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

The basics of proning a patient

The lecture duration is 48min.

1 CPD Point, 1 CEU, 1 CME credit approval pending.
Accredited by CPDUK, CBRN and Provider Pending.

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Kathleen Vollman
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