Turn Medical

11/25/2025

🩺 Prone Positioning vs. ECMO: Managing Caregiver Strain

Both manual prone positioning and ECMO can be physically and mentally demanding for ICU staff.

Considerations of prone therapy:

✅Early implementation can improve oxygenation and survival (PROSEVA trial, Guérin et al., 2013)

✅The Pronova-O2 Automated Prone Therapy System increases efficiency, offers safe patient handling, and helps minimize hemodynamic shifts.

✅Less resource-intensive compared with ECMO.

ECMO considerations:

☑️Cannulation and post-insertion care carry risks such as vascular injury and hemolysis (CESAR & ELSO Registries)

☑️Requires dedicated perfusionists and specialized ICU personnel

📌 At Turn Medical we have worked with many ECMO facilities helping to provide support for teams wanting to implement prone positioning while also having the option to deliver ECMO to their most critically ill patients.

☎️ Call us today to assist you with case studies or protocol development. We'd love to share our experience.

📞855-ASK-TURN

-O2™ ™

11/24/2025

A first in patient care took place at Prisma Health Richland Hospital this past week in Columbia, South Carolina. Dr. Mohammad A. Khan performed the very first bronchoscopy on a prone patient inside the Pronova-O₂® Automated Prone Therapy System.

This achievement reflects the incredible collaboration between the Prisma Health clinical team who continue to push the boundaries of what’s possible in caring for patients with severe respiratory compromise.

Innovations like this matter. They help clinicians deliver necessary interventions without interrupting prone therapy that is so critical for many ARDS patients, ultimately supporting safer, more effective care when every minute counts.

Proud to see frontline teams leading the way in advancing critical care practice. 👏

11/21/2025

🌎From Miami to Columbia, South Carolina, Turn Medical has been all over the Southeast this week providing our customers with education concerning respiratory issues and the use of the Pronova-O2 Automated Prone Therapy System. Our mission is to empower you with knowledge and skills - let's learn and grow together! 💪✨

If you are looking for education, information on the Pronova-O2, or just need a refresher class in product use, give us a call at 855-ASK-TURN. We LOVE to educate!!!

11/20/2025

🟣 Today we’re proud to support World Pressure Injury Prevention Day.

Preventing pressure injuries is essential to patient safety and comfort, as well as managing hospital cost. It’s a responsibility we all share. For those of you that utilize prone therapy, you know that typically its not a question of if a patient will develop a PI, it is when.

The proprietary InteliDerm® Powered Skin Protection System that comes with every Pronova-O2® Automated Prone Therapy System helps teams take a proactive approach with smarter moisture management, targeted pressure redistribution, and consistent protection where patients need it most.

In fact, data (Turn Medical Registry) demonstrates that patients placed on the Pronova-O2® System with InteliDerm® have a less than 5% incidence of reported pressure injuries. Real world problems, real solutions.

Today, we recommit to raising awareness, supporting caregivers, and advancing solutions that protect skin integrity every day.

®

11/20/2025

💡 Quick Deployment vs. Specialized Circuits: How Does This Shape Your ARDS Treatment Plan?

Prone therapy, especially automated prone therapy with the Pronova-O2™, can be initiated quickly by trained ICU staff to target oxygenation deficits immediately. Early prone positioning has been shown to reduce mortality by over 50% when applied within 36 hours of intubation. The PROSEVA trial (Guérin et al., 2013) underscores the survival benefit of early implementation.

ECMO, on the other hand, requires specialized equipment and a dedicated perfusion team (Peek et al., 2009). It is typically reserved for patients whose oxygenation remains dangerously low despite optimal proning and other standard interventions.

📌 Guiding principles:

Understand your unit’s resources and protocols, and consider less invasive interventions

Escalate per facility guidelines—many programs reserve ECMO for truly refractory cases.

Follow current guidelines (ESICM, ATS, Grasselli et al., ICM 2023; Qadir et al., AJRCCM 2024).

✅ Takeaway: A measured, evidence-based approach balances patient benefit with practical realities, ensuring safe and effective ARDS care.

