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What Is Fowler's Position?

By Glyn Sinclair
Updated Mar 03, 2024
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Fowler’s position refers to the position a patient is placed in before, during and after surgery. Named after George Ryerson Fowler during the late 1800s, the Fowler position is actually several different positions. They all refer to differing degrees of height and angle and include low, semi-high, high and the standard Fowler’s position, also simply known as “Fowler’s”. The positions are typically used to release strain on the patient’s muscles and to improve breathing. They are also help with fluid drainage during and after certain surgeries.

Different surgical procedures tend to have patients in different Fowler’s positions. The low position will have the head of the bed raised approximately 15 to 30 degrees. The semi position has the patient seated in a semi-upright position of 30 to 45 degrees with the knees bent or straight. This placement is often used for nasal, shoulder, cranial and even breast reduction surgeries. It can ease tension on the stomach muscles and help with breathing.

The patient’s head is raised 45 to 60 degrees in the standard Fowler’s position, whereas in the high position the head is raised 80 to 90 degrees. The high position is typically used for feeding patients, taking X-rays and when they are experiencing breathing difficulties. The standard Fowler’s position is often used during surgeries to the nasal and oral cavities and helps to promote drainage and prevent aspiration, which is inhaling substances from the stomach into the respiratory tract.

There are other patient positions that are related to Fowler’s position. The Trendelenburg position has the patient lie on his back with his feet at a slightly elevated position to the head, typically in the range of 15 to 30 degrees. The reverse Trendelenburg position has the patient in the same flat position but this time the configuration is reversed. This position is typically used for gynecological and abdominal surgery as it works to draw the intestines away from the pelvis. This allows greater access to the organs.

The Sims’ position is generally used when performing rectal examinations. The patient will lie on their left side with the right knee bent, taking care that it does not come into contact with the right leg. The right arm extends behind the back and the left hand is drawn up to the face. A pillow is usually placed beneath the patient’s head. This position can be a little uncomfortable for elderly people.

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Discussion Comments
By Ana1234 — On Jan 28, 2013

I think that people get used to the idea of a single position for all surgeries because they see it on TV all the time. But, it only looks like that on TV because they want the patient to look like a person for dramatic effect and that means the face needs to be visible.

In reality, I'm sure that doctors often need to have the patient face down or even on their side all the time, but that just doesn't look as good on TV.

By pleonasm — On Jan 27, 2013

@croydon - When my mother went in to have her pacemaker put in, she was only under a local and so she was awake through the whole thing (although she was very groggy). She said that the position was actually the worst thing. They didn't want her to see the operation (I guess so she wouldn't panic) and they kind of had her slightly on her side, with a sheet covering her head so that she couldn't see anything.

The sheet made her panic more than the operation, because she couldn't move and felt like she was going to suffocate. Luckily they had someone sitting at her head the whole time to make sure she was OK and he moved the sheet for her so that she felt better.

By croydon — On Jan 27, 2013

I've never really thought about the fact that they might need to position people differently for different operations. I guess I knew that if they were operating on the brain, the person was usually upright so that the head was closer to the surgeon (and also so that the person was comfortable, since they are often kept awake to monitor brain activity), but that was about it.

I guess they have all of this stuff down to a science, since it can make the difference between life and death for a patient.

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