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Safety Assessment of a Noninvasive Respiratory Protocol for Adults With COVID‐19
Author(s) -
III William E Soares,
Schoenfeld Elizabeth M,
Visintainer Paul,
Elia Tala,
Medarametla Venkatrao,
Schoenfeld David A,
Deutsch Ashley,
Salvador Doug,
Dietzen Diane,
Tidswell Mark A,
II Peter A DePergola,
Marie Peter St.,
Westafer Lauren M
Publication year - 2020
Publication title -
journal of hospital medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.128
H-Index - 65
eISSN - 1553-5606
pISSN - 1553-5592
DOI - 10.12788/jhm.3548
Subject(s) - medicine , intubation , nasal cannula , covid-19 , respiratory distress , emergency medicine , retrospective cohort study , protocol (science) , intensive care medicine , cannula , disease , anesthesia , surgery , pathology , infectious disease (medical specialty) , alternative medicine
As evidence emerged supporting noninvasive strategies for coronavirus disease 2019 (COVID‐19)–related respiratory distress, we implemented a noninvasive COVID‐19 respiratory protocol (NCRP) that encouraged high‐flow nasal cannula (HFNC) and self‐proning across our healthcare system. To assess safety, we conducted a retrospective chart review evaluating mortality and other patient safety outcomes after implementation of the NCRP protocol (April 3, 2020, to April 15, 2020) for adult patients hospitalized with COVID‐19, compared with preimplementation outcomes (March 15, 2020, to April 2, 2020). During the study, there were 469 COVID‐19 admissions. Fewer patients underwent intubation after implementation (10.7% [23 of 215]), compared with before implementation (25.2% [64 of 254]) ( P < .01). Overall, 26.2% of patients died (24% before implementation vs 28.8% after implementation; P = .14). In patients without a do not resuscitate/do not intubate order prior to admission, mortality was 21.8% before implementation vs 21.9% after implementation. Overall, we found no significant increase in mortality following implementation of a noninvasive respiratory protocol that decreased intubations in patients with COVID‐19.