Ziqitza Limited - What Is Pruning and how it helps COVID-19 patients
                     Ziqitza Limited - What Is Pruning and how it helps 
COVID-19 patients?
Covid-19 patients gasping for oxygen lining up outside 
hospitals across the country has been the defining 
image of the Coronavirus pandemic in the second 
wave. Shortness of breath and fluctuating oxygen 
levels are among the major symptoms of Covid-19. 
However, not every patient facing breathing issues 
requires hospitalisation. The Union Health Ministry 
has recommended the technique of "pronging" to 
help increase oxygen levels for those in home 
isolation. Pronging is a technique in which the patient 
lies on the stomach, face down, to try and improve 
the oxygen levels in the body where the oxygen level 
between 94-100 is considered healthy.
How to do proning?
This simple technique may help patients breathe just by changing 
their body position. Here’s how Ziqitza Rajasthan and 
Ziqitza Limited Rajasthan help you to know how to do proning. All 
we need for proning are 4-5 pillows. The patient usually undergoes 
a series of manual turns that are done in a synchronized pattern. 
This includes:
Step 1:   Turn the patient in the prone position (i.e., lying on the 
belly).
Step 2:   Next turn the patient laterally (i.e., sideways) on the right 
side.
Step 3:   Then make the patient sit up with the spine straight.
Step 4:   Next turn the patient laterally (i.e., sideways) on the left 
side.
Step 5:   Finally, turn the patient to the initial prone position.
Step 6:   Alternate the position every 30 minutes.
Step 7:   Each position requires the patient’s heart rate, blood 
pressure and pulse oxygenation level to remain stable during each 
move.
Step 8:   It is advisable not to spend more than 30 minutes in each 
position.
It can be done as many times as tolerable. One can prone up to 16 
hours a day in multiple cycles. While proning one must keep in 
mind injuries and pressure sores.
Why does proning work?
Flipping a patient on their stomach helps respiration because 
oxygenation getting more oxygen into the blood is easier in the 
prone position. ZHL Rajsthan further explains it's a function of 
anatomy, as the human body has more lung tissue in the back 
of the body than in the front. The Coronavirus causes 
abnormal fluids and secretions to pool toward the back, where 
there's more lung tissue and leads to greater interference with 
lung function. When a patient is in the prone position, gravity 
helps the secretions move downward, so more of the good 
lung is on top and therefore less affected says Dr Datar Medical 
Director, Ziqitza Healthcare Ltd. (ZHL) Proning is also an 
effective treatment for a condition called acute respiratory 
distress syndrome, a life-threatening complication of 
Coronavirus infection that manifests as shortness of breath and 
quickly progresses.
Where to place the pillows?
The pillows are arranged in the following manner to provide 
comfort to the patient:
Step 1: Place a pillow below the neck.
Step 2: Place 1 or 2 pillows below the chest and upper thighs.
Step 3: Place 2 pillows below the shins.
Step 4: Place 1 pillow below the head.
 
Things to take care while proning:
- Avoid proning for an hour after meals
- Maintain proning for only as many times as easily tolerable
- One may prone for up to 16 hours a day, in multiple cycles, as 
felt comfortable
- Pillows may be adjusted slightly to alter pressure areas and for 
comfort
- Keep track of any pressure sores or injuries, especially around 
bony prominences
When should you avoid proning:
- During pregnancy
- Deep venous thrombosis (treated in less than 48 hours)
- Major cardiac conditions
- Unstable spine, femur, or pelvic fractures
Ziqitza Limited says self-proning is a good way to 
boost oxygen levels at critical times when securing 
medical help may not be possible or manage 
symptoms at home. However, remember, it is only one 
of the ways that guarantees temporary relief and not 
a proper alternative for hospitalized care or oxygen 
support. Deep breathing, yogic pranayama, ample 
access to fresh air, staying hydrated, eating iron-rich 
foods, and light exercises also help in improving the 
oxygen level of patients while in home isolation.