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Updated: Nov 24, 2025

An Educational Video Demonstration of How to Prone a Critically Ill Intubated Patient
Published on: November 30, 2022
Prone positioning for ARDS patients-tips for preparation and use during the COVID-19 pandemic
Ken Kuljit S Parhar1,2, Danny J Zuege3,4, Karen Shariff3,4
1Department of Critical Care Medicine, University of Calgary and Alberta Health Services, Foothills Medical Center, Calgary, AB, Canada. ken.parhar@albertahealthservices.ca.
Abstract:
Many patients with coronavirus disease (COVID-19) will develop acute respiratory distress syndrome (ARDS). Prone positioning is an important non-pharmacologic strategy that should be considered for all invasively ventilated patients with moderate to severe ARDS (including those with COVID-19). Prone positioning offers several physiologic and clinical benefits, including improving hypoxemia, matching ventilation with perfusion, reducing regional hyperinflation, and improving survival. To safely offer prone positioning, appropriate training, simulation, and health system planning should be undertaken. In this review, we offer ten tips, based on the Alberta provincial prone positioning strategy during COVID-19, to safely implement and improve the appropriate use of prone positioning. We provide special considerations for its use during the COVID-19 pandemic or future respiratory pandemics.
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