Left Lateral Positioning for Nonpregnant Individuals
The left lateral decubitus position is not routinely recommended for nonpregnant individuals as it provides no significant hemodynamic benefit compared to other positions. 1
Physiological Differences Between Pregnant and Nonpregnant Individuals
Pregnant Individuals
- Left lateral positioning in pregnancy is specifically recommended to:
Nonpregnant Individuals
- No significant aortocaval compression occurs in nonpregnant individuals 4
- Inferior vena cava volume in nonpregnant individuals is significantly higher than in pregnant women in the supine position (17.5 ± 7.8 ml vs. 3.2 ± 3.4 ml) 4
- Aortic volume does not differ significantly between pregnant and nonpregnant individuals 4
Evidence-Based Positioning Recommendations
For Nonpregnant Individuals:
- Standard supine positioning is appropriate for CPR and most medical procedures 1
- Hand placement for chest compressions should be in the center of the chest 1
- No special positioning considerations are needed for airway management 1
For Pregnant Individuals:
- Left lateral tilt or manual left uterine displacement is recommended when the uterus is palpable at or above the umbilicus 1
- For endoscopic procedures after 20 weeks gestation, left lateral or left pelvic tilt position is advised 1
- A 30° left lateral tilt is needed to effectively reduce inferior vena cava compression 4
Clinical Applications
During Cardiac Arrest:
- For nonpregnant individuals: Standard supine positioning on a hard surface 1
- For pregnant individuals: Supine with manual left uterine displacement or left lateral tilt 1
During Endoscopic/Surgical Procedures:
- For nonpregnant individuals: Position based on procedure requirements 1
- For pregnant individuals: Left lateral or left pelvic tilt position after 20 weeks gestation 1, 2
Autonomic Nervous System Considerations
While one study found that nonpregnant women had greater normalized high-frequency power (indicating higher vagal tone) in the right lateral decubitus position 5, this finding has not been incorporated into clinical guidelines for nonpregnant individuals.
Key Takeaway
The left lateral position provides specific hemodynamic benefits in pregnant women due to the anatomical changes of pregnancy, particularly relief of aortocaval compression. These benefits do not apply to nonpregnant individuals, and therefore this special positioning is not routinely recommended for them.