This was posted almost exactly two years ago. Look at all of us boning up on our pulmonary physiology during the pandemic. Crazy times. Thank you Jonathon! Be well everyone!
@sl49834 жыл бұрын
Can they actually turn a patient on their stomach in the hospital bed though? What about all the stuff they have connected?
@Elevatorbakery4 жыл бұрын
Guilty!
@phasetwentyeight4 жыл бұрын
@@sl4983 It is possible and employed, but needs a coordinated well trained team of at least 3 members.
@eileenmacdougall89454 жыл бұрын
@@sl4983 They were doing it in china with better affect.
@sl49834 жыл бұрын
Are ventilators connected to 60 GHz powering (5G)?
@Spiritual-journey94 жыл бұрын
The best articulated and explained lecture on Prone ventilation I’ve heard! Thank you!
@afraidtoask4 жыл бұрын
I agree. Excellent! But please get a better microphone, please!
@alext88284 жыл бұрын
I'm sorry, I didn't understand a word of it. I'm not a doctor.
@mervynsfontillas13914 жыл бұрын
This is the most helpful and easiest explanation of this topic I've ever seen, kudos sir!!! Thanks for making this
@atlantisrose67904 жыл бұрын
as a soon to be respiratory therapist this was an amazing explanation of the rationale and physiology of why proning is so beneficial. thank you for this great content.
@cornelbacauanu15444 жыл бұрын
Essential info these days .Excellent explanation .Thank you .
@ParaACP6 жыл бұрын
Great new blog Jonathan. Helped me understand the mechanisms involved much better than I previously did by just reading the literature alone. 👌👌👌
@TheCriticalCarePractitioner6 жыл бұрын
Scott Hawkins thanks Scott. Had to record this twice having screwed it up the first time so glad it is useful.
@rbbruni14 жыл бұрын
Neonatologist here. I also tend to think that in babies prone positioning drops the abdominal organs, allows larger diaphragmatic excursion, and that increases (potentially )lung volumes
@LifestyleLabUK4 жыл бұрын
Brilliant video: simple, concise, no-"water". Thank you very much!
@TheCriticalCarePractitioner4 жыл бұрын
You're welcome!
@richs42216 жыл бұрын
Well explained!Thank you for sharing i understand more the pathophysilogy of prone positioning and including the list of literature. I need it for my revisions.
@snowgurl214 жыл бұрын
The best ARDS explanation and proning!! Covid 19 lungs are similar and some are put on a rotopron bed
@ThePerpetualStudent4 жыл бұрын
sars 2 can cause ARDS
@aja3694 жыл бұрын
Great video! I’m a new adv care practitioner in US and your videos are very helpful and informative!
@davidgarcia3844 жыл бұрын
Thank you so much for your video from Madrid. Including the list of scientific papers.
@lucylulusuperguru34874 жыл бұрын
After seeing your presentation here...I'd happily work with you in a heartbeat...excellent grasp of the entire thing!
@TheCriticalCarePractitioner4 жыл бұрын
Thank you. That's very kind. More coming soon!
@bella1207ful4 жыл бұрын
Excellent explanation, thank you!
@eileenmacdougall89454 жыл бұрын
Great information. Thank you .
@jamesbuchanan97494 жыл бұрын
I adopted the prone position when I had flu in November 2018. I lay on my front with my head over the edge of the mattress, because the mucus that was running into my chest was making me cough and it was becoming very painful. It took me several weeks to recover with the help of some anti-biotics. From a lay-mans point of view it seems a practical method to get the fluid out of the lungs to have your head at a lower level whilst lying on your front.
@tdahanayake4 жыл бұрын
Thank you very much! From Sri Lanka🇱🇰
@caterina21224 жыл бұрын
Can you review the “Odom Ultra flu A&B testing ?? Instructions on collecting samples. Also instruction on collecting strep testing ? I just subscribed after your lecture on supine/prone ARDS, brilliant!!
@katymcgowan36184 жыл бұрын
This helped so much! thank you
@Yazanyghi1234 жыл бұрын
Thanks for the excellent explanation and presentation!
@TheCriticalCarePractitioner3 жыл бұрын
Glad it was helpful!
@ashutoshmeena61396 жыл бұрын
Thanks, nicely explained..👍🏼
@TheCriticalCarePractitioner6 жыл бұрын
Thank you, glad it helped.
@dinahweisberg7504 жыл бұрын
This is fascinating and very helpful!
@berry.x93887 ай бұрын
very good video, sir, thank you!
