Table 4.

Examples of relative contraindications to the prone position in awake, non-invasively ventilated patients on medical wards. Adapted from ICS (2020)32

Absolute contraindicationsAdditional considerations
Respiratory distressRR>35, PCO2≥6.5 kPa, accessory muscle use
Immediate need for intubation
Haemodynamically unstableSBP<90 mmHg, arrythmia
Agitation or altered mental state
Unstable spine/thoracic injury/recent abdominal surgery
Relative contraindications
Facial injury
Neurological issuesFrequent seizures
Morbid obesityMay include gross ascites
PregnancySecond/third trimesters
Pressure soresParticularly facial/sternal
  • PCO2 = partial pressure carbon dioxide; RR = respiratory rate; SBP = systolic blood pressure.