Supine Position is one of our most favorite positions-- it refers to lying on your back with your face up. Most of us enjoy this position especially when we are relaxing on our bed at home or when we are chilling out on the beach. It is the most general way therapist and clinicians prescribe for patients in the hospital when being operated upon.
Here are some examples of the Supine Position outside of laying in bed:
Therapists
Therapists or even personal trainers who teach core stabilization workouts to patients may direct them to lie in a supine position. Your therapist or personal trainer can provide instructions on strengthening core muscles, such as the lumborum muscle, located deep in the abdomen. The supine position also makes it easier for health care practitioners to examine their patients properly.
Technicians
Technicians, such as x-ray technicians, must also be aware of the different positions as defined in medical terminology. In radiology, the supine position implies that the patient is lying down with the X-ray being taken parallel to the horizon.
During surgery
In an operating room, patients that must be in a supine position often have their upper extremities elevated on pillows to avoid complications of being in this position, such as compartment syndrome.
Some anesthesiologists working in conjunction with their surgeon will provide a lumbar plexus block to alleviate elderly patients from severe hip pain. The procedure can be done in a supine position that is guided by ultrasound. The block is also given as a precursor to hip surgery or in tandem with other nerve blocks.
Claude Dixon, a leader in colorectal surgery, recognized the importance of the supine position. He developed the “Dixon surgery” that deals with anterior resection of the colon for tumor removal. However, not all colorectal surgeries take place in this position. A sigmoid colectomy takes place in a lateral decubitus position.
Lumbar puncture procedure
Patients who are to undergo a lumbar puncture lie in this position to help the body re-establish their blood circulation. Also, the cerebral pressure that may be created during a lumbar puncture may lead to headaches which can be prevented by lying in the supine position.
CPR
Patients are placed in the supine position for CPR. The position allows the best access to the respiratory and cardiac systems, especially in cases when the rib cage must be broken in order to get better access.
Women who are to undergo a cesarean delivery also lie in a supine position with pillows to help with proper positioning.
Supine Position Directional Terminology
There are many specific medical terms that refer to positions. It’s crucial that those who work in the medical field, whether as a surgeon or therapist, know exactly what part of the body is being referenced. Here are some common terms and their definitions.
Supine Position Definition:
A supine position is when a person is lying on their back with their face facing upwards. The technical supine definition means that a person’s dorsal (back) side is down while the ventral (abdominal) side is facing up.
A prone position means that you are lying face down. It is the opposite of supine.
Left lateral decubitus position (LLDP) means that the patient is lying on his or her left side. The word decubitus refers to the position adopted by a person who is lying down.
A left lateral position is also called a lateral position. This is when the patient lies on their left side with their upper knee and thigh drawn upward.
Ipsilateral position means belonging to or occurring on the same side of the body. For instance, an ipsilateral lung tumor recurrence is defined as a lung tumor that reoccurs in the same lung as a previous episode.
Variations Of The Supine Position
There are alterations to the supine position and this typically involves tilting the patient in various planes. Among these include the left lateral tilt, right lateral tilt, the Trendelenburg position, and the reverse Trendelenburg. These positions tend to vary depending on the needs of the doctor and the patient during treatment.
Certain surgical procedures require a supine body position with variations. During childbirth, women are often placed in a lithotomy position, where the patient is placed in a supine position with the legs separated in raised stirrups. This position is also used for cytoreductive surgery, a type of surgery to remove tumors in the abdominal area.
Conversely, with the Trendelenburg position, the body is laid on a supine position with the feet elevated above the head. This position allows better access to the intra-abdominal organs as gravity helps pull the organs away from the pelvis.
Disadvantages Of Supine Position
When the body is in the supine position, it can lose its maximum effectiveness in regulating normal venous return. Another downside to this sleeping position is that chest expansion and lung volume can be compromised. Complete inflation of your lungs can become restricted and cause congestion due to the amount of secretion collected. Studies show that a semi-recumbent position (upright positioning of the head and torso at an angle of 45 degrees) is better than a supine position when a person is on mechanical ventilation. Patients in the latter position have a greater chance of developing pneumonia.
Complication linked to lying in a supine position include:
Increased likelihood of gastro-oesophageal reflux. This includes premature infants who may need the head of their crib raised. These babies have not yet fully developed the musculature that can keep acid from coming up the throat.
Brachial Plexus injuries. In the operating room, patients are often placed in the supine position. Proper positioning of the patient is vital to avoid brachial plexus injuries.
Patients who have been diagnosed with obstructive sleep apnea (OSA) are not recommended to go into a supine body position because their airway is more likely to become restricted or obstructed. This can lead to difficulty in breathing which can interrupt your sleep at night.
