As hospitals across India are reeling under a severe shortage of medical grade oxygen, Centre has released a set of instructions explaining what proning is and how it helps in improving oxygenation in Covid patients.
Proning is a medically accepted position to improve breathing comfort and oxygenation. Covid patients with compromised breathing comfort in home isolation will find it extremely beneficial, says the government.
Covid-19 affects the respiratory system, as a result of which many patients
have reported shortness of breath and lower oxygen levels. As such, the demand
for supplemental oxygen has risen manifold. A normal oxygen level is usually
95% or higher.
Is it helpful?
Lying on the chest and stomach position, or on the sides, is considered to help the body get air into all areas of the lungs rather than lying flat on the back. The technique has proven to be an effective measure for a long time in the treatment of patients with acute respiratory disease syndrome (ARDS) and is considered “a simple and safe method to improve oxygenation”, as per a study published in the European Respiratory Journal, 2002.
How does it work?
Prone positioning can help recruit collapsed alveoli and improve oxygenation in patients with ARDS when mechanical ventilation doesn’t help. It lets the lungs, particularly their dependent areas, expand, resulting in improved oxygenation that occurs primarily within the first hour. In the prone position, lung compression is decreased, secretions drain better, and collapsed alveoli reopen.
What do you need for proning?
About four to five pillows are needed for proning — one has to be placed below the neck, while one or two can be placed below the chest through upper thighs and two pillows can be placed below the shins.
One needs to change the lying position every 30 minutes from lying on the belly to lie on each side and then sitting up before going back to the first position of lying face down.
When not to do proning?
The Ministry has listed four conditions when proning should be avoided: pregnancy; deep venous thrombosis (treated in less than 48 hours); major cardiac conditions; unstable spine, femur or pelvic fractures.
