Prone Positioning of Patients With Acute Respiratory Distress Syndrome Related to COVID-19: A Rehabilitation-Based Prone Team

Physical Therapy
Jillian A NgJoseph Tolland

Abstract

Prone positioning is an effective intervention for acute respiratory distress syndrome (ARDS). An increasing number of patients with ARDS related to coronavirus disease 2019 (COVID-19) required prone positioning, which posed a challenge to the intensive care unit (ICU) staff at Brigham and Women's Hospital. 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. The service evolved over 7 weeks, expanding to 24-hour coverage and adding responsibilities to support the staff as patient volume grew. 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 ICU experience and leadership qualities, multidisciplinary collaboration, availability of needed positioning devices and supplies to protect the integument, and well-defined roles...Continue Reading

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Citations

Sep 16, 2020·American Journal of Critical Care : an Official Publication, American Association of Critical-Care Nurses·Vinciya PandianMichael J Brenner
Sep 2, 2020·European Journal of Physical and Rehabilitation Medicine·Francesco NegriniUNKNOWN International Multiprofessional Steering Committee of Cochrane Rehabilitation REH-COVER action
Apr 21, 2021·AACN Advanced Critical Care·Karen MiguelXianghong Sean Wang
Apr 30, 2021·Critical Care Explorations·Shewit P GiovanniCatherine L Hough
Jun 20, 2021·Ophthalmology and Therapy·Mariana Leuzinger-DiasPaulo Freitas-da-Costa
Jul 10, 2021·PM & R : the Journal of Injury, Function, and Rehabilitation·Marina B WasilewskiLawrence Robinson

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