For patients with suspected or confirmed COVID-19 who are in a prone position without an advanced airway, attempt to place in the supine position for continued resuscitation.
Although the effectiveness of CPR in the prone position is not completely known, for those patients who are in the prone position with an advanced airway, it may be reasonable to avoid turning the patient to the supine position, unless able to do so without risk of equipment disconnections and aerosolization. If unable to safely transition the patient to a supine position, place the defibrillator pads in the anterior-posterior position and provide CPR with the patient remaining prone with hands in the standard position over the T7/10 vertebral bodies.
Prone position used to improve oxygenation in mechanically ventilated patients and also used in surgical procedures
Used in the management of Acute Respiratory Distress Syndrome (ARDS)
Highly recognized during COVID-19
• Hand position during Prone CPR
Over T7-T10 Vertebral bodies or 0-2 vertebral segments below the inferior angle of the scapula
• Rate and depth remain the same
• ET-CO2 feedback can be used to define effective compressions
Position of the defibrillator pads follow same principals as supine position
• Can take up to 5 minutes to turn a patient to supine position
• Can take up to 5 individuals to turn patient delaying CPR
• Cycling hypoxemic patients from prone to supine can aggravate hypoxemia through accidental disconnection of ventilator
• Increase in airborne risk of infection to healthcare
*AHA INDIA SUMMIT 2023. Calicut, Kerala, India*