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Conscious Proning: An Introduction of a Proning Protocol for Nonintubated, Awake, Hypoxic Emergency Department COVID‐19 Patients
Author(s) -
Jiang Lynn G.,
LeBaron Johnathon,
Bodnar David,
Caputo Nicholas D.,
Chang Bernard P.,
Chiricolo Gerardo,
Flores Stefan,
Kenny James,
Melville Laura,
Sayan Osman R.,
Sharma Manish,
Shemesh Amos,
Suh Edward,
Farmer Brenna
Publication year - 2020
Publication title -
academic emergency medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.221
H-Index - 124
eISSN - 1553-2712
pISSN - 1069-6563
DOI - 10.1111/acem.14035
Subject(s) - medicine , ards , prone position , emergency department , covid-19 , intensive care medicine , pandemic , emergency medicine , hypoxia (environmental) , work of breathing , respiratory failure , medical emergency , mechanical ventilation , anesthesia , lung , disease , infectious disease (medical specialty) , nursing , chemistry , organic chemistry , oxygen
The novel coronavirus, or COVID‐19, has rapidly become a global pandemic. A major cause of morbidity and mortality due to COVID‐19 has been the worsening hypoxia that, if untreated, can progress to acute respiratory distress syndrome (ARDS) and respiratory failure. Past work has found that intubated patients with ARDS experience physiological benefits to the prone position, because it promotes better matching of pulmonary perfusion to ventilation, improved secretion clearance, and recruitment of dependent areas of the lungs. We created a systemwide multi‐institutional (New York–Presbyterian Hospital enterprise) protocol for placing awake, nonintubated, emergency department patients with suspected or confirmed COVID‐19 in the prone position. In this piece, we describe the background literature and the approach we have taken at our institution as we care for a high burden of COVID‐19 cases with respiratory symptoms.