Are You Flipping Crazy: Indications, Timing and Application of Safe Prone Positioning for ARDS Patients

The basics of proning a patient

1 CPD Points, 1 CEUs, 1 AMA PRA Category 1 Credits.
Providers: CPDUK, CBRN, EB Medicine

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Kathleen Vollman help_outline
Critical Care Clinical Nurse Specialist, Educator and Consultant, USA
Lecture Summary

Prone positioning has been utilised to recruit alveoli to improve oxygenation while preventing complications of ventilator-induced lung injury in patients with ARDS for over 30 years. Recently with new studies, the use of prone positioning is now considered front line therapy and utilisation of the technique has increased significantly since COVID 19. With the mortality rate of the ARDS patient remaining at 40%, we need to implement evidence-based practices that work. This session discusses the physiological mechanisms of the prone position for reducing lung trauma and improving oxygenation. How a team can successfully build and implement a proning protocol is outlines. An exploration of the evidence used to define the patient likely to respond to prone positioning, identify the appropriate time to initiate therapy, and time spent in the prone position are discussed. Evidence-based strategies for turning and sustaining the patient in a prone position are outlined to ensure safety for the patient and healthcare worker. As practitioners, we have the potential to influence patient outcomes through a safe non-invasive positioning technique.

Target Audience

Critical Care Nurses
Trainee Critical Care Doctors

Learning Objectives:

Upon completion of this activity, you should be able to:

  • Explain the physiologic rationale for improved oxygenation and reduced lung injury with the prone position in patients with severe ARDS
  • Discuss the various strategies to prone patients in times of crisis
  • Identify evidence-based strategies for determining when to turn, how long to remain prone while preventing airway and skin complications
  • Determine the indications for and strategies to facilitate awake prone position for non-intubated patients
Release Date

1 November 2020

Termination Date

31 October 2023

Accreditation

This activity has been planned and implemented in accordance with the accreditation requirements and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint providership of EB Medicine and Continulus. EB Medicine is accredited by the ACCME to provide continuing medical education for physicians.

Credit Designation

EB Medicine designates this internet-enduring material for a maximum of 1 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Needs Assessment

The need for this educational activity was determined by surveys of the target audience and experts in the specialty. Further assessment was provided by examining the topics of recently published evidence-based medicine reviews, national clinical guidelines, and specialty society recommendations, as well as suggestions from evaluations of previous learning programs to determine practice gaps.

CME Faculty Disclosure

It is the policy of EB Medicine to ensure objectivity, balance, independence, transparency, and scientific rigor in all CME-sponsored educational activities. All faculty participating in the planning or implementation of a sponsored activity are expected to disclose to the audience any relevant financial relationships and to assist in resolving any conflict of interest that may arise from the relationship. In compliance with all ACCME Essentials, Standards, and Guidelines, all faculty for this CME activity were asked to complete a full disclosure statement. The speaker did not report any relevant financial interest or other relationship with the manufacturer(s) of any commercial product(s) discussed in this educational presentation.

Earning Credit

In order to earn CME credit, the participant must take the pre-test, watch the course, take the CME post-test, and complete the post-test evaluation.

Hardware/Software Requirements

Online learners will need a computer or web-enabled device to access the podcast, additional learning materials, and CME test.