[dissle]

Our unit policy states that patients can remain proned for up to 24 hours with head and arm position changes every 4 hours IF stable enough to do so.
This may seem prolonged but it works, the gasses are miles better a very short time after pronation.
We only prone when the pateint gasses are poor on 80%fio2 or above. so established lung injury. Pesonally i think it should be used a bit earlier than this.
Its usually the sickest of patients who we dont know what else to do with! Its a last ditch attempt to save them.
Interesting that you use pronation as an alternative position, i dont know why we dont use it for this more often, i suspect that it has allot to do with the inconvenience of all the bits ans bobs that have to be rearranged!

[sharrie]

bear in mind it has been over 6 years since I left ICU, things will have changed greatly since then and having read through some of the literature today there was very little about how often or for how long prone should be used.

If it works for your patients then it works and as you say your using it on the very sickest who will have very poor skin integrity anyway therefore will be at greater risk of pressure injuries.