@dankan17034 жыл бұрын
Hi Jonathan, thank you for the great explanation. I had a patient who was COVID +ve, and had a LT lower lobe collapse, supine CO2 was 12. What would be the cause of this ? When would you consider proning to be a contraindication ?
@multanocte64314 жыл бұрын
Thank you!
@rickyrn19844 жыл бұрын
FreakING bad ass lecture from an ICU CCRN. Thank you doctor!!!!!!!!!!!!!! Respect respiratory!!!!!!
@noemarcial4 жыл бұрын
Concidering corrent sanitary emergency and the fact that many people don't gets the ventilator witch are the downside of start prone the patient between 250 p/f and 150 p/f. Concidering that studies like proseva have show the best result close to 150 p/f ( but i dont find data about proning before) . today a small change that make a small improvement in the survival rate of covit 19 it will mean thousands of lifes
@sagek79494 жыл бұрын
3:20 was the most helpful part.
@peacenow423 жыл бұрын
The positioning of the arms may be helpful also. When I raise my arms, it calms my bronchospasms...I learned to do this via a family that always tells kids when they are choking on food to raise their arms.
@jeetthakkar85053 жыл бұрын
Thanks ❤️
@l33tsh33p4 жыл бұрын
Thanks! Could you please discuss these same factors as found in a patient who is primarily sitting or reclining? As might be found during typical hospital care or home illness. Would patients dealing with some form of respiratory stress/distress be well served by adopting a prone position?
@Ivanalunamar4 жыл бұрын
Good question
@book678912 ай бұрын
I had a bad cold or flu last week and for 1.5 hours while I was trying to sleep on my back I was constantly coughing and I had a lot of gurgling and bubbling of fluid in my lungs. I've had that before so I was not alarmed but it was distressing to think I had the whole night ahead of me. I flipped over to sleep on my stomach and ALL of the bubbling and gurgling in my lungs went away and the coughing reduced to near zero. I was shocked at how dramatic the change was. I was basically able to sleep the rest of the night. I also slept on my stomach the 2nd night, though I had a little bit of coughing but I was eventually able to sleep most of the night. To sleep on my stomach I sleep with my head on the edge of the pillow so my face is angled slightly down and I prop up my shoulder with 3 folded towels and I also lift my hip on that same side with a crumpled up bedsheet. This reduces the amount of neck rotation needed to sleep on my stomach. Another trick is to add something to keep your head from sliding off the pillow. It's hard to describe but basically I use pillowcase with the T-shirt in the end of it that sticks out from under my pillow and that creates a stop (like a wedge) to prevent my head from sliding off the side of the pillow. I've worked out these tricks for sleeping on my stomach over the past 2 years because I find stomach sleeping helps me sleep a lot better. I'm 57 years old and turning my head to the side to sleep on my stomach is more difficult than a younger person, so these methods reduce the amount the head needs to be turned for stomach sleeping.
@clavo33524 жыл бұрын
RE CoVid patients: Does forward or backward tilting of the patient in the prone position help with fluid in the lungs control; and, will diuretics help remove some of the lung fluids? Non-medical, non-engineer inventor. Have read Richtel's : "An Elegant Defense" 5 times though. Based on that, Dr. Fauci has a known plan for developing a therapeutic, I believe.
@maryjanekeao23513 жыл бұрын
Thank you, sir.🤠😊👍🏽🇺🇸
@knheard5 жыл бұрын
Thank you for this information. My Brother In Law will be in a ROTO-BED in a few hours. 13 days with A(H1N1) and complications from the double pneumonia. This has to save him. Praying for his recovery.
@thatone12314 жыл бұрын
Update? My grandmother is in ICU with double pnemonia and they are putting her in a roto bed today
@chaunceking82084 жыл бұрын
Hope everything went well
@sabrinaalston12434 жыл бұрын
PRAYING TOO
@drfilthiest4 жыл бұрын
Great explanation. Anaes doc.
@LynnFishmanMeditation4 жыл бұрын
excellent
@sl49834 жыл бұрын
Do hospitals and doctors do this though?
@chuchoclar3 жыл бұрын
Hello Jonathan. Do you Know a consensus? Or which Is you opinion about when to stop prononing? 3,4,5..8,9 data?
@gissie3914 жыл бұрын
Anluer said we sit jp when chest infevtions and i asked about whh ventilators were set so low and ...nio answer .later i saw tbwt increase of acudosis yet optimum penstrayion for crona is pH 5:5 yet it t flourishes at lower pHs too because a idif solutions dont kill it off sp is sitting pstiejtz up with chest infectionz only wben no ARDS ?sitti g patie ts up in hrart failure vhest infectinz what hhdb do.
