How proning helps to improve the oxygen level in Covid-19 ?

How proning helps to improve the oxygen level in Covid-19 ?

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The second wave of pandemic ruled all over the country. Followed by the signs and symptoms, are changing vigorously. This wave is very dangerous as it lowers the oxygen level and pushes you to death. so, in this pandemic, ‘proning’ is a simple and safe method to pump up your oxygen level.

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Proning is the most beneficial maneuver that helps to improve oxygen saturation. It is also clinically accepted and officially approved by The Union Ministry of Health and Family Welfare, India. The experts also say, “ proning works as a potent technique in the patient having covid-19.”

What is proning?

It is nothing but a therapeutic position for compromised covid-19 patients. Proning helps to prevent death related to impaired oxygen saturation. this is also considered an effective intervention in Acute Respiratory Distress Syndrome(ARDS).

According to Nancy,”proning is the process of turning a patient with precise, safe motions from their back on to their abdomen(stomach), so the individual lying face down.”

Who all are going to practice it?

  • The oxygen level goes below 94% when measured in the pulse oximeter.
  • persons who are in home isolation and having breathing difficulties.
  • Compromised covid positive patient waiting for medical help.
  • Covid -19 associated with acute respiratory distress syndrome,also patients are supposed to practice proning.

Benefits of proning

Proning use in severe respiratory distress, ARDS, and hypoxemia in spontaneous and assisted breathing patients. It has a lot of benefits like;

  • It improves the oxygen level in the blood.
  • Improves ventilation and tissue perfusion.
  • Prevent pneumonia and minimize the need for intensive care.
  • Best way to ventilate the dorsal lung regions which are going to be damaged by the alveolar collapse.
  • Keeps alveolar units open for breathing easily
  • Facilitates the drainage of mucosal secretions.
  • It decreases the mortality rate by reducing the incidence of ventilator-associated lung injury.

When to avoid proning?

  • Avoid proning, during pregnancy.
  • If you have major cardiac problems.
  • After intake of food, it causes vomiting.
  • Deep venous thrombosis.
  • Unstable spine, femur, or pelvic fractures
  • Having any pressure sores and injury
  • Do this positioning up to 16 hours a day in multiple cycles. If you don’t feel comfortable then don’t do that.

What is required for proning?

For self proning, all we need are 4-5 pillows and a flat surface. Here one pillow is placed just below your neck. 1-2 pillows are placed below the thoracic region through the upper thighs. The other 2 pillows are below the shins.

If the patient is on the ventilator, the equipment requires;

  • pillows(3-4)
  • Flat sheets
  • Flow pads,dry(2-3)
  • Doughnut pillow for head
  • Enteral feeding if possible
  • Oral suction and endotracheal tube suction catheter
  • Special bed
  • Appropriate sized suction and endotracheal tube 
  • Endotracheal tube holder

Self proning procedure

The steps are like;

Health ministry advises 'proning' for Covid-19 patients to breathe better; here's what it means

source image;

  1. Start lying on your tummy.
  2. Lying on your right side.
  3. Sitting up with your legs extended in front of you.
  4. Lying on the left side.
  5. Go back to lying on your belly.

( to get the best result, spend at least 30 minutes in each position)

How does the oxygen level improve by it?

By this exercise, the lung capacity of an individual is generally increasing. This helps the person to inhale sufficient air to meet the body’s demand. As a result of which the oxygen level of the body increased.

Also, you can do simple kinds of breathing exercises. In this, you can take a deep breath. Hold your breath for 40 seconds then release. It is for the patient whose conditions are not severe.

Does proning is applicable for severely ill persons?

As the second wave is severe,proning is recommending for all age groups. but, sometimes it provides restrictions for the person who is unable to do it. So, any exercise that you can do. Please do with proper consultation.

Other alternative exercises?

Some alternative exercises are like anulom vilom, Kapal Vati, and bhastrika pranayama. These are the most recommended exercises for covid-19 as it has zero complication. In anulom vilom, holding one nostril closed while inhaling and holding the other nostril closed while exhaling.

Kapalbhati and bhastrika are also a series of rapid breathing exercises like proning. They are loading with effectiveness to increase the oxygen level. Last but not the least, alternative breathing exercises are done by anyone from kids to older. 



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