Post Proning Nursing Checklist

Head/Face: 

 - Check ETT/tracheostomy is accessible/not kinked (ETT cm at teeth …..)

 - All connections between ETT and ventilator circuit secure

 - Note ETT/tracheostomy cuff pressure

 - ETT positioned in middle of mouth, not compressing lips

 - Dermal gel pads placed between ETT cotton ties and patient’s skin

 - Confirm ears are not bent over

 - Perform ETT/tracheal suctioning immediately post proning

 - Eyes taped shut

 - No direct pressure on the eyes

 - Ensure 30° foot down positioning (Reverse Trendelenburg)

 - Move patient’s head from side to side 2 hourly to relieve pressure

 - NG tube secure and not displaced (cm at nose=…..)

 - NG tube not causing pressure to nostril

Neck:

 - Verify that patient’s lower back and neck are not hyper-extended

 - Front of neck free from compression

 - Central line secure

Chest:

 - Chest drains patent and on correct suction

 - Breasts supported and free from pressure

Abdomen:

 - Abdomen free

Pelvis:

 - Pelvis support cushion in place

 - Male genitalia positioned between legs

 - Catheter tubing is free and between legs

Arms:

 - Placed by side of patient

 - Shoulders not rotated

 - No compression over elbows

 - Wrists in neutral position

 - Hands free

 - Alternate Swimmers Position 2-4 hourly

 - No peripheral IV lines under patient

Legs:

 - Pillows positioned under shins to prevent extension

Infusions/Monitoring:

 - All monitoring recommenced

 - All infusions connected and infusing

 - Check CRRT lines patent

 - ECG leads not underneath patient

 - Ensure patient is well sedated and pain free

 - Infusion lines not resting on patient’s skin

 - Mattress is in dynamic mode

 - Check ABG 20-30 mins post prone positioning



PDF: https://www.ficm.ac.uk/sites/default/files/prone_position_in_adult_critical_care_2019.pdf



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