Bed postural care is fundamental in avoiding joint deformities and skin ulcers.
Any of the bed positions should be as comfortable as possible, painless and allow the patient to breathe and move easily.
Even in periods of complete rest, it is convenient to have the patient sit in bed, supporting the back with pillows or cushions.
There are two positions commonly used while the patient remains lying down, face up or the side position (left or right), and it is recommended to alternate these every 3-4 hours.
The FACE UP position places the least amount of pressure on the spine. The bed should be horizontal, resting the head on the pillow, keeping the body in line, legs extended, and placing cushions or a pillow to support the leg and foot, avoiding the outer rotation of the lower extremity and the "fallen" foot. Pillows should NOT be placed below the knees since this can lead to flexion deformity, and we should not forget to protect the pressure areas, such as elbows and heels, to prevent skin lesions, and also avoid having the sheets place pressure on the feet.
In the SIDE POSITION the bed should also be horizontal, resting the head on the pillow in line with the back, positioning the arms comfortably for the patient, with legs partly bent, placing a pillow between the knees to avoid pressure, and if necessary, another one for the back.
These side positions are ideal when performing the chest clapping procedure that consists of softly "tapping" the chest with cupped hands in order to mobilize lung secretions.
This position is not recommended, except to prevent or correct flexion contractures of hips and knees, or when ulcers are present on buttocks, hips and heels. In these situations avoid using the pillow below the head, place the arms lengthwise next to the body or flexed below the head, and position a small pillow below the abdomen in order to relax the lumbar region.
The feet may hang over the edge of the bed to prevent clubfoot deformity.