-Fowler’s

The patient lies with the head of the bed elevated 30-45 degrees and legs extended. 

The position is used for comfort, to ease breathing and promote lung expansion, to reduce the risk of aspiration during tube feedings, and to reduce strain after abdominal surgery.

High-Fowler’s

The patient lies with the head of bed elevated to 60-90 degrees and legs extended. 

The position is used to ease respiratory distress, prevent aspiration during meals, assist with tube feedings or insertion of nasogastric tube, and for certain exams and imaging studies.

Knee-Chest

The patient kneels and lowers his shoulders so his face and chest rest on the exam table. 

The position is primarily used for rectal exams and some lower spine surgeries.  A modified knee-chest position can be obtained by patients lying on their left side and pulling their knees to their chest.

Trendelenburg

The patient lies flat on his back with the head of bed lowered 15-30 degrees below the feet. 

The position improves surgical access to pelvic and lower abdominal organs by using gravity.  It was historically used to treat shock and hypovolemia, but this is no longer a routine practice.

Reverse Trendelenburg

The patient lies flat on his back with the head of bed raised 15-30 degrees above the feet. 

reduces blood flow and pressure to the head, prevents acid reflux, and helps surgeons visualize upper abdominal organs.

Orthopneic

The patient in a sitting position leans his body forward with arms propped over the bed table, pillows, or his knees. 

This eases respiratory effort by pulling abdominal organs away from the diaphragm, allowing maximum chest expansion, and engaging accessory muscles in the neck and shoulders