Indications:
Contraindications:
- C-spine precautions
- Haemodynamic instability (although can still perform CPR in prone position)
- Increased or concern with abdominal pressure
- Extreme obesity
- Increased intracranial pressure
- Staff not trained/skilled or not enough personnel to carry out safely
Initial Prone Position Manoeuvre:
| Team Discussion |
- Role designation
- Team leader (likely airway person) to communicate all steps of the procedure. Clarify terminology on start and stop for safety.
|
| Plan Resources |
- Anaesthetist or appropriate medical personnel skilled in airway procedure
- Nursing staff to perform procedure (minimum of 4, assessment of situation will need to be performed)
- ICU Team on standby
|
| Preparation |
- Sliding sheets
- Position ventilator, drains, catheter and medication pumps in preparedness of new position
- Provide all cares before procedure. Eye protection is required.
|
Review
|
- Sedation
- Paralysis
- Monitoring
|
| Time Out |
Pause to prepare team |
| Safety |
Re-Check:
- Airway
- IV lines, drains
- ECG monitoring is no longer on anterior aspect
|
| Start Position |
- Start with patient in supine position
- Place patients hands under buttocks
- Place padding or pillows across ankles, pelvis and chest
- Place sheet on top and roll together with bottom sheet ('The Cornish Pasty')
|
| Slide Across |
Slide across to edge of bed
|
| Side Lie |
Slide patient into side lie position |
| Re-check |
- Airway
- Vital signs and ventilator readings
- IV lines, drains
|
| Side lie to prone position |
- Process to prone position
- Turn head and maintain airway as moving into prone position
- Gel pads can be used to protect head and other at risk areas
- Reposition 1 arm and head for 'swimming' or 'superman' position
|
| Posture Change |
Every 2hrs
- Anaesthetist or appropriate medical personnel skilled in airway procedure
- Reposition arms to side of patient
- Position ventilator, drains, catheter and medication pumps in preparedness of new position
- Slide up bed so head off the bed with Anaesthetist supporting head and airway throughout
- Rotate head to face opposite direction as previous position maintaining airway
- Slide down bed so body fully supported
- Reposition other arm for 'swimming' or 'superman' position
|
Video Resources:
Note:this is not a formal guide or competency checklist for performing prone position procedure
ICUnurses (discuss • contribs) 11:12, 11 September 2014 (UTC)
