The second wave of the Covid-19 has left infected patients gasping for breath as lack of oxygen at hospitals is creating one of the biggest hurdles in the ongoing Covid crisis in India. With resources running scarce, making family and friends of patients run desperately seeking Oxygen cylinders, people are being recommended home remedies and therapies to manage the condition at home. Amongst them is ‘proning position’ which helps to improve oxygen level. Proning can help the patient sustain till hospital arrangements are made.
Due to the damage caused by the virus on the red blood cells in the body, the oxygen level goes down in covid patients. The virus can badly affect the heart, lungs and muscles because of which many patients report shortness of breath. This has increased the demand for supplemental oxygen manifolds. That is why proning position is now being actively recommended to covid positive patients. Those in home isolation due to mild cases and if their SPo2 levels are fluctuating can also improve oxygen level with a prone position.
But before you go self-proning, let’s see what this technique is and how to practice it safely. Here’s a quick run-down:
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What is Prone Position?
The prone position is a body position in which the person lies flat with the chest down and the back up. It is a medically accepted position to improve breathing comfort and oxygenation in COVID-19 patients. The patients who are suffering from any sort of respiratory distress or compromised breathing issues should be turned with precise, safe motions, from their back onto their abdomen (stomach), so the individual is lying face down.
Prone position has been used for decades to improve clinical outcomes for those suffering from acute respiratory distress syndrome (ARDS), the lung condition that patients with severe COVID-19 cases develop.
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How To Improve Oxygen Level With Prone Position?
The “SpO2” reading on a pulse oximeter shows the percentage of oxygen in someone’s blood. A normal level of oxygen is usually 95% or higher. Some people with chronic lung disease or sleep apnea can have normal levels of around 90%.
Proning should be especially tried if external support is hard to find and when your home SpO2 reading starts to drop below 94 and continues to fluctuate through the day. This manoeuvre is now considered a simple and safe method to improve oxygenation.
One needs to have plenty of pillows to sleep in the prone position and keep changing positions on a half-hourly basis. Let’s have a look at a step-by-step guide to do pronal breathing-
For pronal breathing and sleeping, pillows need to be placed in this manner-
- one below the neck,
- two below the chest and
- two pillows placed below the shins.
NOTE- Place the pillows under the head, chest, and pelvis for support but the abdomen should not be compressed (your hands can pass through it).
The Health Ministry has also listed out some guidelines for pronal breathing. Here’s how to attempt self-proning and get relief from sudden oxygen deprivation:
- Start with lying on your belly
- Lying on your right side
- Sitting up with your legs extended in front of you
- Lying on the left side
- Go back to lying on your belly
Things To Note-
- Maintain proning for only as many times as easily tolerable
- Make sure that while you keep alternating your positions, do not spend more than 30 minutes in one position.
- One may prone for up to 16 hours a day, in multiple cycles, as felt comfortable
- The pillows can also be adjusted to suit pressure and comfort, according to your needs.
- Keep a track of any pressure sores or injuries, especially around bony prominences
- If the patient is on oxygen support, then turn the head to the left/right side and continue O2 support.
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Benefits
- Improves ventilation, makes breathing easier.
- Keeps the alveolar units open, ensuring that they are less likely to require ventilator support.
- Especially helpful if your SPO2 goes below 94.
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Avoid
Avoid proning in conditions like:
- Pregnancy
- Deep Venous thrombosis
- Major cardiac conditions
- Unstable spine, femur, or pelvic fractures.
- It should not be done for an hour after meals.