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Padding in Bed

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The goal of padding is to relieve pressure between your bones and the surfaces you sleep or sit on. The following instructions are only guidelines, not rules, to use when padding in bed. You must watch your skin and make adjustments to padding, as needed, based on your individual needs.

Padding is just one aspect of preventing and treating pressure sores. Whenever using a new product, like foam pads or “quad pads,” a new pillow, or a new mattress, make sure it reduces pressure especially to the boney areas of your body. If you notice any redness or skin irritation, remove pressure from the area and contact your wound care specialist or primary care provider immediately.

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Revised: 1/2015

Back or "Supine" Position

PadBody PartPlacement
Pad #1HeadPlace a pillow under the head and upper shoulder for comfort and to keep neck neutral.
Pad #2A Pad#2BTailbonePlace pad 2A above sacrum and pad 2B below sacrum. When pads 2A and 2B are placed correctly, a flat hand can be placed between the body and the bed to ensure that pressure has been relieved. If pressure has not been relieved, an additional pad can be added under 2A and 2B.
Pad #3KneesIf the knees appear to be hyper-extended, pad above the knee space; otherwise no padding is needed. Pad must NOT be placed directly under the knees.
Pad #4HeelsPad above the heels to prevent pressure.
Pad #5FeetPad the feet to provide proper foot position.
Pad #6Lower LegsPad between the knees and ankles to prevent pressure at the knees and inside of the ankles.
Pad #7a, 7b, 7cArmsPosition pillow to keep chest open and shoulders back as in the diagram below.

Half-Back or "Semi Supine" Position

PadBody PartPlacement
Pad #1HeadPlace a pillow under head and upper shoulder for comfort.
Pad #2BackPlace a pillow behind patient’s back. Do not push pillow up against shoulder blade. Keep shoulder blade in a back position to keep chest open.
Pad #3Lower ArmDo not pinch the lower arm under the body. Support arm with a pillow. See diagram below.
Pad #4Upper ArmKeep elbow of upper arm at side. Position the upper arm so the chest is open. Support arm with pillow (per diagram).
Pad #5Lower BackTurn hips to side and support position with pad to lower back.
Pad #6Lower LegsPlace a pillow lengthwise between the lower legs. The top leg is positioned forward on the pillow. Do not position legs directly on top of each other. May need to bend the knee more to prevent from rolling back.
Pad #7AnklePad above the ankle bone on the bed.

Stomach or "Prone Position

PadBody PartPlacement
Pad #1HeadPlace a pillow under the head for comfort.
Pad #2ChestThis is an optional pad for comfort.
Pad #3A Pad #3BHip BonesPlace pad 3A above hip bones and pad 3B below hip bones. When pads 3A and 3B are properly placed, pressure is relieved: 1) on the hip bones, 2) on the suprapubic catheter, and 3) on penis and scrotum of the male patient. These pads also allow for proper body alignment and ease breathing.NOTE: Pads 3A & 3B are not standard on all patients unless required to promote catheter tube drainage or prevent pressure on male genitalia.
Pad #4KneePad above the knees to maintain the natural curvature of the knees and relieve pressure on the knee bone.
Pad #5Lower LegsPlace pillow(s) crosswise under both lower legs (the shins). This pillow allows: 1) the lower leg and foot to be slightly flexed at the knee, 2) pressure relieved at knee, 3) correct extension of muscles of the thigh, and 4) prevents foot-drop if feet do not extend to the end of the bed.
Pad #6Between Lower LegsPad between the knees and ankles to prevent pressure at the knees and the ankles.

