This weeks COVID learning: I remain sceptical about proning patients on CPAP...

Proning improves SpO2 but patients feel breathless and can’t tolerate it for long. We’ve been able to wean FiO2 but there is no carry over when they turn back. Some patients felt too unwell to try.

Side lie also SpO2 and FiO2. But again on CPAP not been well tolerated. Patients managing about 15 minutes. Perhaps RR too or PEEP too?

More success with half prone- sitting leaning forwards onto pillows. Again SpO2 and FiO2 but only tolerated for 15 minutes.

Patients more willing to try half prone. Appear more comfortable, but it requires sitting high PEEP and O2 dep patients on edge of bed.

Perhaps proning SV patients on O2 (not CPAP)? Haven’t seen any longer term benefit- still deteriorating overall.

Could proning mask deterioration?

We are still getting experience about pillow placement and getting comfort right. This is more challenging with CPAP mask.

Who are the right patient group to be doing this with? level of PEEP/O2 / RR/ WOB/ what about using the ROX score?

I’m really keen to hear people’s experiences and how they compare. @uclh @TheACPRC @thecsp @oliviachappers @laura_janePT @cjblack_physio @agordon79 @Ronanastin @LouisaWeighill @HeleneBellas @NinaHoldenPT @emaroids1 @Char_Massey @Pereiracharlie #Covid_19 #Physiotherapy #proning