Cardiopulmonary Resuscitation in the Prone Position: A Good Option for Patients With COVID-19

Ludwin, Kobi; Szarpak, Łukasz; Ruetzler, Kurt; Smereka, Jacek; Böttiger, Bernd W.; Jaguszewski, Miłosz; Filipiak‬, Krzysztof J.

doi:10.1213/ane.0000000000005049

Cited by 8 publications

(10 citation statements)

References 7 publications

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“…Over the course of the past several months, it is now increasingly likely that cardiopulmonary arrests will occur in the prone position, 22 and there has been a call for more evaluation, education, and guidance when completing CPR in the prone position in patients with COVID-19. [22][23][24] Though our simulation does not involve a COVID-positive patient, we believe that it provides a basic framework upon which to build when considering prone CPR in any patient.…”

Section: Discussionmentioning

confidence: 99%

Cardiopulmonary Arrest and Resuscitation in the Prone Patient: An Adult Simulation Case for Internal Medicine Residents

et al. 2021

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Introduction Acute respiratory distress syndrome (ARDS) is present in approximately 10% of ICU admissions and is associated with great morbidity and mortality. Prone ventilation has been shown to improve refractory hypoxemia and mortality in patients with ARDS. Methods In this simulation, a 70-year-old male had been transferred to the ICU for ARDS and was undergoing scheduled prone ventilation as part of his care when he experienced a cardiopulmonary arrest secondary to a tension pneumothorax. Learners demonstrated how to manage cardiac arrest in a prone patient and subsequently identified and treated the tension pneumothorax that was the cause of his initial arrest. This single-session simulation for internal medicine residents (PGY 1-PGY 4) utilized a prone mannequin connected to a ventilator in a high-fidelity simulation center. Following the simulation, facilitators led a team debriefing and reviewed key learning objectives. Results A total of 103 internal medicine residents participated in this simulation. Of those, 43 responded to a postsimulation survey. Forty-two of 43 agreed or strongly agreed that all learning objectives were met, that the simulation was appropriate for their level of training, and that their participation would be useful for their future practice. Discussion We designed this simulation to improve learners' familiarity with prone cardiopulmonary resuscitation and to enhance overall comfort with cardiac arrest management. Postsimulation survey results and debriefings revealed that the simulation was a valuable education opportunity, and learners felt that their participation in this simulation would be helpful in their future practice.

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Section: Discussionmentioning

confidence: 99%

Cardiopulmonary Arrest and Resuscitation in the Prone Patient: An Adult Simulation Case for Internal Medicine Residents

et al. 2021

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“…A sandbag or a bag of saline is sufficient for this purpose [ 5 ]. The effectiveness of CPR is affected by the depth of chest compressions, and therefore it is still recommended to place the patient on a hard surface or to place a rigid board under the patient [ 6 ].…”

Section: Reviewmentioning

confidence: 99%

Prone Cardiopulmonary Resuscitation (CPR) Protocol: A Single-Center Experience at Implementation and Review of Literature

McCraw¹,

Baber²,

Williamson³

et al. 2022

Cureus

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The prone position is a crucial position used in the operating rooms and the intensive care units, with its importance highly recognized during the COVID-19 pandemic in patients with acute respiratory distress syndrome (ARDS). Cardiopulmonary resuscitation (CPR) is a cardinal procedure that is indicated and performed on any eligible patient who has cardiopulmonary arrest and resultant lack of perfusion and oxygenation. When a patient has a cardiopulmonary arrest in the prone position, the options include rotating the patient supine before starting cardiopulmonary resuscitation (CPR) or beginning CPR while prone. Prone CPR has not had a widely accepted use so far. In this article, we narrate the process of protocol development and staff education at our hospital for the initiation of prone CPR and review the literature related to it. Prone CPR is an effective technique with good outcomes and involves a learning curve.Appropriate training needs to be done before implementing the protocol, and adequate quality control measures need to be set to ensure that the skill set is maintained.

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“…However, the process of turning the patient supine may prove time-consuming and challenging with several healthcare workers to be engaged and numerous potential adverse events (e.g., displacements and disconnections of medical devices). This may result in additional exposure and increased transmission risk for healthcare workers as well as time loss for the patient [ 49 ]. The available literature supports the effectiveness of prone CPR [ 50 ] and therefore it is reasonable to consider it as a temporary measure if an immediate turn into the supine position is not available.…”

Section: Advanced Life Support In Covid-19mentioning

confidence: 99%

How to Maintain Safety and Maximize the Efficacy of Cardiopulmonary Resuscitation in COVID-19 Patients: Insights from the Recent Guidelines

Chojecka

Pytlos

Zawadka

et al. 2021

JCM

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Since December 2019, the novel coronavirus disease 2019 (COVID-19) caused by Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) has remained a challenge for governments and healthcare systems all around the globe. SARS-CoV-2 infection is associated with increased rates of hospital admissions and significant mortality. The pandemic increased the rate of cardiac arrest and the need for cardiopulmonary resuscitation (CPR). COVID-19, with its pathophysiology and detrimental effects on healthcare, influenced the profile of patients suffering from cardiac arrest, as well as the conditions of performing CPR. To ensure both the safety of medical personnel and the CPR efficacy for patients, resuscitation societies have published modified guidelines addressing the specific reality of the COVID-19 pandemic. In this review, we briefly describe the transmission and pathophysiology of COVID-19, present the challenges of CPR in SARS-CoV-2-infected patients, summarize the current recommendations regarding the algorithms of basic life support (BLS), advanced life support (ALS) and pediatric life support, and discuss other aspects of CPR in COVID-19 patients, which potentially affect the risk-to-benefit ratio of medical procedures and therefore should be considered while formulating further recommendations.

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Cardiopulmonary Resuscitation in the Prone Position: A Good Option for Patients With COVID-19

Cited by 8 publications

References 7 publications

Cardiopulmonary Arrest and Resuscitation in the Prone Patient: An Adult Simulation Case for Internal Medicine Residents

Cardiopulmonary Arrest and Resuscitation in the Prone Patient: An Adult Simulation Case for Internal Medicine Residents

Prone Cardiopulmonary Resuscitation (CPR) Protocol: A Single-Center Experience at Implementation and Review of Literature

How to Maintain Safety and Maximize the Efficacy of Cardiopulmonary Resuscitation in COVID-19 Patients: Insights from the Recent Guidelines

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