The position that puts resident at greatest risk of shearing injuries to the back, sacrum, and coccyx is

The position that puts resident at greatest risk of shearing injuries to the back, sacrum, and coccyx is

• A. Supine
• B. High-Fowler's
• C. Side-lying
• D. Semi-Fowler's

Answer: (B)

Shear injuries happen when the skin slides against a surface while the underlying tissues remain fixed. This friction is most harmful over bony prominences like the sacrum and coccyx, where skin is close to bone. In the High-Fowler’s position, the torso is raised high and gravity tends to pull the body toward the edge of the bed, causing the buttocks to slide against the mattress even as the upper body remains supported. That sliding creates shear forces at the sacral and coccygeal areas, increasing the risk of tissue damage there. Lower or flatter positions, or side-lying with proper support, reduce this sliding, so the risk is less. To minimize shear, use proper positioning aids (like a draw sheet or trapeze) and ensure the resident is well-supported and repositioned regularly.

Shear injuries happen when the skin slides against a surface while the underlying tissues remain fixed. This friction is most harmful over bony prominences like the sacrum and coccyx, where skin is close to bone. In the High-Fowler’s position, the torso is raised high and gravity tends to pull the body toward the edge of the bed, causing the buttocks to slide against the mattress even as the upper body remains supported. That sliding creates shear forces at the sacral and coccygeal areas, increasing the risk of tissue damage there. Lower or flatter positions, or side-lying with proper support, reduce this sliding, so the risk is less. To minimize shear, use proper positioning aids (like a draw sheet or trapeze) and ensure the resident is well-supported and repositioned regularly.