Proning - A Simpler Way to Help Treat COVID-19

Proning - A Simpler Way to Help Treat COVID-19

Dr. Levitan’s experience treating COVID-19

Dr. Richard Levitan is an airway specialist who has practiced emergency medicine for over 30 years. His expertise led him to develop an imaging system for teaching intubation.  Dr. Levitan is currently working on the front lines in the COVID-19 care units of one of New York’s largest hospitals and his home hospital in New Hampshire.  Dr. Levitan’s experience with COVID-19 patient care led him to believe that the majority of patients with COVID pneumonia can be managed with less invasive techniques than high-risk intubation such as patient movement and proning (face down positioning).  These simple techniques can often rapidly correct and improve oxygenation and reduce the effort required to breathe, helping to avoid disease progression and the need for intubation, according to Dr. Levitan.  He became such a believer in proning that he and his brothers founded a non-profit, to educate and advocate for proning techniques.

Dr. Richard Levitan discussing proning


The Problem with Proning

The problem with proning is that it is extremely uncomfortable to lie face down for the recommended 16 hours per day, especially for people who have back problems or are overweight.  Without a very expensive, proning table costing more than $10,000 each, patients must lie flat with their heads turned to the side, often with oxygen tubes or masks attached.  It was keeping patients from the full benefits of proning.


How did Earthlite get involved?

When the news of COVID-19 started to spread, members of the Earthlite team began speaking to a numerous doctors, nurses and healthcare workers about their critical needs.  In our conversations with Dr. Levitan, we found that he was searching for a pillow or mattress to make proning COVID-19 patients easier.  As a result, Earthlite adapted a pregnancy bolster that was designed to accommodate an expecting mother’s stomach for use with COVID-19 proning treatment.  Earthlite’s Prone Comfort Bolster accommodated larger patients comfortably, was easy to move around, was cleanable, and had room for oxygen masks and tubes.  In short, the hospitals and patients loved them.  Earthlite began to donate bolsters to Dr. Levitan’s non-profit.  To date, Earthlite has donated more than $60,000 worth of bolsters to Dr. Levitan’s non-profit to help hospitals in this time of crisis.    


What is proning and why does it work?

Proning or prone positioning is the placement of a person into a prone position so that they are lying on their stomach to open their lungs to facilitate breathing. With the heart down on the sternum (prone) the posterior lower lung segments are not compressed the way they are in a supine or sitting position.

Woman using prone bolster


Whether biking over the Alps or climbing the highest mountains on the planet, humans that are facing severe oxygenation challenges typically position themselves as prone as possible. The fastest animals on the planet all run prone. You see lots of athletes lean forward when they pause or after they are finished.  Aerobic capacity is optimized by maximizing lung volume and area for oxygen absorption while being in a prone position.


When is proning effective?

Proning is used in the treatment of patients, not just in intensive care with acute respiratory distress syndrome (ARDS), but also for deep breathing practices. It has been especially tried and studied for patients on ventilators but, during the COVID-19 pandemic, it is being used for patients with oxygen masks and CPAP (continuous positive airway pressure ventilator) as an alternative to ventilation. Dr. Levitan and his team has collected testimonials from around the world that report that COVID patients improve their oxygenation not only with supplemental oxygen, but with prone positioning patient oxygenation rates improves significantly.  Breathing effort is also lessened, and respiratory rates slow down.  Patients report being much more comfortable.


Why use a proning bolster?

Earthlite’s FDA registered Prone Comfort Bolster™ dramatically increases comfort during face down treatment and recovery, enabling patients to be comfortably proned for extended periods of time.  The Earthlite bolster provides generous memory cushioned support to accommodate many body shapes and sizes, especially those who are significantly overweight.  Its angled design relieves pressure on the lower back, while the adjustable cushioned headrest adjusts to the position and size of the patient’s head.  The large open area under the face cushion enables the use of CPAP masks and oxygen tubes.  The compact and portable proning bolster easily fits on stretchers and hospital beds and can be easily disinfected.  More can be found here:


Would you like to donate?

Prone bolster given to Memorial Hospital


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Sources: Wikipedia / /

Disclaimer: Prone2Help Inc. and do not provide medical advice and do not recommend any specific treatment strategies. All airway management and oxygenation strategies must be determined by the applicable clinician(s) caring for the patient, with the consent and under the direction of the clinician’s hospital or medical facility and the patient, as applicable. None of Prone2Help Inc. and, its officers, directors or affiliates is responsible for the use, misuse or non-use of proning cushions or other treatment strategies, equipment or supplies (whether provided by Prone2Help Inc. or or otherwise). Patients should consult their own clinician about the risks and benefits associated with proning and other strategies; clinicians, hospitals and medical facilities should consider the risks and benefits associated with proning and other strategies before recommending their use.