Caring for a Patient in Prone Position

Amidst the global COVID-19 pandemic, nurses of all clinical areas may be considered to work in high acuity areas such as critical care environments (DoH 2020). General nurses will be working alongside critical care trained nurses and may need to assist in the care of a patient who may be in a prone position.

What is Prone Ventilation?

The prone position is a body position in which the patient lies flat on the stomach with their limbs unextended. Prone ventilation is the delivery of ventilation to a patient in this position (Biology Dictionary 2018; Malhotra & Kacmarek 2019).

Mechanical ventilation is usually delivered with the patient in the supine position, however, a patient with acute respiratory distress syndrome (ARDS) may be manoeuvred into the prone position to assist with oxygenation when other traditional or advanced modes of ventilation have not been successful. The patient may be hypoxic (Malhotra & Kacmarek 2019).

Prone positioning improves gas exchange by reducing dorsal lung compression and improving lung perfusion. It also assists in moving secretions using gravity to assist in alveoli recruitment and improve oxygenation (Malhotra & Kacmarek 2019).

The effects of prone ventilation can include:

• Improved bronchial secretion drainage;
• Improved gas exchange (oxygenation); and
• Increased alveoli recruitment.