Proning may help improve oxygen levels in Covid-19 patients. Here is a step-by-step guide

The Union Health Ministry has recommended the technique of "proning" to help increase oxygen levels for those in home isolation.

UPDATED: April 29, 2021 16:19 IST

Covid-19 patients gasping for oxygen lining up outside hospitals across the country has been the defining image of the coronavirus pandemic in the second wave. Shortness of breath and fluctuating oxygen levels are among the major symptoms of Covid-19. However, not every patient facing breathing issues requires hospitalisation.

The Union Health Ministry has recommended the technique of “proning” to help increase oxygen levels for those in home isolation. Proning is a technique in which the patient lies on the stomach, face down, to try and improve the oxygen levels in the body. Oxygen level (SpO2) between 94-100 is considered healthy.

Requirements for proning

For proning, one will need five pillows and a flat surface to lie down. One pillow should be kept below the neck, one or two below the chest through the upper thighs and two below the shins. One should not spend more than 30 minutes in each position.

Importance of prone lying:

– Prone positioning improves ventilation, keeps alveolar units open and breathing easy.

– Proning is required only when the patient feels difficulty breathing and the oxygen level goes below 94.

– Regular monitoring of SpO2, along with other signs like temperature, blood pressure and blood sugar, is important during home isolation.

– Missing out on hypoxia (compromised oxygen circulation) may lead to worsening of complications.

Cautions while proning:

– Avoid proning for an hour after meals

– Maintain proning for only as many times as easily tolerable

– One may prone for up to 16 hours a day, in multiple cycles, as felt comfortable

– Pillows may be adjusted slightly to alter pressure areas and for comfort

– Keep track of any pressure sores or injuries, especially around bony prominences

When should you avoid proning:

– During pregnancy

– Deep venous thrombosis (treated in less than 48 hours)

– Major cardiac conditions

– Unstable spine, femur, or pelvic fractures

Steps for non-self-pronating patients (in an emergency):

For those who cannot do it themselves, here is a five-step method to place a patient in the prone position using a regular bed and flat sheet.

– Using a flat sheet, pull the patient to one side of the bed.

– Place the flat sheet around the arm that will pull through (the side you are turning toward).

– A second flat sheet is placed on the bed and tucked under the patient. This sheet will pull through as you are turning the patient.

– Using the sheet, turn the patient over and position the patient prone. The arm and sheet will pull across the bed.

– Pull and center the patient. Discard the sheet that was used to place the patient in a supine position. Straighten lines and tubes.

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