P PRONE CPR

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Prone CPR in Children

What is Prone CPR?

Prone CPR refers to performing chest compressions while the patient is lying face down (prone position) instead of the usual supine position. It is mainly considered in specific situations, such as:

• Patients who cannot be turned supine quickly (e.g., intubated patients in prone ventilation, trauma, or spinal instability).

• Operating room or ICU settings where repositioning is difficult.

Is Prone CPR Effective in Children?

• Limited research in pediatrics, but adult studies suggest it can generate near-normal cardiac output.

• Used in cases where prone positioning is necessary for lung function (e.g., severe ARDS).

• Some pediatric case reports support its use as a temporary measure until supine positioning is possible.

Technique for Prone CPR in Children

1. Identify Hand Placement

   • Locate the T7-T10 vertebrae (mid-thoracic spine, at the scapular level).

   • Hands should be placed over the spine between the scapulae.

2. Chest Compressions

   • Deliver adequate depth (~1/3 of the chest, as per AHA pediatric guidelines).

   • Compression rate: 100-120/min.

   • Allow full recoil.

3. Airway Management

   • If an advanced airway is present, continue breaths at 10/min.

   • If no airway, attempt face mask ventilation with head turned to the side.

4. Transition to Supine ASAP

   • Prone CPR should be a bridge until repositioning is feasible.

Key Considerations

✔ May be beneficial in ICU patients on prone ventilation
✔ Effective perfusion has been demonstrated in adults
✔ Should not replace standard CPR unless necessary

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