From the, Department of Emergency Medicine, NYP Weill Cornell Medical Center, New York, NY, USA.
the, Department of Emergency Medicine, NYP Queens, Queens, NY, USA.
Acad Emerg Med. 2020 Jul;27(7):566-569. doi: 10.1111/acem.14035. Epub 2020 Jun 23.
The novel coronavirus, or COVID-19, has rapidly become a global pandemic. A major cause of morbidity and mortality due to COVID-19 has been the worsening hypoxia that, if untreated, can progress to acute respiratory distress syndrome (ARDS) and respiratory failure. Past work has found that intubated patients with ARDS experience physiological benefits to the prone position, because it promotes better matching of pulmonary perfusion to ventilation, improved secretion clearance, and recruitment of dependent areas of the lungs. We created a systemwide multi-institutional (New York-Presbyterian Hospital enterprise) protocol for placing awake, nonintubated, emergency department patients with suspected or confirmed COVID-19 in the prone position. In this piece, we describe the background literature and the approach we have taken at our institution as we care for a high burden of COVID-19 cases with respiratory symptoms.
新型冠状病毒（COVID-19）迅速成为全球大流行疾病。导致 COVID-19 发病率和死亡率的一个主要原因是不断恶化的低血氧症，如果不加以治疗，可能会发展为急性呼吸窘迫综合征（ARDS）和呼吸衰竭。过去的研究发现，ARDS 插管患者采取俯卧位会带来生理上的益处，因为它可以更好地使肺灌注与通气相匹配，促进分泌物清除，并复张依赖区肺。我们制定了一项全系统多机构（纽约长老会医院企业）协议，用于让怀疑或确诊 COVID-19 的急诊科清醒、非插管患者采取俯卧位。在本文中，我们将介绍背景文献以及我们在机构内的做法，因为我们要照顾大量出现呼吸症状的 COVID-19 患者。
