Proning ARDs patients

Specialties MICU

Published

Hi everyone,

Our ICU is starting to get really aggressive in identifying and aggressively treating ARDS patients much sooner. We have used the huge KCI beds that rotate with much success. With that said we want to try proning more patients sooner and much more often. The KCI just isn't feasible all the time.

I was wondering is if anyone could comment/walk me through as to how they prone patients on the bed. Ive heard it can be done safely with a log roll and would be greatful to hear how you do it.

Thank you all in advance.

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Specializes in ICU.

1) Get a bunch of people in the room

2) get a bunch of pillows (or expensive pads) for pressure points

3) turn them over

3) a. Doing so without displacing ETT, lines, etc. is preffered.

4) repeat process to supinate

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Specializes in Surgery, Trauma, Medicine, Neuro ICU.

What he said. We've done that in the middle of the night when we couldn't get a hold of the bed.

Otherwise...we use the RotoProne pretty much exclusively.

What about the RotoProne has been unfeasible for you? We've been pretty successful with them.

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So ya just flip em eh? Will give it a go.

Work for a big county hospital, many uninsured so it's hard to get reimbursed on the KCI.

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Thank goodness this therapy is back in fashion. It makes sense and shows results. Our hospital is cheap with the rotos.....so as said....bundle up the team.....secure the lines....and get creative. I know our patients are often over 300 lbs....but treat their bodies just as you would a baby and move their lungs around. It just takes teamwork.....as mentioned......pillows......logrolled blankets.....and lots of laughter.

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Specializes in CVICU, CCU, Heart Transplant.

At my last job we had a large number of ARDS patients and used rotoprone bed pretty regularly. It really is amazing how well the beds work once you find their "sweet spot". I Remeber having to place them on their back for assessments and having to work very quickly, as their sats would plumit and they become hemodynamically unstable.

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Specializes in SICU, trauma, neuro.

We use the Rotoprone

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Specializes in Emergency/Trauma/Critical Care Nursing.

Out of curiosity (I have never dealt with an ARDS pt long term in the ED), when you prone a pt do you just turn their heads to the side or do the beds have openings like a massage table at the head of the bed? Also, how does proning these pts help to treat ARDS?

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Specializes in CVICU, CCU, Heart Transplant.
Out of curiosity (I have never dealt with an ARDS pt long term in the ED), when you prone a pt do you just turn their heads to the side or do the beds have openings like a massage table at the head of the bed? Also, how does proning these pts help to treat ARDS?

Yes, sort of a padded cage that supports the body. It doesn't help to treat the ARDS per se, but it does help with hypoxia which is secondary to ARDS. ARDS disrupts gas exchange. When you place a patient prone you're basically causing blood to get shunted to an area of the lung that has less impairment, ie the apex.

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wishing we have these rotoprone beds for our ARDS patients. What is the patient outcome with these beds?

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thank you for explaining...

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Specializes in MICU.

We use the rotoprone. I don't think we've ever had trouble getting ahold of it-- a lot of the docs will have us call and get one in for patients they suspect will need it. Unfortunately here lately the past few pts we put on it did not do well. I think it's because they waited too long to put them on it- after nitric, paralytics, and high peep weren't enough.

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