Health ministry advises proning position in self care for Covid-19 patients

New Delhi: The Union health ministry on Thursday advised proning for self-care for coronavirus patients, stating that it is extremely beneficial for such patients with compromised breathing comfort, especially during home isolation.

The ministry, in a document, said proning is the process of turning a patient with precise, safe motions, from their back onto their abdomen so that the individual is lying face down.

Proning 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, the document stated.

Listing the importance of prone lying, the ministry said 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, the document said.

The ministry, however, cautioned to avoid proning for an hour after meals and maintaining it for only as many times as easily tolerable.

One may 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 the bony prominence, it said.

According to the document, proning should be avoided in conditions like pregnancy, deep venous thrombosis, major cardiac conditions, unstable spine, femur, or pelvic fractures.

It also mentioned a five-step method to place a patient in the prone position in an emergency using a regular bed, flat sheet, and family members.