Anne Dabrow Woods, DNP, RN, CRNP, ANP-BC, AGACNP-BC, FAAN, Chief Nurse of Wolters Kluwer Health Learning, Research & Practice, adjunct faculty for Drexel University, and a critical care nurse practitioner for Penn Medicine, Chester County Hospital, and Collette Hendler, RN, MS, MA, CIC, Editor-in-Chief for Lippincott Solutions and certified by the Certification Board of Infection Control and Epidemiology, Inc. as an Infection Preventionist, answer questions related to oxygenation and prone positioning of COVID-19 patients. These questions were submitted by attendees of the webcast, Calming the COVID-19 Storm: Delivering Effective Clinical and Nursing Care, which took place on May 7, 2020. This podcast covers the following questions:
- Can you explain why COVID-19 patients go into acute hypoxemic respiratory failure and ARDS?
- What is silent hypoxemia?
- How do you manage they symptoms of shortness of breath and anxiety in a non-intubated patient?
- I heard the goal is to not intubate the patient; is this true? How do you optimize oxygenation in patients before they are intubated and placed on the ventilator?
- We had several questions about positive end expiratory pressure, or PEEP. Can you talk about the role of PEEP please? Is there an average or maximum level of PEEP that is recommended?
- If you have a patient who has COPD, is your management of the ventilator any different?
- Do you recommend proning a nonintubated patient? What is the trigger to start proning patients with ARDS?
- I know you said that CPR can be performed with the patient prone. Isn't it difficult to do CPR with the patient prone? How do you do CPR in a proned patient?
- Can a laryngeal mask airway, or LMA, be used to oxygenate a patient with COVID-19?
- Have they tried administering surfactant as they do in the NICU for respiratory distress syndrome?
*Note: this podcast was recorded on May 19, 2020. For the most up to date information, please visit our Coronavirus (COVID-19) Resource page, where you'll find links to the on-demand webcast (earn 1 free contact hour!), CDC and WHO, plus free access to our point-of-care tools and more.