@giacomovasarri80013 жыл бұрын
I'm afraid there is a mistake. In the supine position the dorsal alveolis, at reast, are smaller and less expanded then the vental ones, but this means that during the inspiration the dorsal alveolis (with the same pressure variation) have a greater expantion in comparison with the ventral ones. Therefore the dorsal region is better ventilated then the ventral region And I still don't understand why in ARDS the the prone position improve the V/Q ratio
@sazu7774 жыл бұрын
superb👍👍👍👍
@TheCriticalCarePractitioner3 жыл бұрын
Thank you! Cheers!
@russellbateman33922 жыл бұрын
I wonder if you'd address methods of lying prone. An obese person has difficulty lying prone. What is your practice in that case?
@geroldatlarge18414 жыл бұрын
Bravo
@johanponin13604 жыл бұрын
You seem to know a bit about lungs. For people with mild dyspnea. Are there movements to help massaging alveolis and improve oxygenation ? I move my shoulders to modify my chest shape and it feels better (now how much is placebo..? hence my question).
@markandrewjavier4 жыл бұрын
Johan PONIN interesting question!
@sherlockholmes69564 жыл бұрын
Will it help a corona patient not yet in resp. Distress? Patient is feverish x 30 days. No sob. On abx but not improving. Diabetic x 30 years uncontrolled.
@oxygen02633 жыл бұрын
Can we use this in covid problem
@winsi40725 жыл бұрын
Thanks for the explanation. But I have a question. What if an ARDS patient had a cardiac arrest during prone ventilation, will you attempt to perform CPR while the patient is in the prone position?
@TheCriticalCarePractitioner5 жыл бұрын
Depends on airway. If not intubated turn over ASAP. If intubated do CPR prone; there is evidence it is just as effective. See guidance on cardiac arrest during neurosurgery which covers this quite well. t.co/ySanGXUwbL
@charlesdarwin51854 жыл бұрын
Did you take into account the weight of the spine and back muscles? Do you need higher airway pressures? What about the personnel needed to keep turning the patient?
@MarshaNHill4 жыл бұрын
Review Respiratory Anatomy and Physiology...
@charlesdarwin51854 жыл бұрын
@@MarshaNHill how many prone ventilation have you seen or done yourself?
@newhorizon40664 жыл бұрын
It's really hard to follow without ample illustrations, and explanation of technical terms, at least to me as a layperson in these matters...
@patriciamorgan65454 жыл бұрын
On the MedCram KZbin channel, there's excellent info, with diagrams, for healthcare workers and also laypeople. This lecture from 2 months ago explains a lot about the virus, and also some about proning: How Coronavirus kills: Acute respiratory distress syndrome (ARDS) and COVID-19 treatment.
@VainerCactus04 жыл бұрын
Question. If you incline the patient so their head is slightly lower than their feet while they are prone, will there be a better draining from the lungs? I seem to remember reading something about doctors doing this during the SARS outbreak in 2002, but I can't find any info about this. Would this be an option for serious cases for the current COVID19 outbreak?
@manthasagittarius14 жыл бұрын
I remember seeing this done years ago when I worked in hospitals as a college student. They called it postural drainage, and it was applied to several firefighters with pretty bad smoke inhalation. The treatment was more aggressive than mere positioning, and involved cupping percussion to the back. They had heads four inches lower than trunk, in prone position. The drainage, which was of course grossly discolored and pretty viscous, was profuse and production without undue effort.
@VainerCactus04 жыл бұрын
@@manthasagittarius1 Getting the nasty stuff out of your lungs is always a good thing.
@TheCriticalCarePractitioner4 жыл бұрын
This is not about draining fluid from the lungs. It is to give the alveoli room to expand in areas with the best blood supply
@VainerCactus04 жыл бұрын
@@TheCriticalCarePractitioner I had and still have been, reading stories about how COVID 19 patients lungs are being damaged by the bodies own attempts to fight the virus. Other stories talk about ICU staff turning the ventilators up very high because patients lungs are so full of fluid that their lungs can't absorb air properly. To me, it makes sense to put the patient in a position that allows gravity to drain the fluid out of their lungs so they can breath better. Of course, I have no medical qualifications, none of my family or close friends have any medical qualifications. It would not surprise me if I am entirely wrong, which is why I asked my question.
@ashvandal56974 жыл бұрын
How smart do you feel right now having posted this 2 years ago?
@lynleeanne2174 жыл бұрын
Great graphic education, thank you but please what is a 'slinky'????
@freedomartwork69504 жыл бұрын
The toy made out of a thin flexible spring.
@infinity-gn9xq4 жыл бұрын
Basically a coil.
