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Semi-Fowler Position

What Is It, Difference from Fowler, and More

Author:Maria Emfietzoglou, MD

Editors:Alyssa Haag,Emily Miao, PharmD,Kelsey LaFayette, DNP, RN

Illustrator:Jessica Reynolds, MS

Copyeditor:David G. Walker


What is a semi-Fowler position?

Semi-Fowler, or low Fowler, position is a supine position in which an individual lies on their back on a bed, with the head of the bed elevated between 30-45 degrees, and the legs of the patient can be either straight or bent at the knees. A pillow can also be placed under the calves for support and comfort. This position is commonly used when a patient has difficulty breathing, has a feeding tube, is experiencing gastroesophageal reflux disease (GERD), or is going through childbirth

Illustration of a patient lying in a hospital bed with the head of the bed raised 45 degrees.

What is the difference between standard Fowler, semi-Fowler, and full Fowler positions?

The difference between a standard Fowler position and a semi-Fowler position is the bed angle. The bed angle in standard Fowler is greater, with the head of the bed elevated at 45-60 degrees, while in a semi-Fowler position, the head of the bed is elevated 30-45 degrees. The standard Fowler position is commonly used for head, shoulder, and chest surgeries as well as for respiratory distress syndrome as the position facilitates breathing. There is also the full, or high, Fowler position where the head is elevated at 60-90 degrees. The full-Fowler position is useful when an individual is eating because it can prevent choking. 

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What is a semi-Fowler position used for?

A semi-Fowler position is used for individuals with respiratory distress as it can improve breathing. It is also useful for those who have a feeding tube, such as a nasogastric tube (i.e., a device that goes through the nose to the stomach, which is used for nutrition) as it reduces the risk of regurgitation and aspiration. The semi-Fowler position is also recommended for people that have gastroesophageal reflux disease (GERD) in which the lower esophageal sphincter is relatively weak, which allows acid from the stomach to go back up into the esophagus after meals. Raising the head of the bed in a semi-Fowler position prevents the stomach contents from going back into the esophagus. A semi-Fowler position is also preferred during childbirth because it is more comfortable for the individual giving birth and has shown to decrease the need for analgesics and other interventions, such as an urgent cesarean section

How does the semi-Fowler position improve breathing?

Semi-Fowler position improves breathing by promoting lung expansion. More specifically, in the semi-Fowler position, gravity pulls the diaphragm (a dome-shaped sheet of skeletal muscle that divides the thoracic cavity from the abdominal cavity) down, increasing the volume of the thoracic cavity, which, in turn, allows the lungs to expand and fill with air, which ultimately improves breathing. 

What are the most important facts to know about the semi-Fowler position?

Semi-Fowler position is a position in which the individual lies on their back on a bed with the head of the bed elevated at 30-45 degrees. In contrast, the head of the bed is elevated at 45-60 degrees in the standard Fowler and at 60-90 degrees in the full Fowler position. A semi-Fowler position is recommended for individuals with respiratory problems, who have a feeding tube, and those experiencing GERD. It is also recommended during childbirth. This patient position can improve breathing by depressing the diaphragm and promoting chest expansion. 

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Resources for research and reference

Berman, A., Snyder, S., & Frandsen, G. (2012). Kozier & Erb’s fundamentals of nursing: Concepts, process, and practice (2nd ed.). Pearson.

Carter, P. J. (2012). Lippincott’s textbook for nursing assistants: A humanistic approach to caregiving (3rd ed.). Wolters Kluwer Health/Lippincott Williams & Wilkins.

Perry, A. G., Potter, P. A., & Ostendorf, W. (2013). Clinical nursing skills and techniques. (8th ed.). Mosby.

Semi-Fowler’s position. In Nurse Plus Academy. Retrieved March 4, 2022, from https://nurse.plus/nclex-terminology/terms-abbreviations/semi-fowlers-position/

Sorrentino, S. A., & Remmert, L. N. (2017). Mosby’s textbook for nursing assistants (9th ed.). Elsevier.

What are the types of Fowler’s position? (2021, July 14). In Steris Healthcare. Retrieved March 4, 2022, from https://www.steris.com/healthcare/knowledge-center/surgical-equipment/fowlers-position-guide

Lippincott Textbook For Nursing Assistants: A Humanistic Approach to Caregiving 3rd ed: ISBN 13 978-1605476353