CPR in Prone Position

Specialties MICU

Published

Just checking to see if anyone has done CPR on a patient in prone position. I had a terrible ARDS case where the patient only saturated 45% while supine even with nitric oxide. It was looking like there was high likelihood of a code and was wondering about performing CPR while the patient remained prone. I was able to find some theoretical articles but was wondering how things go in reality. Thankfully the patient did not need CPR but now my curiosity is piqued.

Specializes in ICU.

It is not only the difficulty of flipping them over to code them but also looking at the fact that it would be pointless to even flip the patient at all because they can not oxygenate in supine position so essentially you are circulating deoxygenated blood with the compressions. If you are able to perform effective CPR in prone position you will at least be circulating oxygenated blood. The patient I had in this situation would desaturate as low as 35% when supine and would be in the mid 90's when prone.

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Hi Codeblue,

Thanks for posting! The foundation of CPR is the performance of effective chest compressions. Compressions need to penetrate the adult chest at least 2 inches. The only way this is possible is due to the "elasticity" provided by the rib-cage and sternum. In the prone position, you would have no way to apply direct pressure to the sternum, alone. Pressure applied to any other location in the chest will most likely produce a rib fracture and increase the possibility of chest cavity trauma.

I hope this has been a help,

Randy

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Specializes in ICU.

On my unit we just flip and then start CPR.

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Specializes in Peds/Neo CCT,Flight, ER, Hem/Onc.
On my unit we just flip and then start CPR.

But if the patient absolutely does not oxygenate when supine what would be the point of doing compressions?

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