ForrestGump

Welcome to OZ!! The hospital you decide may be dictated by where you are going to live. If you decide to go agency just don't sign any binding contracts as they can be quite restrictive. As far as ICU's go my recommendation would be RPA or Liverpool. What ever you do AVOID St George Hospital like the plague. Hope you enjoy it. Forrest :monkeydance:

hey all, my first post here - how exciting!! firstly to answer the original questions; 1. do you typically prone ards patients on your unit? no, especially now the doctors have a brand new ecmo machine they are keen to get some mileage out of. 2. if so, do you prone early or late? of the times i have seen it done it has always been late. usually after considerable time on high fio2 and following failure of prostacyclin. usually used as a last ditch effort. 3. did you see changes in oxygenation? often see early and marked improvement in oxygenation however have noted that this improvement is not sustained past two hours. 4. did the patient survive? i would say the vast majority of pts i have seen proned died. 5. did you have complications from the proning? yes. dislodgement of central line, development of pressure sore on the pts forehead and severe peri-orbital swelling. anecdote aside, the evidence on this topic provides no real consensus on whether prone ventilation is beneficial. seminal studies indicated that whilst oxygenation was improved in the short term this did not extrapolate to improved mortality. criticism regarding these original studies centered around the "late" timing of prone positioning in ards pts. as a result subsequent studies have aimed to prone pts "earlier" which has demonstrated some improvement in mortality. despite these studies there still remains no widely accepted standard on when, how or even if to use prone ventilation. so until then we will continue to wallow in anecdote and speculation on whether we should be flipping our pts like the eggs i am just about to cook myself for breakfast. kind regards, forrest :monkeydance: