Non-invasive technique like placing patients face down on stomach reduces need for ventilators: DAK

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Doctors Association Kashmir (DAK) on Thursday said the prone positioning in which the patients are placed face down on their stomach or sides while lying down reduces the need for ventilators in COVID-19 patients.

“We can save lives by this simple non-invasive technique,” said DAK President and influenza expert Dr Nisar ul Hassan in a statement. “In proning, patients are placed face down onto their stomach or onto their side while lying down,” he said.

“By flipping over or to the side, you open up lungs that would otherwise be compressed when you are on your back,” said Dr Hassan, adding that “proning improves blood oxygen levels among Covid-19 patients struggling with abnormally low levels.”

He said when the COVID-19 pandemic first struck proning was not a go-to intervention. “Instead, COVID pneumonia patients with severely low oxygen levels were often quickly put on ventilators. Now, we are using this technique at SMHS hospital and the results are encouraging. Patients who are awake are placed in a facedown prone position along with supplemental oxygen. Many patients are improving with this technique and they no longer require a ventilator.”

Dr Hassan said various studies have shown that proning prevents COVID patients from being ventilated.

“A study published in the Journal ‘Accident Emergency Medicine’ tested proning in 50 Covid-19 patients who were struggling with dangerously low oxygen levels. The study found that after just 5 minutes of proning oxygen levels rose to the near normal level and in the end, about three-quarters of the patients never had to be put on a ventilator,” he said.

“Researchers at Columbia University found that 76 percent of COVID-19 patients who were in respiratory distress improved with proning and they didn’t need to be intubated,” he added.

Dr Hassan said it is important to understand that mechanical ventilators are no panacea for critically-ill COVID-19 patients. “Most patients in our experience who end up on ventilators pass away. And many of the patients who continue to live can’t be taken off the mechanical breathing machines,” he said.

“We now have a risk free technique to avoid these machines. Proning is a therapeutic intervention and should be considered in all awake COVID-19 patients who are in respiratory distress not maintaining oxygen saturation levels,” he said.