Tags

Type your tag names separated by a space and hit enter

Prone Positioning of Patients With Acute Respiratory Distress Syndrome Related to COVID-19: A Rehabilitation-Based Prone Team.
Phys Ther. 2020 09 28; 100(10):1737-1745.PT

Abstract

OBJECTIVE

Prone positioning is an effective intervention for acute respiratory distress syndrome (ARDS). An increasing number of patients with ARDS related to coronavirus disease 2019 require prone positioning, which poses a challenge to the intensive care unit staff at Brigham and Women's Hospital.

METHODS

A prone team service of physical therapists and occupational therapists with critical care experience was established to assist with increasing demands for prone positioning of patients who were mechanically ventilated. The goals of the rehabilitation-based prone team were to provide support to nursing and respiratory therapy; create a consistent, efficient process; and ensure patient and staff safety.

RESULTS

The service evolved over 7 weeks, expanding to 24-hour coverage and adding responsibilities to support the staff as patient volume grew. The volume of requests to the rehabilitation-based prone team generally increased to week 4 and has, since then, declined. Key points for successful implementation included identification of rehabilitation therapists with intensive care unit experience and leadership qualities, multidisciplinary collaboration, availability of needed positioning devices and supplies to protect the integument, and well-defined roles of all disciplines participating in position change process.

CONCLUSION

The description of the development, operations, evolution, and utilization of a rehabilitation therapist prone team acts as a guide for future development and implementation.

IMPACT

This case report is one of the first reports of a rehabilitation-based prone team established to assist with positioning patients in prone as an intervention for ARDS related to coronavirus disease 2019 and will help guide other institutions.

Authors+Show Affiliations

Department of Rehabilitation Services, Brigham and Women's Hospital, 75 Francis St, Boston, MA 20115 (USA).Department of Rehabilitation Services, Brigham and Women's Hospital.Department of Rehabilitation Services, Brigham and Women's Hospital.Department of Rehabilitation Services, Brigham and Women's Hospital.Department of Rehabilitation Services, Brigham and Women's Hospital.Department of Rehabilitation Services, Brigham and Women's Hospital.Department of Rehabilitation Services, Brigham and Women's Hospital.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

32691056

Citation

Ng, Jillian A., et al. "Prone Positioning of Patients With Acute Respiratory Distress Syndrome Related to COVID-19: a Rehabilitation-Based Prone Team." Physical Therapy, vol. 100, no. 10, 2020, pp. 1737-1745.
Ng JA, Miccile LA, Iracheta C, et al. Prone Positioning of Patients With Acute Respiratory Distress Syndrome Related to COVID-19: A Rehabilitation-Based Prone Team. Phys Ther. 2020;100(10):1737-1745.
Ng, J. A., Miccile, L. A., Iracheta, C., Berndt, C., Detwiller, M., Yuse, C., & Tolland, J. (2020). Prone Positioning of Patients With Acute Respiratory Distress Syndrome Related to COVID-19: A Rehabilitation-Based Prone Team. Physical Therapy, 100(10), 1737-1745. https://doi.org/10.1093/ptj/pzaa124
Ng JA, et al. Prone Positioning of Patients With Acute Respiratory Distress Syndrome Related to COVID-19: a Rehabilitation-Based Prone Team. Phys Ther. 2020 09 28;100(10):1737-1745. PubMed PMID: 32691056.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Prone Positioning of Patients With Acute Respiratory Distress Syndrome Related to COVID-19: A Rehabilitation-Based Prone Team. AU - Ng,Jillian A, AU - Miccile,Lauren A, AU - Iracheta,Christine, AU - Berndt,Carolyn, AU - Detwiller,Meredith, AU - Yuse,Carolyn, AU - Tolland,Joseph, PY - 2020/05/12/received PY - 2020/07/08/accepted PY - 2020/7/22/pubmed PY - 2020/10/8/medline PY - 2020/7/22/entrez SP - 1737 EP - 1745 JF - Physical therapy JO - Phys Ther VL - 100 IS - 10 N2 - OBJECTIVE: Prone positioning is an effective intervention for acute respiratory distress syndrome (ARDS). An increasing number of patients with ARDS related to coronavirus disease 2019 require prone positioning, which poses a challenge to the intensive care unit staff at Brigham and Women's Hospital. METHODS: A prone team service of physical therapists and occupational therapists with critical care experience was established to assist with increasing demands for prone positioning of patients who were mechanically ventilated. The goals of the rehabilitation-based prone team were to provide support to nursing and respiratory therapy; create a consistent, efficient process; and ensure patient and staff safety. RESULTS: The service evolved over 7 weeks, expanding to 24-hour coverage and adding responsibilities to support the staff as patient volume grew. The volume of requests to the rehabilitation-based prone team generally increased to week 4 and has, since then, declined. Key points for successful implementation included identification of rehabilitation therapists with intensive care unit experience and leadership qualities, multidisciplinary collaboration, availability of needed positioning devices and supplies to protect the integument, and well-defined roles of all disciplines participating in position change process. CONCLUSION: The description of the development, operations, evolution, and utilization of a rehabilitation therapist prone team acts as a guide for future development and implementation. IMPACT: This case report is one of the first reports of a rehabilitation-based prone team established to assist with positioning patients in prone as an intervention for ARDS related to coronavirus disease 2019 and will help guide other institutions. SN - 1538-6724 UR - https://www.unboundmedicine.com/medline/citation/32691056/Prone_Positioning_of_Patients_With_Acute_Respiratory_Distress_Syndrome_Related_to_COVID_19:_A_Rehabilitation_Based_Prone_Team_ L2 - https://academic.oup.com/ptj/article-lookup/doi/10.1093/ptj/pzaa124 DB - PRIME DP - Unbound Medicine ER -