There is increasing evidence that Awake Self-Proning of our Covid-19 patients can improve oxygenation. Proning the patient can has several effects which can dramatically improve their SaO2
- Improves Ventilation to back of the lung (the back of the lung contains more alveoli than the anterior lung)
- Improves Perfusion – as blood supply to the back of the lung is always better than the front
- Improves Clearance of secretions
- Be patient can take 15-20min
Contraindications (all seem obvious)
Absolute contraindications:
- Respiratory distress (RR ≥ 35, PaCO2 ≥ 6.5, accessory muscle use)
- Immediate need for intubation
- Haemodynamic instability (SBP < 90mmHg) or arrhythmia
- Agitation or altered mental status
- Unstable spine/thoracic injury/recent abdominal surgery
Relative Contraindications:
- Facial injury
- Neurological issues (e.g. frequent seizures)
- Morbid obesity
- Pregnancy (2/3rd trimesters)
- Pressure sores / ulcers