💻 Learn more: Visit Turn Medical’s Clinical Resources or enroll in Turn University for step-by-step prone therapy guidance and in-depth training. We can also be reached at 855-ASK-TURN, by email at info@turnmedical.com, or visit our website at www.turnmedical.com.

™ -O2™

11/18/2025

With flu season already painting the U.S. map in deeper shades on the CDC’s FluView, it’s hard not to think about the incredible strain this places on the caregivers who show up day after day. As patient volumes rise, so does the toll on our nurses—physically, emotionally, and mentally.

This seasonal surge puts a spotlight on one of the most pressing challenges in healthcare today: nurse retention. Supporting and protecting the teams who care for all of us isn’t optional, it’s essential. Now more than ever, we need to prioritize meaningful solutions that reduce burnout, improve working conditions, and keep our caregivers safe and supported.

Turn Medical's CEO, Tara Psencik, takes an in-depth look at what Nurse Leaders are saying about this issue and how innovation and technology can help.

To every nurse stepping into the storm this flu season—thank you. Your resilience drives healthcare forward.

https://turnmedical.com/five-keys-pronova-o2-can-play-with-nurse-retention/

11/18/2025

🩺Some teams debate whether prone positioning has peaked in effectiveness once you consider ECMO. However, Schmidt et al. (2020) reported that proning can still provide boosts in oxygenation during ECMO support.

Randomized data is limited, but observational studies show encouraging trends. The central message: Prone therapy isn’t merely a placeholder for severely compromised patients, it’s a first-line intervention (Grasselli, et al., ICM 2023 and Qadir et al., AJRCCM 2024) that can continue being valuable if ECMO is deployed.

This approach can help maintain gas exchange, mobilize secretions and improve V/Q mismatch while closely watching for complications like bleeding or hemodynamic changes. We know because we have utilized the Pronova-O2™ with ECMO on many occasions!

Choosing a dual approach requires strong teamwork, protocols and the right tools. Respiratory therapists, ICU nurses, and physicians all add vital perspectives. By uniting around evidence-based practice, patient safety and resource management can stay balanced.

Got questions about prone therapy, the Pronova-O2™, or how our device integrates with ECMO?
📞 Call 855-ASK-TURN — our team is ready to help!

-O2™

11/17/2025

The simplest interventions in medicine are often the most powerful but are many times overlooked. Positioning is one of those for patients in respiratory distress, but is many times forgotten.

"Why? Positioning isn't glamorous. It doesn't beep, it doesn't graph, and it doesn't get charted like ventilator settings. But it can quietly save lives".

This a powerful reminder that simple solutions can provide tremendous benefit if only we remember to use them! Enjoy

The Forgotten Role of Positioning in Respiratory Care “Sometimes, the most powerful intervention doesn’t come from a ventilator it comes from gravity.” We often focus on ventilator settings, oxygen delivery, and medications. But one of the most underrated tools in respiratory care is positioni...

11/13/2025

💡 Are there benefits to both prone therapy and ECMO?

Absolutely. Research shows that prone positioning can significantly improve survival in severe ARDS (Guérin et al., 2013), while ECMO remains a vital rescue option for refractory hypoxemia (Combes et al., 2018).

📊 When guided by current best-practice algorithms (Grasselli et al., ICM 2023; Qadir et al., AJRCCM 2024) and combined thoughtfully, these therapies can help clinicians deliver evidence-based, patient-centered care.

⚙️ Prone therapy demands precise coordination and careful patient turning.
🫁 ECMO requires advanced cannulation, continuous monitoring, and dedicated expertise.

Each carries unique risks — from pressure injuries during proning to a 46% major bleeding rate with ECMO (Combes et al., 2018) — yet both can be lifesaving when used for the right patient at the right time.

👍 As teams refine ARDS protocols, remember:
No single approach fits every patient.
Consistent escalation pathways, education, and communication remain the keys to the best outcomes.

For structured training and evidence-based tips, turn to Turn Medical. Let’s keep our focus on safety, stewardship, and appropriate application of the data.

☎️ Call us at 855-ASK-TURN or email: mailto:info@turnmedical.com for more information.

