Proning – Step By Step Guide Recommended for Covid -19 Patients
The second all-India surge of the Covid-19 pandemic has been more devastating than the first. It has also appeared to be different from last year’s surge in several ways, increasing worries and anxiety. Shortness of breath is the most common clinical feature among symptomatic patients in the second wave. This has lead to increase in demand for medical oxygen across the country and short fall of supply has resulted in high death rate.
COVID-19 patients are required to keep a check on their oxygen saturation frequently. If the saturation goes below 94 per cent, one should try ‘proning’ (lying on your belly) to improve oxygen levels. It is extremely beneficial in COVID-19 patients with compromised breathing comfort, especially during home isolation.
First let’s understand what do we mean by Proning – PRONING is the process of turning a patient with precise, safe motions, from their back onto their abdomen (stomach), so the individual is lying face down. In laymen’s language – Lying face down is known as proning. Prone positioning improves ventilation, keeps alveolar units open and makes breathing easy. Timely proning and maintaining good ventilation could help in saving lives.
Requirements for Self Proning:
- 4-5 Pillows.
- Regular alterations in lying position
- Best is not to spend more than 30 minutes in each position
Positioning of Pillows:
- Place one pillow below the neck
- Place one or two pillows below the chest through the upper thighs
- Place two pillows below the shins
Steps to follow:
- Start with lying on the belly
- Lying on the right side
- Lying on the left side
- Go back to lying on the belly
- Sitting up with legs extended in front
How to do it, correctly?
One may prone for up to 16 hours a day, in multiple cycles, suitable to a patient’s comfort and ability. Pillows may be adjusted slightly to alter pressure areas and for comfort. Keep a track of any pressure sores or injuries, especially around the bony prominence.
Precautionary measures that need to be taken?
- Avoid proning if pregnant
- Avoid proning for an hour after meals
- Maintain proning for only as many times as easily tolerable
- Avoid proning if you have major cardiac conditions
- Avoid proning if you have an unstable spine, femur or pelvic fractures
Potential Benefits of Proning:
- Increases oxygen saturation
- Opens up the back of the lungs
- Reduces the pressure of the heart on the lungs
- May prevent or decrease the harmful infectious fluid build-up in the lungs
- Being studied as an alternative to intubation.
Physical position affects the distribution and volume of air in the lungs, and can have direct effects on the expansion of the lungs to permit the exchange of oxygen & carbon dioxide in the blood. It is a medically accepted process that involves turning a patient with precise, safe motions, from their back onto their abdomen so that the individual is lying face down to improve breathing.
Regular monitoring of SpO2, along with other signs like temperature, blood pressure, and blood sugar, is important during home isolation. Moreover, missing out on Hypoxia (compromised oxygen circulation) may lead to worsening of complications. Therefore, advice must be taken from the doctor on ways to effectively practice proning at home. So stay home, stay safe and keep reading….