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Explained: How Proning can help COVID-19 patients at home?

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Proning can be a low-risk, low-cost manoeuvre to help COVID-19 patients. It may restore SpO2 levels for some. It may help critical patients buy time till they get professional medical care.

Explained: How Proning can help COVID-19 patients at home?
As India struggles to provide medical supplies, including oxygen and hospital beds to COVID-19 patients, doctors have come up with helpful tips for those in home care.
To tackle falling oxygen levels in blood, doctors have advised proning, or lying on one’s stomach. Apart from possibly helping some patients restore healthy blood oxygen levels (SpO2 or blood oxygen saturation), proning can assist critical patients buy more time till professional medical help arrives, The News Minute (TNM) reported.
What is proning?
Proning, a medically accepted position, is the process of turning a patient with precise, safe motions from their back onto their abdomen (stomach), so that the individual is lying face down, according to the Ministry of Health and Family Welfare.
The Union Health Minister guidelines also suggested that timely proning and maintaining good ventilation could save many lives.
Who can do proning and how it helps?
Dr Rajavardhan R, consultant intensivist at Manipal Hospital in Bengaluru, said proning definitely helps to improve the oxygen levels, ventilation and perfusion, according to the TNM report. Proning can also be a low-risk, low-cost manoeuvre to provide possible help to COVID-19 patients and can delay or reduce the need for intensive care, the report added.
However, Dr Rajavardhan cautioned about proning for critical patients since the patients will experience the reduced oxygen if they turn back. He also said proning just gives some time for medicines to act in critical care conditions, adding that patients should not depend on proning alone if there is medical help available, the report said.
Dr Prashanth NS, a medical doctor and public health researcher at the Institute of Public Health, Bengaluru, said the awake prone position is a safe measure and can be advised for COVID-19 patients isolating at home, especially if their oxygen saturation falls to 90 percent, TNP reported.
According to the government’s COVID-19 guidelines, “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, are important during home isolation.”
The guidelines added that “missing out on hypoxia (compromised oxygen circulation) may lead to worsening of complications” and “timely proning and maintaining good ventilation could save many lives”.
Method of proning using pillows
The patient should place one pillow below the neck, one or two pillows below the chest through the upper thighs, and two pillows below the shins, the Health Ministry guidelines mentioned.
Patients doing proning should alternate their lying position (lying on either side and sitting up), and that it is best not to spend more than 30 minutes in each position, the guidelines added.
Who should avoid proning?
Proning is not advised for pregnant women, those suffering from deep venous thrombosis (treated in less than 48 hours), major cardiac conditions and for patients with unstable spine, femur or having pelvic fractures.