Coronavirus: This is how senior citizens practicing home isolation can ensure good oxygen supply to their lungs

We all know that COVID-19 can cause serious lung infection and in acute cases it may also result in acute respiratory distress syndrome (ARDS) and pneumonia. But, one should remember that not everyone gets to the stage of ARDS. It’s important to understand and identify which stage is severe and further needs care.

Stages of infection

1. This is where the asymptomatic case comes in. The person is infected but acts only as a carrier and shows no visible signs of infection. Such individuals are super-spreaders as they are not aware of the infection within.

2. The next category involves those who have an infection in the upper respiratory tract, and show visible symptoms such as mild fever, stomach ache, diarrhoea and fatigue, cough, headache, conjunctivitis etc

3. Here, the symptoms are more acute. The blood oxygen starts fluctuating and may require hospitalization. The Oxygen level in the blood should be regularly monitored and should not fall below 94% on the pulse oximeter and hospital admission may be required on the advice of a doctor

4. The fourth category comprises severe cases that may lead to acute respiratory distress syndrome. This results in low oxygen levels in the blood, due to damage to the alveolus. The condition results in shortness of breath and breathing difficulties. Once the patient progresses to ARDS, it eventually leads to pneumonia.

Techniques to ensure adequate supply of oxygen

For many senior citizens who already have compromised immune system due to underlying medical conditions like diabetes, respiratory disease, hypertension or other comorbidities, it becomes all the more important for them to be aware of ways to ensure an adequate supply of oxygen to their lungs in case of a COVID-19 infection.

Senior citizens need to continue doing breathing exercises to keep their lungs strong. They can also do self proning when they are in self-isolation at home and the oxygen level falls below 94% on the oximeter. The position improves ventilation and helps in breathing easy and avoid the condition of hypoxia (compromised oxygen circulation)

Proning improves breathing comfort and oxygenation and is particularly comforting to patients showing signs of breathing difficulty and when timely done can be very beneficial in supporting a patient’s lungs.

How is proning done?

One would need 4-5 pillows: one below the neck, one each below the chest and upper thighs. Two pillows to be placed below the shins. There are around-4 proning positions suggested, and the senior citizen should alternate between positions every 30 minutes. One needs to remember that one should not lie in a proning position till an hour after taking a meal.

Different positions in a proning cycle are as follows:

1. 30 minutes to 2 hours lying on your stomach

2. 30 minutes to 2 hours lying on your right side

3. 30 minutes to 2 hours sitting up

4. 30 minutes to 2 hours lying on your left side

5. Then back to your position of lying on your stomach

Cautions while practicing proning

● Avoid proning for an hour after meals

● Avoid proning in pregnancy and deep venous thrombosis

● Patients with cardiac conditions and spinal issues, femur or pelvic fractures

● Should be done as long as comfortable or maximum up to 16 hours a day in multiple cycles.

● Avoid hurting any pressure sores, injuries or bony prominences

Proning has been found to be extremely beneficial in avoiding a situation of ARDS and have evidently helped in preventing worse complications when practiced timely.

[The author is Dr. ShilpiKulshreshtha, Medical Doctor, Antara - A Max Group company specializing in senior care]