It’s one of the lessons from the hospital front lines and it was reinforced during the recent coronavirus pandemic, positioning matters.
A significant percentage of pneumonia patients were placed on their stomachs or sides early on were able to avoid mechanical ventilation.
As patients began to flood the hospitals in March and April, ventilators were in short supply.
That’s when some emergency doctors began to rethink patients positions in bed. Traditionally on their backs.
“Just by the weight of your media sternum, your heart and your chest on the lungs, it collapses some of the spaces of the lungs. You turn the patients over and what that does is that helps to open up some of the collapsed lung,” said Dr. Nicholas Caputo, MD, Emergency Physician.
Airway specialists Dr. Richard Levitan volunteered at a New York hospital for ten days and saw the benefits and the drawbacks of being awake in a prone position.
“Patients sometimes are uncomfortable laying down on their stomachs, and I came up with the idea to use a pregnancy massage cushion as a way to help patients lay on their stomach comfortably,” said Dr. Richard Levitan, MD, Emergency Physician.
Dr. Levitan coordinated with a company in California that made proning boosters and had some distributed to several hospitals in New York.
At the same time, Dr. Levitan and Dr. Caputo did a small study following 50 COVID-19 patients who were placed in a prone position at one hospital in the Bronx.
“And in those 50 patients within the first 24 hours we were able to avoid intubation in three quarters of them,” said Dr. Caputo.
A small change in position making a life altering difference in some COVID-19 patients.