When should a therapist consider placing a patient in the prone position?

The correct answer is that a therapist should consider placing a patient in the prone position when the FiO2 is greater than 60% and the PEEP is greater than 12 cmH2O. This recommendation is rooted in the practice of treating patients with acute respiratory distress syndrome (ARDS) or severe hypoxemia. Proning can improve ventilation-perfusion matching, recruit collapsed alveoli, and promote better oxygenation, particularly in patients with significant hypoxemia.

When the FiO2 exceeds 60%, it indicates that the patient is experiencing substantial difficulty in oxygenation, necessitating interventions to enhance lung function and oxygen transfer. A PEEP level above 12 cmH2O suggests that there is likely significant intrinsic positive end-expiratory pressure and alveolar collapse, further supporting the need for strategies like positioning in prone to alleviate these issues.

In contrast, the other scenarios provided do not present indications for proning. For example, low levels of FiO2 with minimal PEEP suggest that the patient's oxygenation status is adequate, making proning unnecessary. Similarly, stability on a ventilator might imply that the patient is managing well without the additional complexity of proning, while effective recruitment maneuvers point to ongoing efforts to open air