Stop the pressure: national pressure ulcer prevention guidance when nursing patients in the prone position (May 2020)

Summary

The prone position is defined as lying in a horizontal position with the front of the body facing downwards. Its use with critically ill patients with respiratory compromise is known to improve short-term oxygenation and lung compliance.

The desired outcome of prone positioning is to improve lung perfusion and oxygenation in patients who are in the early stages of pneumonia or who have an acute lung injury (ALI) or acute respiratory distress syndrome (ARDS) which is common in COVID–19 patients.

One of the most common complications of nursing patients in the prone position is the occurrence of pressure ulcers. Pressure ulcers are likely to occur as patients are repositioned far less frequently once in prone (generally only after 16 hours) and also the patient may develop significant facial oedema. It is important therefore to take precautions to reduce the risk of pressure ulcers when preparing for and caring for the patient in the prone position.

This NHS guidance promotes good skin care during prone positioning.