TURNING AS A NURSING MANEUVER

Turning is one of the general kinds of nursing actions during care of patients. Turning is one of the general kinds of nursing actions during care of patients. Critically ill patients turning maximizes ventilation to improve oxygenation which in turn would affect the individual’s ability to maintain an internal environment that allows normal cellular function The critical care nurse plays a crucial role in the assessment, diagnosis, and management of patients with respiratory problems who develop hypoxemia.

position changes had a significant effect on oxygenation in mechanically ventilated patients

The improvement in arterial blood gases depends on site and extent of lung pathology Normal lungs lungs Bilateral disease disease Unilateraldisease ABG are improved in all positions The best position is prone The subsequent are right and then left The subsequent are right and then left The same improvement in duration and frequency but less than in normal lung Are improved with the good lung down Are improved with the good lung down Are worsened with the affected lung down Are worsened with the affected lung down

In both Healthy lungs Diseased lungs Prone and side lying positions enhance the efficiency of O 2 transport and thereby minimize or avoid use of high concentration of supplemental oxygen and positive end expiratory pressure.

body positioning is a 24-hours concern For any critically ill patient

Patients with normal lungs and patients with bilateral lung disease Tur n Left 1.5 hr Prone 1.5 hr Right 1.5 hr Supine 1.5 hr

Patients with right lung disease Turn Left 1.5 hr Prone 1.5 hr Right 0.5hr Supine 1.5 hr

patients with left lung disease Tur n Prone 1.5 hr Right 1.5 hr Supine 1.5 hr No left

Position change is asimple way to reduce shunting and improve oxygenation Position change is a simple way to reduce shunting and improve oxygenation It allows reduction in FIO 2 and PEEP and reducing their complications *do your patients a good turn *Try the position changes early in the course of illness Turning a critically ill patients is not difficult. It requires four trained nurses

Hospital administration Schools of nursing Critical care units *pre-service training programs (for newly critical care nurses) *in-service training programs (for already critical care nurses) *pre-service training programs (for newly critical care nurses) *in-service training programs (for already critical care nurses) Books and scientific magazines The care of critically ill patients in their programs