Robert Green, MD DABEM FRCPC FRCP(Edin)
Dr.
Nova Scotia Health; Dalhousie University, United States
Disclosure information not submitted.
Kabilan Thanapaalasingham, MD
Dr.
Dalhousie University, United States
Disclosure information not submitted.
Nelofar Kureshi, MBBS MHI
Dr.
Dalhousie University, United States
Disclosure information not submitted.
Title: Clinical Evaluation of a Novel Proning Device in COVID-19 Patients with Severe Respiratory Failure
INTRODUCTION/HYPOTHESIS: COVID-19 patients and others with severe respiratory failure often require proning. In response to challenges with proning COVID-19 patients, the Apparatus and Method for Moving a Patient (AMMP) was developed to improve patient and provider safety. This trial evaluated use of the AMMP to prone COVID-19 patients with severe respiratory failure.
Methods: In 2021, providers including physicians, nurses, and respiratory therapists working in the ICU at the QEII Health Sciences Centre (Halifax NS) participated in a clinical trial using the AMMP to prone COVID-19 patients with severe respiratory failure. Subject selection was quasi-random and included members of the healthcare team assigned to care for ICU patients. Education on proper use of the AMMP was provided prior to movements. Paper-based surveys were administered upon completion. Providers were asked to evaluate ease of use, time, safety, and any adverse events during the proning procedure.
Results: Overall, a total of 52 ICU healthcare providers completed surveys after using the AMMP to prone COVID-19 patients. Most providers found it easy to apply the AMMP to the patient (92%; 48/52), adjust strap length (90%; 47/52), and remove after completing the movement (90%; 47/52). Compared to standard proning procedures, 87% (45/52) felt physical demands were reduced using the AMMP and 68% (34/52) agreed it took less time to complete prone positioning. Most providers believed the AMMP improved patient safety (88%; 46/52) and healthcare team safety (92%; 48/52), and that fewer providers were required to move patients into prone position (88%; 46/52). 81% (42/52) of respondents reported no adverse events while proning critically ill patients. Of the reported adverse events, the majority were related to pillows or padding after proning (6/10; 60%). Oxygenation desaturation by ≥5% was described in 2 responses (n=2), while one patient had a >20% change in heart rate or blood pressure (n=1). One incident of AMMP anchor strap malposition was reported (n=1). There were no incidents of endotracheal tube dislodgement or patient injury.
Conclusions: Critically ill patients were safely proned using the AMMP. Healthcare providers concluded the AMMP improved the ease, length of time and safety of proning patients compared to their standard proning approaches.