Prone Position Pressure Injury Check — FRCA Final MCQ

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EasyIntensive Care MedicineProne Position Pressure Injury CheckFRCA Final

A 50-year-old man on ICU with ARDS has been proned for 16 hours with improvement in oxygenation. Before turning the patient supine, which complication must be specifically checked for?

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Correct answer: B — Pressure injuries to the face, eyes, and dependent pressure points

Prone positioning for prolonged periods (≥16 hours as per PROSEVA protocol) carries specific risks of pressure injuries. Areas at highest risk include: face (chin, forehead, cheeks), eyes (corneal abrasion, raised intraocular pressure), ears, genitalia in males, breasts, knees, and iliac crests. These must be systematically checked on return to supine positioning. Other complications of proning: endotracheal tube displacement, vascular access problems, facial/periorbital oedema, brachial plexus injury, and difficulty with CPR if cardiac arrest occurs. A structured turning protocol with role allocation minimises these risks.

Reference: ICS – 2024 – Prone positioning guidelines; Guérin C et al – 2013 – PROSEVA trial