Fowler’s position is known as a standard patient’s position and was the invention of George Ryerson Fowler. The technique is generally carried out for oral and nasal gastric feeding of the patients in the hospital, for radiology that is, if the X-ray is required to be taken from the side of the bed, when the patient faces difficulty in breathing or is undergoing some breathing treatment, when the person is dependent on the drainage after going through abdominoplasty, or sometimes for general grooming, etc. (1)
What is Fowler’s Position?
A person is basically in Fowler’s position when the top of the bed is raised up. The body of the patient can be inclined at an angle ranging from 90 to 15 degrees depending on the variant of Fowler’s position that the person is in. The legs of the patient may be straight, or either bent at the knees.
The position is generally preferred as an option in respiratory distress syndrome since it allows better chest expansion and improves breathing by facilitating oxygenation (2). This position is also ideally suitable for implementation of oral and gastric feeding in the patient’s body. For the patients who are incapable of moving, this position allows normal talking, eating and supports easy swallowing using the principle of gravity.
There are three variants of the Fowler’s position, viz, semi Fowler’s position, low Fowler’s position and high Fowler’s position. The application of particular type depends upon the requirement of the patient or his medical conditions.
Semi Fowler’s Position
A person is in semi Fowler’s position if he is lying in the supine position on the bed which is inclined at an angle of 30 to 45 degrees. This position is often applicable for the patients who have cardiac problems, respiratory ailments or neurological issues. It is also considered as the most comfortable position for patients who have the nasogastric tube fitted as it ensures that the tube remains fixed in its place. Besides this, semi Fowler’s position is also used for shoulder, nasal, cranial, abdominal and breast reconstruction surgeries.
Another factor that contributes to the popularity of this posture is the fact that the person resting in the Semi Fowler’s position experiences the lower intensity of nausea as compared to the one lying in other surgical positions such as supine position. This thus makes it perfect for the patients undergoing the treatments that trigger nausea such as chemotherapy. According to a study, the patients who were administered with chemotherapy in Semi Fowler’s position experienced comparatively less severe nausea (3).
Low Fowler’s Position
This position is considered best considering the rest of patient’s body. In this position, the head of the bed is generally inclined at an angle of 15 to 30 degrees.
High Fowler’s Position
This is the position in which the patient is straightened up. The upper part of the body generally makes an angle of 60 to 90 degrees with respect to the lower portion of the body. While allowing easy breathing, this position is also considered the best position for defecating, eating, swallowing and also for taking the x-rays.
The patients falling in the older age group generally spend more time resting in their beds. This is the reason they often face the problems associated with the digestion and respiration. This position is thus popularly prescribed to the elderly patients as it is scientifically proven to aid the digestion process and also helps the person to overcome the breathing problems. However, it also has risks associated with it as the studies have revealed that resting in this position also applies pressure on the sacral and gluteal areas. This makes the patients prone to the development of pressure ulcers. Besides this, the position is not as comfortable as the other alternatives (4).