# Transport Positions



## micsaver (Oct 28, 2008)

Looking for a list of the kinds of pts or conditions in which you're suppose to transport with pt laying on their left side. Only one I can think of at the moment is a pregnant woman. Also when is it not good to lay the person flat, when is it not good to raise them up to semi-f?


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## jochi1543 (Oct 28, 2008)

Flat is not particularly comfortable for someone with shortness of breath - you usually wanna put them in semi-Fowler's, it makes it easier for them to breathe.
I don't have my book now, I think if you have someone with decompression sickness/air embolism, you turn them on their side, but I can't remember if it's on the right or left side. Something about trapping air bubbles in the right atrium, so I'd assume on the left, but double-check this in the diving emergencies section of your textbook.


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## FF-EMT Diver (Oct 28, 2008)

The reason for laying a pregnant female on her left side is some times the Pt. will be hypotensive from the uterus pressing down on the Vena cava, Also this position is sometimes just more comfortable for them.

A CHF Pt.does not need to be layed supine due to fluid buildup, Especially if you can hear the fluid on inhalation/exhalation.


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## rmellish (Oct 28, 2008)

Breathing difficulties such as COPD exacerbation, and some CHF issues do better in semi-fowlers. 

SF would not be good for patients in shock. 

Whenever realistic, transport in a position of comfort for the patient.


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## KEVD18 (Oct 28, 2008)

skip memorizing all sorts of bs rules and try thin one on for size:

unless otherwise contraindicated(i.e. cspine, impaled object, etc), transport your patients in the position of comfort.

chf'ers are going to want to sit bolt upright. are you going to make them recline becuase a text book says so? abd pain patients will frequently want to assume the fetal position(or as close to it as they can). again, why argue?

i love simple rules of thumb that work across almost the entire spectrum. simple, easy to remember.


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## Code 3 (Oct 28, 2008)

micsaver said:


> Looking for a list of the kinds of pts or conditions in which you're suppose to transport with pt laying on their left side. Only one I can think of at the moment is a pregnant woman. Also when is it not good to lay the person flat, when is it not good to raise them up to semi-f?



As stated above by FF-EMT Diver, pregnant woman could potentially suffer from Supine Hypotensive Syndrome and you should use the left lateral recumbent position. If they require C-spine, you can place padding under one side of the backboard in order to tilt it.

Here are some other reasons for using the recovery position:


Stroke patients (position on unaffected side)
ETOH

I know there are a few more, but I can't recall them at this time. The book also states that patients should not be in this position for longer than 30 minutes due to circulation issues.


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## JPINFV (Oct 28, 2008)

KEVD18 said:


> skip memorizing all sorts of bs rules and try thin one on for size:
> 
> unless otherwise contraindicated(i.e. cspine, impaled object, etc), transport your patients in the position of comfort.



This, a million times this. Position of comfort (POC) rules. The only two times I can think of for laying a person on their side (excluding times where POC is on their side) is altered nausea/vomiting patients and pregnant patients. If the patient is laying facing you then it's easier to clear the airway if they are already on their side. Of course patients in shock being laid supine takes priority to lateral recumbent and fowlers/semifowlers takes priority over both.


Since we're dealing with patient position, don't be afraid to think outside of the box. One transport that I had that stuck out was a board and care patient (A/Ox4, no hx of neuro/psych disorders) with an arm fracture that was confirmed prior to being called by a mobile x-ray. I ended up just using a cardboard long splint cut to size to immobilize the arm with the arm being straight. Now how do you transport a patient when their arm is in a long splint? Simple. Obtain consent from the patient to restrain their splinted arm to the armrest on the gurney. The splint/arm unit can be tied down with gauze at 3-4 points which would provide a nice platform for the arm to rest on. To unrestrain at the ER we just cut the gauze and moved the patient over.


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