It’s been greater than a 12 months since Intermountain Healthcare handled its first COVID-19 affected person. Throughout that point, clinicians, bodily therapists and bodily remedy assistants from throughout the Intermountain system needed to tackle new duties distinctive to the pandemic, together with studying methods to assist preserve the sickest COVID-19 sufferers alive within the ICU.
These caregivers labored alongside docs and nurses on specialised, multidisciplinary groups that repositioned sufferers within the ICU, shifting them from mendacity on their backs to their stomachs to enhance their respiratory. They’re known as proning groups.
Prone positioning, or ‘proning’ is an arduous course of that makes use of exact and secure actions to show a affected person over from their again to their stomach – after which again once more a number of hours later.
In an ICU, a affected person could also be sedated or have bother shifting, so it usually takes at the least 5 caregivers to securely flip a affected person over and may take between 30 to 45 minutes.
“It may be exhausting work at instances after we flip 12 sufferers two instances a day. You may see the actual toll COVID-19 has on individuals,” stated Bambi Carr, a Intermountain bodily remedy assistant on the proning crew at Intermountain Medical Heart in Murray. “It’s work that we’re not used to in our subject, however we all know it’s essential.”
Prior to now, clinicians in hospitals would use advanced inclined positioning beds for turning sufferers however the excessive quantity of COVID-19 sufferers within the ICU has required caregivers to do the heavy lifting.
Analysis has proven that proning improves oxygenation and survival in COVID-19 sufferers with extreme acute respiratory misery syndrome, also referred to as ARDS.
Intermountain caregivers first noticed how effectively proning groups may work and the advance seen in sufferers whereas in New York serving to overwhelmed clinicians in hospitals there in the course of the peak of the pandemic. 100 volunteer caregivers from Intermountain traveled to NYC in April 2020 to assist groups there.
Dixie Harris, MD, pulmonary and demanding care doctor at Intermountain Healthcare, was one of many caregivers who traveled to New York. She noticed how caregivers in a determined state of affairs helped mould a greater course of.
“They had been hit so laborious they needed to discover one thing that labored and these proning groups confirmed to have a significant impression on outcomes,” stated Dr. Harris. “We’ve been in a position to preserve our mortality charge decrease as a result of we realized proning can assist forestall a affected person from needing to be intubated.”
Dr. Harris stated proning works by permitting the lung sacks to open up whereas relieving strain from liquids and tissue within the physique. Whereas it does profit sufferers on a ventilator, Dr. Harris says it’s particularly essential for stopping a affected person from needing one within the first place.
The method of proning isn’t nearly turning somebody over however guaranteeing they’re in a secure place on their abdomen. It’s why nurses within the ICU have been grateful for the experience PT’s and PTA’s have delivered to COVID-19 groups.
“They know a lot about correct muscle placement and motion and our nurses are studying new methods to make sure sufferers are secure and cozy,” stated Pamala Brown, Respiratory ICU nurse supervisor at Intermountain Medical Heart. “Most of all they’ve been there to assist our nurses with no matter they want, and it’s been an enormous aid.”
Proning has different advantages which assist with the care of a affected person. As soon as an individual is on their abdomen gravity goes to work – enhancing blood circulation, caregivers can even bathe them, whereas checking for and stopping mattress sores.
The proning crew was developed not only for the security of the sufferers but additionally the security of the caregivers. Lifting sufferers a number of instances a day might be laborious on the physique and if caregivers don’t take precautions it could actually result in accidents.
Most of the therapists have been serving to on the proning crew since Might of 2020, and so they anticipate to proceed for the following a number of months.
Dani Brady, a PTA working within the Intermountain Medical Heart COVID-19 ICU, says she hopes the vaccine and a give attention to security tips will assist flip the nook on the pandemic.
“Even when issues appear to be slowing down, they all the time spike once more and we see our ICUs refill with extra COVID-19 sufferers,” stated Brady. “If individuals may see what we take care of day in and day trip I believe they might know why we proceed to ask for his or her assist following tips.”