Positioning really does work!

Hey all,
At the moment I'm on prac in ICU. We have a patient who is a recent C4 complete quadriplegic. His Chest Xray shows left middle zone consolidation (though it is improving with comparison to previous Xrays). We were called to see him as his oxygen saturation had dropped to 86% after being turned. He was lying on his right side and on auscultation his right lung had widespread crackles and exp wheezes. We did some ventilator hyperinflation, combined with some exp vibes and numerous suctions but to no avail. We needed to reposition him as the secretions had appeared to drain into his "good " lung (right) and since this was preferentially perfused, it was compromising his gas exchange. Even though it required 5 of us to reposition him onto his left side (halo traction and cervical spinal precautions), it was defiantly worth it! His oxygen saturation instantly rose back up to 98%. The now drained left lung became the dependent lung and was therefore better perfused, therefore maximising his gas exchange. It was really good to see an effect occur almost immediately and was valuable to see how simple, yet effective positioning is.