Transport of a Nonintubated Prone Patient with Severe Hypoxemic Respiratory Failure Due to COVID-19

Prehosp Emerg Care. 2021 Jan-Feb;25(1):55-58. doi: 10.1080/10903127.2020.1819492. Epub 2020 Oct 12.

Abstract

With the COVID-19 pandemic, healthcare systems have been facing an unprecedented, large-scale respiratory disaster. Prone positioning improves mortality in severe hypoxemic respiratory failure, including COVID-19. While this is effective for intubated patients with moderate-to-severe ARDS, it has also been shown to be beneficial for non-intubated patients. Critical care transport (CCT) has become an essential component of combating COVID-19, frequently transporting patients to receive advanced respiratory therapies and distribute patients in concert with available resources. With increasing awake proning, CCT teams may encounter patients supported in the prone position. Historically, transporting in the prone position has not been embraced due to substantial risks of desaturation during transport. In this case report, we describe the first known report of transporting a non-intubated, critically ill COVID-19 patient in the prone position.

Keywords: ARDS; hypoxemia; patient safety; prone; transport.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • COVID-19 / complications
  • COVID-19 / therapy*
  • Critical Care
  • Emergency Medical Services
  • Humans
  • Male
  • Patient Positioning*
  • Prone Position*
  • Respiratory Insufficiency / etiology
  • Respiratory Insufficiency / therapy*
  • SARS-CoV-2