11/12/2025

Ever wonder about the guideline sequence? According to the most current ESICM and ATS guidelines (Grasselli, et al., ICM 2023 and Qadir et al., AJRCCM 2024), clinicians should prioritize prone therapy for moderate-to-severe ARDS before exploring ECMO.

❓Why? The evidence, including the PROSEVA trial (Guérin et al., 2013), shows notable survival benefits and proning carries fewer resource burdens than ECMO. If oxygen levels remain critically low after a thorough trial of prone sessions, moving to ECMO becomes a justified step.

That said, ECMO is not a guaranteed fix: The EOLIA RCT (Combes et al., 2018) yielded mixed mortality data alongside higher bleeding risk. This is where real-world experience, resource logistics, and multidisciplinary input all come into play. Clarity in guidelines helps teams plan safer, standardized workflows.

Turn Medical is proud to offer the Pronova-O2™ to help simplify the proning process, and protect patients and caregivers alike.

Call us at 855-ASK-TURN for more information.

™

11/11/2025

Although my father and uncle are no longer with us, they both proudly donned the uniform of the United States Army and served in places like Vietnam, Korea, and Germany. For all those that have answered the call to serve, those of us here at Turn Medical offer our profound gratitude. God Bless America!

11/11/2025

Choosing how best to stabilize severe ARDS patients is a difficult task. Should your team prone early or consider advanced options like ECMO? While both are viable options, each has its strengths and challenges.

With prone therapy, the PROSEVA trial (Guérin et al., 2013) demonstrated that early and extended prone positioning can nearly halve mortality rates in severe ARDS compared with remaining supine. Prone therapy also:

✅ Improves Oxygenation

✅Reduces potential for ventilator induced lung injury

✅Improves ventilation/perfusion matching.

Prone therapy does incur some risk with the potential for ET dislodgement, loss of lines, and the risk of caregiver injury. Automated prone therapy with the Pronova-O2 can help with these issues due to its intelligent design.

The use of ECMO has demonstrated mixed outcomes. The CESAR trial (Peek et al., 2009) demonstrated a 63% reduction in freedom from death or major disability compared to 47% in the control group but there were a number of issues noted in the study. 24% of the ECMO group did not require ECMO and only 70% of the control group received lung protective ventilation as opposed to 90% of the ECMO group. Prone positioning was only used in 42% and 37% of patients in the control group and ECMO group respectively. These results demonstrated the importance of lung protective ventilation and specialist input rather than the benefits of ECMO.

In the EOLIA trial (Combes et al., 2018), prone positioning and neuromuscular blocking agents were encouraged with 90% of the control group undergoing prone positioning compared to 66% in the ECMO group. There was no significant difference in mortality between the two groups. The trial did suggest the potential for ECMO to be used as a rescue effort in patients in whom conventional management failed. 43% of patients that failed conventional management and were crossed over to ECMO were alive at day 60. Subsequent meta-analyses combining data from these trials show that there seems to be a reduction in mortality at 60 days in patients with severe ARDS treated with ECMO.

Complications with ECMO are similar to those seen with other central venous access procedures:

✅Bleeding

✅Haematoma

✅Damage to adjacent structures

✅Pneumothorax

✅Arrhythmias

✅Use of longer guidewires and large cannulae also can cause tricuspid valve injury, cardiac perforation/tamponade and air embolism

When choosing the appropriate intervention, practice guidelines are a good place to start. International guidelines (Grasselli, et al., ICM 2023 and Qadir et al., AJRCCM 2024) advise teams to start with prone maneuvers before stepping up to ECMO if oxygenation still falls short. As you weigh these data, it’s vital to consider staffing, resource availability, and associated risks. Prone therapy typically deploys quickly and minimizes vascular injury. ECMO can be lifesaving in certain refractory cases but requires a specialized crew and constant monitoring.

For more information about automated prone therapy and the Pronova-O2™, call us at 855-ASK-TURN, email at mailto:info@turnmedical.com , or visit our website at http://www.turnmedical.com .

It’s all about choosing the right option, safely, systematically, and according to your unit’s capabilities.

™ -O2™