How Proning position can work for COVID-19 patients when their SPO2 levels fluctuate in home isolation - Recommended by Dr. Dhruv

Proning is the process of turning a patient with precise, safe motions, from their back onto their abdomen (stomach), so the individual is lying face down. It is a medically accepted position to improve breathing comfort and oxygenation. It is extremely beneficial in COVID-19 patients with compromised breathing comfort, especially during home isolation. 


Here is Dr. Dhruv Dev, a physiotherapist in Delhi, helping patients with chest physiotherapy in COVID-19 recovery explaining how to lay down a patient in the proning position to amplify the inflow of oxygen in the body. 

Dr. Dhruv is currently associated with Indian railways wrestling team & Indian tennis circuit.

IMPORTANCE OF PRONE LYING:
  • Prone positioning improves ventilation, keeps alveolar units open and breathing easy. 
  • Proning is required only when the patient feels difficulty in breathing and the SpO2 decreases below 94 (less than 94). 
  • Regular monitoring of SpO2, along with other signs like temperature, blood pressure and blood sugar, is important during home isolation. 
  • Missing out on hypoxia (compromised Oxygen circulation) may lead to worsening of complications. 
  • Timely proning and maintaining good ventilation could save many lives.

Caution:  

  • Avoid proning for an hour after meals.
  • Maintain proning for only as many times as easily tolerable.
  • One may be prone for up to 16 hours a day, in multiple cycles, as felt comfortable.
  • Pillows may be adjusted slightly to alter pressure areas and for comfort.
  • Keep a track of any pressure sores or injuries, especially , around bony prominences.
Avoid Proning in conditions like:
  • Pregnancy 
  • Deep venous thrombosis (Treated in less than 48 hours) 
  • Major cardiac conditions 
  • Unstable spine, femur, or pelvic fractures

Source - https://www.mohfw.gov.in/pdf/COVID19ProningforSelfcare3.pdf

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