PPPP: Patient Positioning for Painful Procedures

All too often I walk through the ED and see nursing staff, junior, and sometimes senior medical staff performing painful procedures (such as venepuncture, IV cannulation, digital nerve block or plaster application to an acute fracture) on patients sitting in chairs, often with the body part being treated resting on the bed or trolley! I also frequently see the patient looking distressed or just getting vagal/pre-syncopal in this position. Occasionally one will faint mid-procedure and fall off the chair, or their friend/relative who was left standing in the corner watching will faint and then we have two patients instead of one.

What could go wrong if you sit a patient in a chair during a painful procedure:

Patient positioning 1

WHOOPS!

Patient positioning 2

Bad for patient because:

  • #embarrassing
  • potential injury
  • failed procedure

Bad for you because:

  • #veryembarrassing
  • failed procedure

SO INSTEAD:

  • Put the PATIENT ON THE BED!
  • Use the chair and save your back

Patient positioning 3

IF THE PATIENT FAINTS

  • They are safe
  • Gently lay them flat

Patient positioning 4

So with that in mind, please follow these simple steps when performing ANY procedure that involves needles, pain or the sight of blood.

  • Do NOT do painful procedures with patient sitting on a chair!
    • Use the BED for the patient’s BODY!
    • If there are no beds/trolley available – the procedure can wait
  • Do not bend over a patient while doing a procedure
    • Use the CHAIR for YOUR body
    • And/or raise the bed so you are not straining your lower back
  • All friends/relatives MUST
    • Leave the room OR be seated during procedures
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