Guide to the Folwer Pose


Patient positioning is critical to a safe and effective surgical procedure. The Fowler position is the most common position for patients to rest comfortably, whether in the medical field or in the emergency department. Also known as the sitting position, the Fowler position is commonly used for neurosurgery and shoulder surgery. Variations of the standard Fowler pose include the low Fowler pose, the half Fowler pose, and the high/full Fowler pose.

For many applications, the Fowler position is used for patients who have difficulty breathing. Because in this position, gravity pulls the diaphragm down allowing for more expansion of the ribcage and lungs.


The basic Fowler position, also known as the sitting position, is commonly used for neurosurgery and shoulder surgery. Bed angle from 45 degrees to 60 degrees. The patient’s legs may be straight or slightly bent. This position is commonly used for head, chest, and shoulder surgeries.

The basic Fowler position is the preferred position to combat respiratory distress syndrome. Because the position of the bed allows for better chest expansion, breathing improves by facilitating better oxygen entry into the body. Other advantages include increased blood volume and cerebrospinal fluid drainage and improved hemostasis.

All models of Mediland’s operating table with 5-part table top support the basic Fowler position in general and the shoulder surgery position in particular. To best support doctors and medical staff in shoulder procedures, Mediland offers a shoulder surgery accessory package that includes: 

Accessories for shoulder surgery PA54 PA14 . high arm board


In addition to shoulder surgery, craniotomy is also a common type of procedure using the Fowler position. In order to best support the posture during the sitting craniotomy, Mediland has the following accessories:

PA30 . head support PA14 . high arm board


The low Fowler position, like the supine position, is when the patient’s head is brought into a 15–30 degree angle. This position can be used after the procedure, to relieve lower back pain, administer medication, and prevent aspiration during tube feeding. The low Fowler position is considered the best position for the patient to rest.


In the Semi Fowler position, the patient is usually supine. Bed angle from 30 degrees to 45 degrees. The patient’s leg may be straight or curved.

Semi Fowler’s Position can be used when the patient is facing shortness of breath or on breathing therapy and when drainage occurs after abdominoplasty. Due to positioning Semi Fowler is the preferred position during childbirth to improve the comfort of the mother. In addition, the patient felt less nausea in this position than in the lying patient.


In High Fowler’s position, the patient is usually seated upright with the spine straight. The upper body is from 60 degrees to 90 degrees. The patient’s leg may be straight or curved. This position is often used when the patient is defecating, eating, swallowing, taking X-Rays, or to help with breathing.

The High Fowler position is often prescribed to elderly patients because it has been scientifically proven to aid digestion and help patients with breathing problems. Resting in the High Fowler position for long periods of time can cause discomfort and increase the development of pressure sores.

Limitations of the FOWLER . Pose

The patient’s position is primarily for the sake of anatomical exposure for the surgical procedure. In cases where the patient cannot tolerate a good sitting posture, adjustments can be made to accommodate any patient intolerances. For example, a patient with a pressure ulcer on the lower back or buttocks may not be able to tolerate a sitting position.

Additional measures may be needed to reduce pressure and contact of the injured area with hard surfaces. These may include additional cushioning, changing the angle, and using an incline to remove pressure at the site of injury. In addition, patients with previous spine surgery may have limited range of motion, making this position contraindicated. The patient should be evaluated for the tolerability of this position and for any intrinsic patient factors that may present any additional risk to the patient.


The Fowler position can be achieved in a variety of ways using other parts of the general operating table or through the addition of operating table accessories and positioning aids. Surgical table positioning aids and accessories commonly used when using the Fowler position include an operating table with Beach Chair position or a foam body position device.

The operating table with Beach Chair position is most commonly used to position High Fowler’s in shoulder orthopedic procedures (total shoulder replacement, shoulder arthroscopy, rotator cuff, etc.). Operating tables with this position usually have removable left and right backs to access the surgical site with the patient’s shoulder. This type of operating table also has a lateral support that is used to keep the patient upright and limit body movement during severe upper limb procedures.

The limb positioner is often used in conjunction with the operating table when using the High Fowler position in shoulder orthopedic procedures. Basic limb locators may include arm and elbow locators to balance the patient’s surgical arm to access the surgical site or the nonsurgical arm(s). to get them out of the surgeon’s operating area. More advanced limb locating devices allow the surgical team to position the patient’s arms in unique spatial positions allowing surgical site access to the shoulder through a range of shoulder joint procedures . Surgeons may also use advanced limb locators for non-Fowlers positions; eg, in a side-lying patient position to allow hovering arm positioning for shoulder orthopedic procedures.

Multi-position armrests are similar to basic limb locators in that they facilitate balanced positioning of the patient’s surgical arm to access the surgical site or(s) non-surgical arm to help the surgeon access the area to be operated on.

Neurosurgery head restraints and head locators are commonly used in Semi-Fowler and High Fowler positions to access the surgical site with the patient’s skull, face, and neck anatomy. The general table is usually positioned using natural table sections (not using the Beach Chair pose) to achieve Fowler’s desired position. The natural head of the operating table is usually removed, and desired anterior or posterior positioning accessories are attached to facilitate head immobilization and access to the surgical site.

Gel and foam locators are commonly used on all Fowler variations. Common positioning aids that assist patients in Fowler positions include head restraints, masks (for Beach Chairs), arm supports, wedge locators (for legs or foot), heel and ankle supports and ovoid foam pads to protect or reinforce key anatomical areas. Preoperative evaluation of the patient is always advised to evaluate the patient’s skin, body morphology, bony prominences, and any special anatomical areas that need to be considered only during surgery. art.


One of the most popular patient positions, the Fowler position provides better surgical exposure and improved breathing. The surgical staff should consider the risks and complications associated with Fowler’s position, such as:

  • Decreased blood return to the heart
  • Venous embolism
  • Gas inside the skull
  • Increased likelihood of airway loss
  • Increased risk of nerve damage and facial swelling

Variations to the Fowler’s position include the Basic Fowler, Low Fowler, Semi-Fowler, and High Fowler positions.

Regardless of which position is being used on the patient during surgery, it is important to follow best practices for positioning. Surgical staff should always refer to their facility’s positioning policies, procedures, and training when locating patients.

  • Having a sufficient number of staff, equipment, and instruments available for positioning operations helps ensure patient and staff safety.
  • Respect patient privacy during positioning: only necessary people in the room when the patient is exposed.
  • Hold the patient in a naturally balanced position. Keep the patient’s head and neck in a neutral position, without excessive rotation and avoid stretching.
  • Verify that the patient’s complete body is in physiologically fit condition and that the hands, fingers, feet, and toes are protected from the operating table joints.
  • Operating room staff must remain safe during patient transfer and positioning.
  • Ensure that the patient does not come into contact with any metal parts of the operating table or positioning devices.
  • Never exceed the weight limit for the table or accessories used and always follow the manufacturer’s instructions and recommendations when using the operating table and accessories.
  • Inspect all equipment, gaskets and accessories prior to use and replace them if necessary.

Leave a Reply

Your email address will not be published. Required fields are marked *