To prevent formation of a sacral ulcer in a bedridden patient, which position is most appropriate?

• A. Position supine with a small pillow under the sacrum
• B. Position with lateral decubitus
• C. Elevate head of bed to 90 degrees
• D. Position prone with a small pillow below the diaphragm

Answer: (D)

Sustained pressure over the sacral area impairs blood flow and can lead to an ulcer, so preventing sacral ulcers means shifting weight away from that region and distributing it over other surfaces. In a bedridden patient, turning to a prone position and supporting the torso with a small pillow under the diaphragm reduces direct contact and load on the sacrum, helping preserve skin integrity and tissue perfusion in that vulnerable area. Elevating the head of the bed increases pressure and shear on the sacrum, and keeping the patient flat on the back or placing a pillow under the sacrum would increase the risk there. Lateral decubitus can relieve some pressure but still concentrates load on the hip and shoulder and doesn’t optimally relieve sacral pressure. So, proning with a pillow under the diaphragm best minimizes sacral pressure and helps prevent ulcer formation.