If a hypotensive pregnant patient is supine on a long backboard, what is the best transportation position?

When a hypotensive pregnant patient is positioned supine, there is a risk of compressing the inferior vena cava due to the weight of the gravid uterus pressing down on the blood vessel. This can lead to reduced venous return to the heart, further exacerbating hypotension. To counteract this issue, tilting the left side of the board is recommended, as it helps alleviate pressure on the inferior vena cava and improves blood flow back to the heart.

Tilting the board to the left side effectively shifts the uterus away from the major blood vessels in the abdomen, promoting better venous return and potentially stabilizing the patient's blood pressure. This position is often referred to as the left lateral tilt and is a standard recommendation for managing hypotension in pregnant patients during transport.

Other positions, such as flat on the backboard or elevated at the head, do not address the compression of the inferior vena cava effectively. In fact, remaining flat may worsen hypotension, and elevating the head can also increase pressure on the vessel. The right tilt is not as effective and can inadvertently lead to more compression rather than relieving it, thus making the left-sided tilt the best choice for improving the condition of a hypotensive pregnant patient on a backboard.