Pre-Proning Checklist

Pre-Proning Preparation for the Mechanically-Ventilated Patient:

• Gather necessary equipment according to Proning Checklist

• Verify ETT is well secured

• Optimize ventilator settings and pre-oxygenate patient: place patient on 100% oxygen

• Suction ETT and oral cavity

• Remove and cap unnecessary lines and tubes

• Provide necessary physical care, including wound care and dressing changes

• Ensure patient is well sedated (using RASS score), including neuromuscular blockade (using TOF) as appropriate

• Have emergency airway cart accessible, including having appropriately sized ETT immediately available

• Prone ventilation is recommended 12-16 hours daily.

Utilize the Organizational Proning Checklist here: https://www.lhsc.on.ca/media/3798/download

Is your critical care team utilizing a Pre-Proning strategy before turning patients? Are you meeting as a group to discuss individual roles to make your process efficient? Comment below what system is working for your team.

References:

• https://www.pulmonologyadvisor.com/home/topics/restrictive-lung-disease/prone-ventilation-limitations-for-patients-with-mild-or-moderate-acute-respiratory-distress-syndrome/