Proning

[nightshift82]

I work in a small community hospital and the manager of the CCU and ICU is considering purchasing a bed for proning. We don't have that many maybe 10 patients or less per that have been proned. The past month the Pulmonary Doc decided 3 needed to be proned but did not seem to change out comes by much. One did well but was only ever on 60%FIO2 and the other two did not make it. Research I have read is +/_ with regards to proning. They seem to indiciate it does not change the mortality rates. Are others still proning or are you using other forms of tx's.

Thanks

[LoveActually]

We prone all the time with rotoprone beds. Seen a few miracles happen after their use.

[NtannRN]

We hardly ever prone. We don't have a special bed for proning, no one wants to go through all the hassel. I've never had a pt. who needed it yet. But, we will use sandbags on the pt's chest instead. Suppose to mimick proning. I don't really know if that does diddly.

[sunnycalifRN]

We hardly ever prone. We don't have a special bed for proning, no one wants to go through all the hassel. I've never had a pt. who needed it yet. But, we will use sandbags on the pt's chest instead. Suppose to mimick proning. I don't really know if that does diddly.

Uhh, sandbags?? That would only make it more difficult for the patient to breathe . . . increase PIP's, drive the RRT nuts. That does not mimic proning.

[NtannRN]

That's what I thought but supposedly, now I'm not the expert by any means but it forces the patient to recruit other lung fields. I'll have to ask out intensivist in the morning.

[LoveActually]

In addition to helping with the pressures, and recruiting different lung feels, proning with a bed works wonders for mobilizing all that crap in the lungs and sinuses. We don't keep them only prone, they get positioned at 45% angles (or other angles) too, with a rotoprone bed of course...

[WalkieTalkie, RN]

Yes we prone. The big problem is that it usually does not occur early enough.

I agree with you 100% on this. Unless we're immediately putting them on ECMO, we should begin the proning process. It seems that it usually takes a couple of days before the docs consider it! I've seen it work miraculous results in a couple of patients (started early)... and I've also seen a couple of patients who somewhat benefited from it, but it was too late to "save" them.

It is possible to prone someone with all kinds of tubes/lines. My last "prone" patient was on the vent (obviously), had about 8 different drips going into two different lines (LSC and R groin Swan), NG, rectal tube, arterial line, and also had SLED running through a line in his RSC. We were able to prone him without incident... heck the dialysis machine never even alarmed!

Anyone here use KCI beds? I guess they don't make the RotoProne anymore? We have been using the Triadyne with the proning kit. It's not the best thing, but you can make it work. It takes a lot of team work to prone most of our patient population... I recommend at least a couple of nurses, an RT, and a couple of techs to ensure no lines/tubes get dislodged during the turn.

[CABGx4, ASN, BSN, MSN, CRNA]

We use KCI here in Pittsburgh and rotoprones are still in use. We switch patients to the Triadyne once they have tolerated being supine for a while and are relatively stable. Then consult for a trach!