@colleenpellant14842 жыл бұрын
Hello Jonathan, I have COPD and am having surgery in the prone position. How safe is intubation in this position?
@TheCriticalCarePractitioner Жыл бұрын
Very safe in experienced hands which I am sure you will have.
@colleenpellant1484 Жыл бұрын
@@TheCriticalCarePractitioner Thank you. I was in the safest hands.
@SM-2gmnl4 жыл бұрын
No wonder why I sleep quickly on prone position!
@SandraS13974 жыл бұрын
Just found out my Aunt was placed in one of these to try and treat her for Covid-19. The medications they tried didn't work so now they're trying this.
@klmoll4 жыл бұрын
I hope she has improved
@winsi40724 жыл бұрын
Hi, can I have a request? For the sake of emergency response on Pandemic situation and the upcoming 2020 CPR Guidelines, can you upload KZbin videos on how to manage a Prone Ventilated Asystolic (cardiac arrest) patient using Prone CPR simulation? Majority of CPR mannequin simulation for Asystolic CoVid-19 patients on KZbin are Really Disappointing, in which they NEVER did a CPR simulation on a patient undergoing prone ventilation since hospital staffs around the world are trained to do PRONING.
@kay49124 жыл бұрын
Win Si thx for posting your comment. I didn’t not realize you could perform CPR on a prone pt. I thought they had to be supinated first. But your question had me look it up and get some valuable information. Now I’m interested in a video
@winsi40724 жыл бұрын
Kay In what video are you interested?
@davidfox16804 жыл бұрын
Severe C-19 ARDS -> Cardiac arrest -> No CPR ????
@markarca63604 жыл бұрын
Noticed that in some news footages of some of the COVID-19 patients in a hospital ICU in Italy and they are placed in prone position. So the theory behind that is to allow phlegm and fluids to drain by gravity, and it is postural drainage in itself.
@patriciamorgan65454 жыл бұрын
The theory appears to be also that the larger part of the lung is more evenly inflated with this method (thus better oxygenation, and removal of carbon dioxide), with less shearing force between the alveoli, thus less ventilator-induced damage if the patient needs to be on a ventilator for a long time (as many do with this virus). Please also see MedCram KZbin channel, which has excellent info for healthcare workers and also laypeople. This lecture from 2 months ago gives a good overview of 3 fairly recent advances in ventilation practices, including proning: How Coronavirus kills: Acute respiratory distress syndrome (ARDS) and COVID-19 treatment. I was curious about that footage from Italy too, and the MedCram lecture explained it perfectly for me. Lots of other great info about the virus there, too.
@TheCriticalCarePractitioner4 жыл бұрын
This is not about draining fluid, rather about giving the alveoli room to expand in areas which have the best blood supply
@igorkyriakin37454 жыл бұрын
My opinion is that it will be much better to lower the head end of the patient's bed by about 10 degrees so that the lungs can drain with the help of gravity naturally in the supine position, in much the same way as one would do with a recovering drowning person. A mixture of a few % alcohol in the patient's inhaled gas would help to break up sticky mucus, ease stress on alveoli and reduce infection. All this work in this vid cited as good, credible med practice is fine, but it makes patients look as if they are on a spit roast. Still, its better than a course of leeches. I would like to add here that as a chronic sufferer of bronchitis, asthma and emphysema for 50 years, I found early that the above worked well to ease my symptoms and quickly restore normal breathing from chronic struggle. For my self-treatment, I used to heat up vodka in a pan and inhale the vapour with a towel over my head for a few minutes, then lie with my head over the end of the bed for a while to drain my lungs, and repeat until I felt somewhat better. It worked and still does, or I would not have done the same all these years without the need for medication. That is what happens when you live in traffic pollution centre London. Matey.
@sl49834 жыл бұрын
Ventilator Induced Lung Injury...Okay people need to know this!!
@patriciamorgan65454 жыл бұрын
Yes, it's well known. Please see MedCram KZbin channel, very good info for healthcare workers and also laypeople. This lecture from 2 months ago explains it very well: How Coronavirus kills: Acute respiratory distress syndrome (ARDS) and COVID-19 treatment.
@sl49834 жыл бұрын
@@patriciamorgan6545 MedCram, thank you
@patriciamorgan65454 жыл бұрын
@@sl4983 👍👌
@sl49834 жыл бұрын
@@patriciamorgan6545 oh boy, are they connected to a 60 GHz system?
@newengresearch12874 жыл бұрын
Would it be more helpful to have the patient on their belly with their hips being higher than their shoulders?
@pacmangumby4 жыл бұрын
wht if they start standing patients up
@DIPPLEDORP4 жыл бұрын
How about putting bed in cardiac chair position.
