Bentley SK, et al. Acad Emerg Med 2020.
Prior studies on proning awake, non-intubated patients with hypoxemic acute respiratory failure, as well as evolving study of similar COVID-19 patients, coupled with experience and dramatic anecdotal evidence from the COVID-19 pandemic, suggest the importance of proning all such patients with COVID-19 to improve oxygenation and reduce respiratory effort. Literature and experience from healthcare teams in the midst of the pandemic suggest that any COVID-19 patients with respiratory compromise severe enough to warrant admission should be considered for proning. We additionally suggest these patients should be considered for proning as well as ongoing patient re-positioning (e.g. right lateral decubitus, seated, and left lateral decubitus positions). Figure 1 represents the proning and positioning instructions developed at New York City Health + Hospitals/Elmhurst, a large, inner-city, tertiary public hospital in the epicenter of the COVID-19 pandemic in New York City, and later adapted and utilized at facilities across the United States.
PMID:32597005 | DOI:10.1111/acem.14067