COVID-19 Awake Proning Policy Update 4.15.2020

Dotphrase .proneawake

The patient has worsening respiratory status and oxygenation and meets criteria for a trial of awake prone positioning. 

Patient currently on nasal cannula / simple mask / NRB / Heated high-flow
Patient’s current O2 need prior to proning is: ­­__L/min / __ % FiO2. 

Continuing to monitor pulse oximetry, mental status, and patient’s ability to tolerate O2 delivery devices in the prone position. If patient tolerates repositioning for 15 minutes, will reassess oxygenation 2 hours later. 

Purpose: Create a guideline for Conscious Proning of COVID-19 positive or PUI. No prior guideline exists. Address the following goals: 

  1. Optimize potential for recovery of O2 delivery after cough, ambulation, or fever. 
  2. Prolong clinical fitness to remain on the floor 
  3. Conserve ICU beds and Ventilator associated medications 
  4. Avoid Delaying necessary intubation 

Scope: Inpatient Acute Care, non-ICU COVID-19 units 

Reviewed and Approved by: Hospital Medicine Pulmonary/Critical Care Nursing Management and Education Respiratory Therapy 

Date: 4/13/2020 

Content Revisions and Edits Owners: Hospital Medicine
Noelle Northcutt (Noelle.Northcutt@dhha.org)
Jack Cunningham (John.Cunningham@dhha.org)

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