Caring for COVID-19 Patients: Turned Upside Down

Winona, MN

The novel SARS-2-Coronavirus (COVID-19) has flooded the healthcare system, affected many, and puzzled healthcare professionals on how to care for patients with COVID-19. Qualitative research was found by conducting monthly reviews of literature (ROL) since July of 2020 through January 2021, to determine current best practices in the treatment and management of COVID-19 patients with respiratory distress. Interviews with healthcare professionals were also conducted to understand first-hand experiences and techniques found effective in their practice. From the interviews and ROL, a prominent theme found in effective treatment of respiratory distress is the use of prone positioning (PP). PP is analyzed from a nursing perspective, including evidence, implications, and identification of possible complications to educate nurses. Research suggests PP compared to supine, creates open space and a shift in pressures to different places in the lungs allowing improved oxygenation. From expert clinician experience, PP has been effective in some patients, both sedated and conscious, if tolerated. PP requires up to 16 hours of laying prone to be the most successful, however any amount of time in PP has shown benefits. Being in PP for this length of time has brought concerns of facial edema, increased risk of blood clots, and risk of disruption of medical interventions. As COVID-19 is an emergent disease and continues to be researched, there is an importance to the continuation of reviewing current data and best practices published to guide the nursing care of COVID-19 patients with respiratory distress.