Pressure Injury Prevention in COVID-19 Patients With Acute Respiratory Distress Syndrome

Frontiers in Medicine

article

Victoria Team¹  Lydia Team³  Angela Jones²  Helena Teede²  Carolina D. Weller¹ 

[1] Faculty of Medicine, Nursing and Health Sciences, Monash University;Monash Partners Academic Health Science Centre;Monash Health;School of Nursing and Midwifery, Deakin University

关键词: acute respiratory distress syndrome;    COVID-19;    guidelines;    intensive care;    pressure injury;    pressure points;    prone positioning;    ventilation;   

DOI  :  10.3389/fmed.2020.558696

学科分类：社会科学、人文和艺术（综合）

来源: Frontiers

【 摘 要 】

Coronavirus disease 2019 (COVID-19), which is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), was identified in China in December 2019 and became a pandemic in a short period of time. While most infected people might have mild symptoms, older people and people with chronic illnesses may develop acute respiratory distress syndrome (ARDS). Patients with ARDS with worsening hypoxemia require prone positioning to improve the respiratory mechanics and oxygenation. Intubated patients may stay in a prone position up to 12–16 h, increasing the risk of pressure injury (PI). Frequent skin inspections and PI risk assessment in COVID-19 patients will be challenging due to hospital infection control measures aimed to reduce the risk for health professionals. In this perspective article, we summarize the best practice recommendations for prevention of PI in SARS-CoV-2-infected ARDS patients in prone positioning. Prior to positioning patients in prone position, the main recommendations are to (1) conduct a skin assessment, (2) use pressure redistribution devices, (3) select an appropriate mattress or an overlay, (4) ensure that the endotracheal tube securing device is removed and the endotracheal tube is secured with tapes, (5) use a liquid film-forming protective dressing, and (6) lubricate the eyes and tape them closed. Once a patient is in prone position, it is recommended to (1) use the swimmer's position, (2) reposition the patient every 2 h, and (3) keep the skin clean. When the patient is repositioned to supine position, healthcare professionals are advised to (1) assess the pressure points and (2) promote early mobilization.

【 授权许可】

CC BY