Fashions change in the position in which patients are nursed, perhaps most noticeably so in the case of neonates and children. However, largely for the convenience of medical and nursing interventions, almost all adult patients in intensive-care units are managed in the supine position. In 1974 Bryan suggested that nursing patients with respiratory failure in the prone position may be beneficial. Piehl and colleagues in 1976 and Douglas and co-workers in 1977 reported much improved oxygenation in patients with acute respiratory distress syndrome (ARDS) when they were turned from supine to the prone position. Although a few papers have appeared over the past 20 years confirming this improvement, it has not gained wide acceptance as a useful therapeutic manoeuvre.