Tips for Breathing Easier with COVID-19

Lying Face Down
Can Help Breathing.
This information is provided for people with COVID-19.
Lying on your stomach (proning) may help your breathing. Proning has proved
helpful for a wide range of mild to severe respiratory conditions since the 1970s
at hospitals, care facilities and private homes.
Research shows that proning helps oxygen inhalation, expelling phlegm,
abdominal breathing and relaxation.

How to Prone Effectively and Comfortably
This leaflet explains how to get into: a complete prone position (* Figure 1), asemi-prone position (* Figure 2), and lying on your front in a seated position (*Figure 3=reverse side)※Please try the following positions as often as you feel comfortable.

Methods
Do not lie on the front of the body immediately after eating. Maintainthe prone posture you feel comfortable with for 15-30 minutes 1-2
times a day. Try these positions for as long as you feel comfortable andas many times as you like (See Figures for reference). Please do notstay in any position that causes discomfort or pain.

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Adjust your posture being careful to not bend your lower back or neck uncomfortablyor twist the neck unnaturally.
Use cushions, pillows, floor cushions, comforters, bath towels, towels, and othersimilar items to support and adjust as needed.

If your lower back bends uncomfortably
while prone, insert a cushion or a similar
item under your stomach for support. Also,
if the position of your breasts or neckcauses discomfort, using a cushion or asimilar item underneath can also help.

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When lying in a semi-prone posture asshown in Fig. 2, try not using a pillow
under your head to breathe easier. If
necessary, you can use a folded towel
instead of a pillow. You may also try using
a hug pillow to stabilize your bodyproviding more comfort. A comforter
folded lengthwise can serve as a hugpillow.

If you find it difficult to breathe while lying
down, try this method in a seated position.
Rest your head on your forearms or hold acushion or a pillow to ease your breathing.
  References used in creating this leaflet
The Japan Academy of Critical Care Nursing the Clinical Practice Group of the COVID-19 Measure Special Project & The Japanese Society ofIntensive Care Medicine the Nursing Practice Guide Group of the COVID-19 Measure Nursing Team (2020). Practical guidelines for caring forpatients with severe COVID-19 Ver. 2.0.: https://www.jsicm.org/news/upload/
Okubo, Y (2006). Validating the rationale for care: A summary of the latest research review. Is a prone position effective and safe in improving
respiratory function? Nursing Today 21 (11), 15.
Omiya Y (2013). Chapter 3: An outlook for prone position therapy as a nursing technique that can be applied to any patient at any time.
Hishinuma N & Kawashima M (eds.). The science and validation of nursing technique version 2: From research to practice, and from practice toresearch. (pp. 17-23). Japanese Nursing Association Publishing Company.
Omiya Y, Sato A, Yokoyama E, Tsuji Y, Onishi K, Shiratori A, Iwabuchi K (2015). The relaxation effect of a prone position. Mejiro Journal of HealthCare Sciences. vol. 9, 9-14.
Kawashima M, Marukawa S (eds.) (2016). Prone position therapy used in nursing care: Regaining physical and mental health by sleeping on thefront. Japanese Nursing Association Publishing Company.

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