Self-proning in Nonintubated Patients with Coronavirus Disease 2019

Abstract

Purpose/Objectives The purpose of this article is to share observations one clinical nurse specialist noted after applying the concept of proning to treat acute respiratory distress syndrome in nonintubated patients with a confirmed or suspected diagnosis of coronavirus disease 2019 (COVID-19). Description of the Project/Problem Respiratory distress was a main symptom of many patients. However, hospitals were unable to meet the demand for automatic proning beds at the beginning of the pandemic, and no literature on prone positioning for nonintubated patients was published. One clinical nurse specialist identified self-proning as a means to improve respiratory distress, subsequently disseminating education and applying the practice with nonintubated patients with respiratory distress in the emergency department and throughout the COVID units in 1 hospital. Outcome Improved oxygenation saturation was observed by bedside staff after self-proning was implemented. Patients verbalized breathing easier while in the prone position. Patients were reminded to self-prone if their oxygenation saturations decreased. Self-proning afforded some patients enough stamina to call their loved ones before requiring intubation. Conclusion Through this observational experience, it was apparent that this low-risk intervention of nonintubated self-prone positioning improved oxygenation in patients with respiratory distress with a confirmed or suspected diagnosis of COVID-19.