I am a huge fan of proning patients who are in ARDS. At one point or another I’ll cover the data behind proning like the PROSEVA trial (no time today or until at least June). There are a variety of ways to prone patients which reflect the disposable income of the facilities where you work and train. At the 3 institutions were I have worked and the others where I have done moonlighting shifts, we’ve all used some good ol’ fashioned muscles and coordination to achieve prone positioning for ARDS.
The PDF quoted and linked here was published in December 2019 and is usually very key during flu season. I am not going to comment about the coronavirus but these patients are developing an ARDS-like syndrome where proning may work. I haven’t seen any data, though. That being said, having the ability to prone patients and do it well could potentially save lives.
In the paper, they cover pretty much everything I would want them to in a document like this that’s beneficial to all. They even discuss chest compressions and defibrillation in these patients, something we all fear.
The PDF is completely free and a direct link. I need to find out the citation for this bad boy. The authors did a great job and a big hat tip to them. There’s a really nice safety checklist and nursing checklist included to help prone positioning for ARDS.
How do you all prone at your institution?
Do you not prone at your shop because of fear of the tube coming out?
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