@TreiHutchinson3 жыл бұрын
It's the SUJUD position ..
@JoshuaKevinPerry4 жыл бұрын
If you are sick, by all means sleep on your stomach.
@hundun56044 жыл бұрын
Maybe I missed it, but why not laying on the l/r- side? That would reduces the stress on the heart. Another thing is, when laying on the back to put both hands behind the head. That opens up the lungs.
@NetRolller3D4 жыл бұрын
Anyone else noticed Windows Vista in the background?
@muhammdyousaf5 жыл бұрын
👍👌👍👌👍👌👍👌👍
@elisabethv233 жыл бұрын
Anyone else think their screen was scratched, below the cabinets? 😅
@vedataslan61214 жыл бұрын
This is why bats hang upside down in moist and cold caves. This position protects the lungs more easily. Gravity helps the secretions.
@sl49834 жыл бұрын
Wow, why don't I think most doctors in America don't know or practice this, especially now...
@triciagrant23154 жыл бұрын
They do.
@TheCriticalCarePractitioner4 жыл бұрын
Yes, I'm sure they do.
@hollyhocks73604 жыл бұрын
I’m here because I noted the Italians had their ITU patients prone during the COVID19
@patriciamorgan65454 жыл бұрын
Besides draining, the theory appears to be also that the larger part of the lung is more evenly inflated with this method (thus better oxygenation, and removal of carbon dioxide), with less shearing force between the alveoli, thus less ventilator-induced damage if the patient needs to be on a ventilator for a long time (as many do with this virus). Please also see MedCram KZbin channel, which has excellent info for healthcare workers and also laypeople. This lecture from 2 months ago gives a good overview of 3 fairly recent advances in ventilation practices, including proning: How Coronavirus kills: Acute respiratory distress syndrome (ARDS) and COVID-19 treatment. I was curious about that footage from Italy too, and the MedCram lecture explained it perfectly for me. Lots of other great info about the virus there, too.
@asrove29533 жыл бұрын
You must have said great things. But please realize that these days patients or their families also Google around to understand the situation and options. So pls simplify for this kind of desperate audience too
@Naturalvibes2024.3 жыл бұрын
Muslims do this 5 times a day on daily basis threw prayer (bowing their forhead down)
@chateaumojo4 жыл бұрын
So proning is upside down planking. I see.
@you7tube7Abukhaled3 жыл бұрын
Actually it is the position of prostration we do in our 5-time daily prayers in Islam. God knows what is the best for us.
@KubieQ3 жыл бұрын
its called gravity. not god.
@you7tube7Abukhaled3 жыл бұрын
@@KubieQ yes right, it's gravity through prostration... and prostration is commanded by God.
@gloriamaggs54534 жыл бұрын
30 years working with ventilator patients. Never in prone position. Cannot see any advantage or practicality in the actual physical care. G.
@rickyw.26314 жыл бұрын
I haven't made it to ICU yet, (The floor I currently work is IMCU/Covid19 unit), U say patients are never positioned in prone?
@alexandrasachlis19644 жыл бұрын
@ricky w. I’m a new graduate RN and I recently was in the ICU for a couple of months as a student and I saw a couple of patients on rotoprone bed therapy. While speaking to nurses on the unit, a couple had positive success stories with previous patients. It can really increase lung compliance. But I’m assuming with a lot of ARDS patients, it’s difficult to reverse. Just sayin, as a student I’ve seen it in south Florida🙂 I know though that patients sometimes get denied as a candidate for this therapy and ECMO. Best wishes and be safe!
@rickyw.26314 жыл бұрын
@@alexandrasachlis1964 Nice, Ur orienting in ICU?
@amayranylucio39593 жыл бұрын
I appreciate you Gloria. Not like these dumb ass doctors that just because their licensed they think they can get away with murder.
@chateaumojo4 жыл бұрын
Why don't they hang them up like bats in daytime?
@stapedium4 жыл бұрын
Abdominal organs weigh on the diaphragm when I’m headstand position. Better if standing up.
@chateaumojo4 жыл бұрын
@Lebensborn 2 oh, uh, yeah. I guess so. Seen Norm McDonald's video/song about eating bats? Very funny.
@noemarcial4 жыл бұрын
Concidering corrent sanitary emergency and the fact that many people don't gets the ventilator witch are the downside of start prone the patient between 250 p/f and 150 p/f. Concidering that studies like proseva have show the best result close to 150 p/f ( but i dont find data about proning before) . today a small change that make a small improvement in the survival rate of covit 19 it will mean thousands of lifes