Set of activities performed to mobilize a patient who is unable to move on their own.
Objectives:
– To place the patient in the indicated position to achieve comfort or to perform some care or exploration. – Prevent possible complications (pressure ulcers, deformities, circulatory disorders, etc).
Equipment:
See equipment for mobilization of patients.
Material:
See material for mobilization of patients.
Procedure:
1. Supine or dorsal decubitus:
– Follow general rules in the mobilization of the patient. – Place the bed in a horizontal position, making sure that it is braked. – Place the patient lying on his back, with legs extended and arms beside the body, keeping the longitudinal axis. – Place the pillow under the head, lumbar area and popliteal hollows. – When the patient moves towards the foot of the bed, raise him/her towards the head according to the patient’s movement procedure. – Adjust the head of the bed according to the patient’s needs and comfort. – Monitor the occiput, shoulder blades, elbows, sacrum, coccyx, heels and toes. – Supine dorsal decubitus position to relax the abdominal muscle walls: the patient is in this position but with the legs bent at the knee and slightly apart. The soles of the feet are resting on the bed. Indications: examination of the chest, abdomen, upper and lower limbs, postoperative, stay in bed, position changes, breast palpation. Contraindications: elderly, respiratory patients, long term bedridden patients.
2. Prone or ventral decubitus:
– Follow general rules for mobilization of the patient. – Place the bed in a horizontal position, making sure that it is braked. – Place the patient in an extended position on the thorax and abdomen. – Rest the head on a small pillow, avoiding excessive distension of the spine. – Place a small pillow under the abdomen below the diaphragm. – Support the arms in a flexed position at shoulder height. – Place a small pillow under the flexure of the feet to elevate the toes. – Watch the toes, knees, genitals in males and breasts in females, cheeks and ears.
Indications: back examinations, spinal surgery patients, postural changes.
3. Roser or Proetz position:
The patient is in supine decubitus with the head hanging, with the objective of maintaining the neck in hyperextension. Indications: tracheal intubation, pharyngeal explorations, surgical interventions (goiter), hair washing in bedridden patients.
4. Lateral decubitus:
– Follow general rules in the mobilization of the patient. – Place the bed in a horizontal position, making sure it is braked. – Place the patient in an extended position on the right or left side. – Place a pillow under the head and neck. – Place both arms in slight flexion. The upper arm rests at shoulder height on the pillow. The other arm rests on the mattress with the shoulder slightly forward. – Place a pillow under the upper leg, semi-flexed from groin to foot. – Place a pillow on the patient’s back to support the patient. – Elevate the head of the bed according to the patient’s needs and safety. – Monitor the areas of the ears, shoulders, elbows, iliac crest, trochanters, knees and malleoli. Indications: administration of enemas, suppositories, intramuscular injectables, bed rest, postural changes and to make the bed occupied.
5. Sitting position:
– Follow general rules in the mobilization of patients. – Place the patient in a seated position, the patient is seated on the bed with the lower extremities extended and with the upper extremities facing forward, with the hands resting on the bed. – Place a pillow to support the head and another in the lumbar area. – The orthopnea position: sitting on the bed with a bed tray on the lap, leaning forward on a pillow. This posture facilitates breathing.
6. Fowler and semi-fowler position:
– Follow general rules in mobilizing patients. – Place the patient in the supine position. – Elevate the head of the bed between 45º and 60º. – Remove pillow from the head. – Place a pillow in the lumbar area, another one under the thighs and a small pillow under the ankles. – Monitor the sacrum, ischial tuberosity, heels and elbows. – The semi-fowler position has a degree of inclination of less than 30º. – The modified fowler position differs from the fowler position in the arching of the knee joint and when the patient is seated with tilt and resting on a table or several pillows. Indications: ENT examinations, patients with respiratory problems (asthma, COPD, emphysema), abdominal muscle relaxation, patients with cardiac problems, head and thorax examinations.
7. Trendelemburg position:
– Follow general rules in the mobilization of the patient. – Place the patient in the supine position, tilting the plane of the bed in such a way that the patient’s head is in a lower plane than the lower limbs. – Monitor shoulder blades, sacrum, coccyx, heels, toes, elbows and head protection. – Monitor the patient’s state of consciousness to avoid aspiration in case of vomiting. – The antitrendelemburg or Morestin position tilts the plane of the bed so that the head is above the lower limbs. Indications: radiographic examinations, in surgical interventions (goiter), in case of hiatus hernia, patients with respiratory problems, facilitates blood circulation at the level of the lower limbs. Indications: improves cerebral circulation, lipothymias or syncope, concussion or shock, drainage of bronchial secretions, to prevent headaches after lumbar puncture, hemorrhages and pelvic organ surgery.
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