Prone Positioning of Patients Found to be Beneficial to COVID-19 Patient Care

Prehospital systems often implement procedures, practices and equipment that change medicine and encourage hospitals to adopt and continue them throughout the patient care treatment cycle.  In this treatment-impact episode of The EMS Today Show, JEMS Editor Emeritus A.J. Heightman moderates an outstanding panel of experts who point out that “prone positioning” of patients is now shown to be one of those procedures.  Proning is easy to do, requires no special equipment and can dramatically improve a patient’s oxygen saturation levels. David A. Farcy MD, FAAEM, FACEP, FCCM, president of the American Academy of Emergency Medicine and chairman, Department of Emergency Medicine and Director, Emergency Medicine Critical Care at Mount Sinai Medical Center and Hildebrandt Emergency Center in Miami Beach, Florida. Dr. Farcy explains patient proning, its history in the treatment of ARDS and the finding that it is extremely effective in the care of patients suffering from COVID-19 infection.  He stresses that proning has been found to take awake, alert patients presenting as “Happy Hypoxic”. This is defined as being awake but presenting with low pulse oximetry levels that, would cause providers to intubate the patient in the past. With nasal or face mask oxygen, their O2 saturation levels were raised up from 88 to 94 (for example), keeping them from being intubated and, in some cases, being placed on ventilators.