Breathe Better with Proning

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A substantial proportion of patients with COVID-19 develop severe respiratory challenges and requires mechanical ventilation, most often matching the criteria for acute respiratory distress syndrome (ARDS). Though fluctuating oxygen saturation level (SpO2) and shortness of breath are among the symptoms of a novel coronavirus, not every patient facing it requires hospitalisation. Doctors have been recommending “prone positioning” to help increase the oxygen level of patients and to keep their lungs healthy during home isolation.

What is Proning?
Proning is a medically accepted process of turning a patient from their back onto the stomach, with safe motions, so the individual is lying face down. It has been in practice for decades on patients who are suffering from respiratory diseases.

It is extremely beneficial for COVID-19 patients, as it improves oxygenation and breathing comfort spontaneously, especially during home isolation.

Some points to keep in mind about Proning
1. Prone positioning improves ventilation, keeps alveolar units open and helps make breathing easy.
2. Proning is required when a patient feels shortness of breath and SpO2 decreases below 94.
3. Regular monitoring of SpO2, along with body temperature, blood sugar and blood pressure is important during home isolation.
4. Missing out on hypoxia (compromised oxygen circulation) may lead to worsening of complications.
5. Maintaining proper ventilation and timely proning is crucial and could save many lives.

How to place your pillows for Proning?
For self-proning, you will need 4-5 pillows; one below the neck, one or two below the chest through upper thighs and two below the shins. It is best to lie on the flat surface and change your positions after every 30 minutes.

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A Step-by-Step Guide to do Pronal BreathingBlog-cover-proning2

A Word of Caution

  1. Avoid proning for an hour after meals.
  2. Maintain proning for only as many times as easily tolerable.
  3. Pillows may be adjusted slightly to alter pressure areas and for comfort.
  4. Keep a track of any pressure sores or injuries, especially around bony prominences, while proning.
  5. Proning should be avoided by pregnant woman, patients with major cardiac conditions, unstable spine, pelvic fractures, femur and deep venous thrombosis (treated in less than 48 hours).

Deep breathing, staying hydrated, access to fresh air, eating iron rich food, and light exercises also help in improving oxygen level of patients. However, please note that the prone positioning is a temporary substitute and not a replacement for oxygen cylinders and hospitals. If you notice your oxygen level dipping considerably, set up a consultation with your doctor.