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Italian Journal of Emergency Medicine 2021 December;10(3):140-3

DOI: 10.23736/S2532-1285.21.00117-8

Copyright © 2021 THE AUTHORS

This is an open access article distributed under the terms of the CC BY-NC-ND 4.0 license which allows users to copy and distribute the manuscript, as long as this is not done for commercial purposes and further does not permit distribution of the manuscript if it is changed or edited in any way, and as long as the user gives appropriate credits to the original author(s) and the source (with a link to the formal publication through the relevant DOI) and provides a link to the license.

lingua: Inglese

Awake self-prone positioning

Giulio CASSANO 1, Stella INGRASSIA 1, Mauro BELOTTI 2, Alessandra MARCHETTI 2, Laura MERLETTI 1, Gioella IACI 2, Paolo VILLA 1, Anna M. BRAMBILLA 1

1 Department of Emergency Medicine, Luigi Sacco University Hospital, Milan, Italy; 2 University of Milan, Milan, Italy

A 72-year-old woman, who had good general condition and no comorbidities was hospitalized for COVID-19 related pneumonia in medical ward. A few days after admission the patient developed hypoxemic acute respiratory failure and she needed noninvasive ventilation with continuous positive end-expiratory pressure (CPAP). The patient showed some episodes of desaturation, so she was encouraged and helped to assume prone position during CPAP treatment. Initially it was not simply to her to accept this modality of treatment, but finally we managed to convince her to change her position. So, when the patient finally got the facing down position, we observed a rapid improvement of SpO2 (from 90% to 96%) and reduction of respiratory rate (from 36 bpm to 24); the patient felt the improvement, and from that moment on she started to rotate and to keep herself in prone position for few hours, several times in the day; during the night she was not able to keep prone position because she was not able to sleep. She understood what was better for her, and one day she told to the nurse that was helping her to rotate: “Now this is my job. And I have to do my job.”

KEY WORDS: Respiratory insufficiency; Prone position; COVID-19

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