As Covid-19 cases surge in the country, India is reeling under the unavailability of oxygen, caused by a shortage due to the rapid rise in cases. ICMR DG Dr Balram Bhargava on Monday said that there is no difference in per cent of deaths between the first and the second wave and added that a higher requirement of oxygen was found in this wave. “Higher requirement of oxygen was found in this wave. There is no difference in the per cent of death between the first wave and second wave from the data we have,” said Balram Bhargava. Even as the current active caseload stands at 20 lakh, Twitter is flooding with messages asking people for help with finding oxygen. As several patients are in home quarantine, and monitoring their symptoms to notice a change or dip in their oxygen levels, a video showing how to ‘improve’ your oxygen levels is going viral.
The video, which was shared on Twitter and forwarded on WhatsApp groups shows a man lying face-down position, with his chest raised, also called the ‘prone method’ and shows how his oxygen level improves from it.
But is it just a viral claim or a hack that actually works? News18 asked an expert.
“The prone method isn’t a hack, it’s a tried and tested and scientifically proven method to improve oxygen supply,” Dr Rajesh Pande, the Senior Director of BLKC Center for Critical Care in Delhi, tells News18. “This is quite scientific, and doctors have been following it for more than 10 years,” he explains.
“Normally, before COVID, this was done for patients who had severe respiratory failure, and on a ventilator. We put them in the prone position for 16 hours, and it would stretch the mortality rate for the patients significant,” he says, adding that, however, before COVID, this wasn’t the norm. “We wouldn’t do this for any and every patient with breathing difficulty. For that, we have two methods of providing oxygen – either with an invasive ventilation technique, by intubating them, or a non-invasive ventilation technique, where a mask is put on them. The patients who were put on the prone method were usually put in this position when they were heavily sedated, on a ventilator, usually to improve their chances. It has now become a norm for Covid-19 patients.”
Dr Pande also explains the science behind the prone method: “The lung has three regions, front, middle and back. When someone is lying with their back down-chest up, the blood supply to the back is the best, and the one to the front is the least. If you look at the air going in, the back gets the least oxygen supply. To change this, when someone is put in the prone position, the heart rests on the breast bone and gives space to the lungs to expand, increasing the airflow to the back, where the blood circulation is the most. So, coupled with better blood circulation, and more oxygen, then it leads to better, effective oxygenation.”
The prone method is also proven for better chances. A study published in New England Journal of Medicine, called ‘Effect of Prone Positioning on the Survival of Patients with Acute Respiratory Failure,’ concludes that “During the study period the mean increase in the ratio of the partial pressure of arterial oxygen to the fraction of inspired oxygen, measured each morning while patients were supine, was greater in the prone than the supine group. The incidence of complications related to positioning (such as pressure sores and accidental extubation) was similar in the two groups.” Since the study also had a control group, it adds that “In patients with severe ARDS, early application of prolonged prone-positioning sessions significantly decreased 28-day and 90-day mortality.”
Dr Pande also explains that while the method is now used in Covid-19, from the ground reality, there is a slight difference in coronavirus affected lungs vs acute respiratory failure, where “the lungs don’t appear that stiff, and how in the majority of patients the lungs are normal, so inflating them is easy with other methods too.”
While there are no long-term recorded negative effects of the prone method, and only positive ones, Dr Pande only recommends following this method at home when you feel a dip in your oxygen levels and can do this while waiting for an ambulance or medical help.
If you feel any Covid-19 symptoms or test positive, here’s a 9 step guide from the Indian Medical Association on what to do.