Table 4.

Examples of relative contraindications to the prone position in awake, non-invasively ventilated patients on medical wards. Adapted from ICS (2020)³²

Absolute contraindications	Additional considerations
Respiratory distress	RR>35, PCO2≥6.5 kPa, accessory muscle use
Immediate need for intubation
Haemodynamically unstable	SBP<90 mmHg, arrythmia
Agitation or altered mental state
Unstable spine/thoracic injury/recent abdominal surgery
Relative contraindications
Facial injury
Neurological issues	Frequent seizures
Morbid obesity	May include gross ascites
Pregnancy	Second/third trimesters
Pressure sores	Particularly facial/sternal

PCO₂ = partial pressure carbon dioxide; RR = respiratory rate; SBP = systolic blood pressure.