Prone positioning in conscious patients on medical wards: A review of the evidence and its relevance to patients with COVID-19 infection

Abstract

Medical teams continue to treat many patients with COVID-19 infection. This disease can result in profound hypoxaemia that may necessitate intubation and invasive mechanical ventilation in those who are critically ill. This intervention carries risk to both patients and healthcare workers and utilises significant hospital resource for prolonged periods. Simple, safe interventions that can be used before critical deterioration are highly desirable. The prone position in conscious non-ventilated patients with COVID-19 infection may improve oxygenation in the short term and defer or prevent the need for intubation in some. However, clinicians must be aware that there is a small evidence base for this intervention currently. This review sets out evidence regarding the use of this technique to aid the decision making of frontline staff.

Keywords: COVID-19; acute respiratory failure; hypoxaemia; oxygenation; prone.