Simple but life saving prone position

 Simple but life saving Prone Position

Doctors engaged in Covid19 care continuously monitor the SpO2 level of the patient. SpO2 is known as oxygen saturation, amount of oxygen carrying heemoglobin in the blood relative to the amount of haemoglobin not carrying oxygen. It is essential to maintain the function of the vital organs including brain, heart, kidney, etc, efficiently. 98-99 is the SpO2 reading of all individuals on Oximeter. Only the Yogis and the persons doing Pranayam regularly can maintain the count 100. 

Covid19 damages the alveoli of the lungs and due to inflammation of the lungs its capacity to inhale oxygen decreases. As a result, the SpO2 level of the patient falls and he/she goes into the stage of hypoxia. Patients with Corona often die of ARDS (acute respiratory distress syndrome).

At home care of Covid19 patient, one may wait upto the SpO2 level of 94, but thereafter, it will be dangerous to wait. O2 is the life of all cells and all organs. Therefore, the patient in need of oxygen support, has to be hospitalised. He may need piped O2, Bipap or intubation any time. 

One can improve the SpO2 level by few points at home without O2 support. The technique is called Prone Position (sleeping on stomach). It helps increase the amount of oxygen that’s getting to their lungs.Conscious prone to be followed for 6-8 hours minimum for Covid19 patients. Prone position increases end-exploratory lung volume, increases chest wall elastane, decreases alveolar shuny and improves tidal volume. Positive results found in Partial pressure of arterial oxygen (PaO2) and in positive pressure of arterial carbon dioxide (PaCO2). 

In case of severe ARDS, Prone Position may be applied for at least 12 hours. Conscious prone position may leads into decrease in mortality rate. Pulmonologists and Critical Care Specialists do insist for Prone Position of the patients on ventilators too, because patients with ARDS who are on ventilators have a lower chance of dying if they are placed on their stomach in the hospital. 

In India we generally sleep on our side, changing left and right, it is to protect the airways by using the gravity. Snoring stops. Some people suffer from sleep apnea (breathing stops periodically during sleep) use CPAP to improve breathing. Medical conditions of COPD (chronic obstructive pulmonary disease, emphysema, asthma, anemia, heart disease, etc, may impair the respiratory system in providing optimal oxygen amounts to the body. It is essential to maintain their SpO2 level. For Covid19 care, conscious prone position is simple but a life saving technique, one may follow.

And those are healthy but elderly may try to sleep by their side to improve oxygen saturation during the sleep. 

Punamchand 

14 June 2020