Side Position

PadBody PartPlacement
Pad #1HeadPlace a pillow under the head for comfort.
Pad #2BackPlace 2 pillows behind the patient’s back to maintain side position. Top hip will be slightly rolled back to prevent patient from lying directly on the hip and leg bones. A 30 degree side lying position is best.
Pad #3WaistPlace a pillow or pad lengthwise from the armpit to the waist to support body weight and to decrease shoulder pressure.
Pad #4A Pad #4BHipPlace pad 4A above the hip and pad 4B below the hip. When pads 4A and 4B are placed correctly, a flat hand can be placed between the body and the bed to ensure that pressure has been relieved. If pressure has not been relieved, an additional pad can be added under 4A and 4B.
Pad #5Lower LegsPlace a pillow lengthwise between the lower legs. The top leg is positioned forward on the pillow. Do not position legs directly on top of each other. May need to bend the knee more to prevent from rolling back.
Pad #6AnklePad above the ankle.

3/4 Stomach or "3/4 Prone" Padding

PadBody PartPlacement
Pad #1HeadPlace a pillow under the head for comfort.
Pad #2ArmThe shoulder should be protracted with the arm forward on a pillow.Bottom shoulder should be pulled backward to decrease pressure on shoulder.
Pad #3LegThe upper leg is in front of the body on a pillow.Bottom leg/hip needs to be rotated to ensure there is no pressure on the hip or the top of the leg bone.
Pad #4AnklesPad above ankle to prevent pressure.

Halo Best / Back or "Supine"

PadBody PartPlacement
Pad #1HeadA soft pillow or small pad can be placed under the patient’s head. AVOID direct pressure on the halo ring. The halo ring must remain off the mattress. There is to be no firm pressure under the neck area as this may cause hyperextension of the cervical spine.
Pad #2Below VestA pad is placed below the back vest hardware to prevent the hardware from puncturing tilt tables, mattresses and linen, and to keep weight off of the halo ring.
Pad #3A Pad #3BTailbonePlace pad 3A above tailbone and pad 3B below tailbone. When pads 3A and 3B are placed correctly, a flat hand can be placed between the body and the bed to ensure that pressure has been relieved. If pressure has not been relieved, an additional pad can be added under 3A and 3B.
Pad #4KneesIf the knees appear to be hyper-extended, pad above the knee space; otherwise no padding is needed. Pad must NOT be placed directly under the knees.
Pad #5HeelsPad above the heels to prevent pressure.
Pad #6FeetPad the feet to provide proper foot position.
Pad #7Lower LegsPad between the knees and ankles to prevent pressure at the knees and inside of the ankles.

Halo Vest / Side

PadBody PartPlacement
Pad #1HeadA soft pillow or small pad can be placed under the patient’s head. AVOID direct pressure on the halo ring and head. The halo ring must remain off the mattress. There is to be no firm pressure under the neck area as this may cause hyperextension of the cervical spine.
Pad #2BackPlace a pillow behind the patient’s back to maintain side position. Top hip will be slightly rolled back to prevent patient from lying directly on the hip. A 30 degree side lying position is best. Avoid direct pressure on shoulder.
Pad #3WaistA pad is placed lengthwise from the armpit to waist to maintain proper body alignment, for vest support and pressure equalization and to prevent undue pain and pressure on the shoulder.
Pad #4HipPlace pad 4A above the hip and pad 4B below the hip. When pads 4A and 4B are placed correctly, a flat hand can be slid between the body and the bed to ensure that pressure has been relieved. If pressure has not been relieved, an additional pad can be added under 4A and 4B.
Pad #5Lower LegsPlace a pillow lengthwise between the lower legs. The top leg is positioned forward on the pillow. Do not position legs directly on top of each other.
Pad #6AnklePad above the ankle.

This resource is provided as a courtesy of Craig Hospital. For more information, contact the Craig Hospital Nurse Advice Line at 1-800-247-0257.

Disclaimer: The content in this document is intended for general informational purposes only and is not a substitute for professional medical advice or treatment for specific medical conditions. No professional relationship is implied or otherwise established by reading this document. You should not use this information to diagnose or treat a health problem or disease without consulting with a qualified healthcare provider. Many of the resources references are not affiliated with Craig Hospital. Craig Hospital assumes no liability for any third party material or for any action or inaction taken as a result of any content or any suggestions made in this document and should not be relied upon without independent investigation. The information on this page is a public service provided by Craig Hospital and in no way represents a recommendation or endorsement by Craig Hospital.