Prone Position (face down) - Not for Homecare Environment
• Prone nursing is usually prescribed as an emergency therapy for patients in acute
respiratory distress or to manage extensive wounds on the dorsum, such as
pressure ulcers or burns.
• The decision to adopt the prone position must be authorised by the clinician
responsible for the patient's care.
Turning a patient into a prone position carries a moving and handling risk to
both the patient and the clinical staff: conduct a full assessment, comply with
local protocols and use positioning aids and side rails where necessary.
The anaesthetist or most senior member of the team should be positioned at the
head end of the bed and will co-ordinate the turning procedure. This person
will also be responsible for the safety of the patient's head, neck and ventilation
tubing. The other members of the team will help safeguard all lines and assist
with the turning procedure as directed.
Before commencing the turn, it is recommended that all non-essential lines and
monitoring equipment are disconnected.
1. Press the Static button to put the pump into Static mode, so that the mattress
cells remain constant with all cells equally inflated.
The mattress must be stable and not alternating while the patient is turned, so
that the patient is correctly positioned on the mattress.
2. Position the patient so that the shoulders are in line with the Shoulder Support
(4th) cell.
3. Open the Vent Valves on the three Head Section cells so that they are deflated.
4. Turn the patient into the prone position whilst supporting the head.
5. Adjust the head position using pillows, foam or gel pads so that a comfortable
posture is achieved without hyperextension.
6. Make sure that any lines/tubes are not placed underneath the head, check that
the ears are free from pressure and bony prominences are well padded.
7. Check that the shoulders are still in line with the Shoulder Support (4th) cell.
The Shoulder Support (4th) cell has no Vent Valve and continues to alternate
to provide both support to the patient's shoulders and pressure redistribution
over the vulnerable shoulder area.
8. Press the Static button to put the pump back into Alternating mode.
Wait for at least one full cycle (10 minutes) before making a final adjustment
of any supporting pillows or pads.
9. Determine an individualised repositioning schedule based upon the patient's
condition.
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