All about proning and how it can help Covid patients

Proning a medically approved position in which patients are made to lie on their abdomen to boost their oxygen levels.

As the second wave of Covid-19 sweeps through the country with deadly consequences, doctors across the state have started advocating proning exercises to improve oxygen levels in Covid positive patients — both in home isolation as well as in hospital. Read on more about the medically approved breathing exercise…

Recently, the Union Health Ministry advised ‘proning for self-care’ for coronavirus patients, stating that it holds high significance for covid positive patients with compromised breathing comfort, especially during home isolation or self-care treatment at home.

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What is proning?

Proning a medically approved position   in which patients are made to lie on their abdomen to boost their oxygen levels. Proning as an exercise is being advised to Covid patients in hospitals, so that they may not require additional oxygen support.

While proned, the patient is made to lie on his/her belly using pillows. One can also lie on their right side( right lateral), left side ( left lateral) or sit at a 60-90 degree angle in the ‘fowler position’.

What is needed for proning?

All we need for proning are 4-5 pillows. One pillow is to be placed below the neck, 1-2 pillows below the chest through upper thighs, and 2 pillows below the shins. A patient should lie on their belly, right and left side alternately. However, experts suggest that at least 30 minutes should be spent in each proned position for best results.

How to do proning?

The patient usually undergoes a series of manual turns that are done in a synchronized pattern. This includes:

Step 1: Turn the patient in the prone position (i.e., lying on the belly).

Step 2: Next turn the patient laterally (i.e., sideways) on the right side.

Step 3: Then make the patient sit up with the spine straight.

Step 4: Next turn the patient laterally (i.e., sideways) on the left side.

Step 5: Finally, turn the patient to the initial prone position.

Step 6: Alternate the position every 30 minutes.

Step 7: Each position requires the patient’s heart rate, blood pressure and pulse oximetry (oxygenation level) to remain stable during each move.

Step 8: It is advisable not to spend more than 30 minutes in each position.

Performing proning 

• Registered and trained nurses (with either critical care or operating room expertise)

• Physical therapists/occupational therapists/patient care technicians

• Respiratory therapists

• Anesthesia physicians

Other ways to improve oxygen levels for patients

Deep breathing, yogic pranayama, ample access to fresh air, staying hydrated, eating iron-rich foods, light exercises also help in improving oxygen level of patients, the Health Ministry suggests.

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