Jump to content

Proning patients, face and neck positioning

MICU   (405 Views | 2 Replies)
by Wildplaces Wildplaces (New) New Nurse

Wildplaces has 6 years experience and specializes in Critical Care.

83 Profile Views; 2 Posts

Hello everyone, I've been working on a specialty COVID-19 positive ICU since the pandemic started. I typically work in the MICU and while we proned patients once in a while, every intubated patient on the specialty unit is now being proned. Most of our patients are currently on a schedule including 16 hours in prone position. We are having difficulty trying to find the best positioning for the patient's head and neck, (particularly if they lack much of a neck). Everyone has tried something, from the OR prone pillows (not having much success, oddly. They are awkwardly large and seem poorly made), to pillow positioning to 1L sale bags on foreheads, to towels rolled into different shapes, and yet nearly everyone's face remains smashed into the wrong position. Arm placement has been usually at 90 degrees by the face but we have tried tucking them by the patient's side as well on some patients as well in attempt to find the most comfortable spot. I understand everyone is different and some patients will be calm in particular positions while others may get irritated (I have some that absolutely HATE being prone, their vital signs showing distress until they are flipped back to supine), but I'm looking for tips and suggestions of you have any to offer. Thank you!

Share this post


Link to post
Share on other sites

280 Posts; 2,543 Profile Views

This would be a great contribution the OR nurses could make in the units.

Share this post


Link to post
Share on other sites

Rose_Queen has 15 years experience as a BSN, MSN, RN and specializes in OR, education.

12 Followers; 4 Articles; 9,459 Posts; 110,004 Profile Views

Actually, my facility is using our surgical technologists for a proning team. The RNs are being floated to other units to work as nurses. Those prone pillows used in the OR are typically utilized with positioning devices that lift the torso higher, which is likely why they aren’t working for you in the ICU. I do know that my facility has kits with all sorts of wedges and padding and sandbags, but since I’m not a member of the proning team I’m not sure what all gets used for which purpose. While the OR has experience placing patients in prone position, it’s going to be very different than what the ICU is doing- we use speciality devices that if used for extended periods of time are going to cause pressure issues. Google Pro-Axis table to see what we use and how miserable it would be for an extended time.

Share this post


Link to post
Share on other sites
×

This site uses cookies. By using this site, you consent to the placement of these cookies. Read our Privacy, Cookies, and Terms of Service Policies to learn more.