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Review
. 2022 Sep 26;14(9):e29604.
doi: 10.7759/cureus.29604. eCollection 2022 Sep.

Prone Cardiopulmonary Resuscitation (CPR) Protocol: A Single-Center Experience at Implementation and Review of Literature

Cameron McCraw  1 , Caroline Baber  1 , Aaron H Williamson  1 , Yanwei Zhang  1 , Rachel S Sinit  1 , Ann D Alway  2 , Shikha Jain  3 , Nitesh K Jain  4 , Kovid Trivedi  5
Affiliations
Review

Prone Cardiopulmonary Resuscitation (CPR) Protocol: A Single-Center Experience at Implementation and Review of Literature

Cameron McCraw et al. Cureus. .

Abstract

The prone position is a crucial position used in the operating rooms and the intensive care units, with its importance highly recognized during the COVID-19 pandemic in patients with acute respiratory distress syndrome (ARDS). Cardiopulmonary resuscitation (CPR) is a cardinal procedure that is indicated and performed on any eligible patient who has cardiopulmonary arrest and resultant lack of perfusion and oxygenation. When a patient has a cardiopulmonary arrest in the prone position, the options include rotating the patient supine before starting cardiopulmonary resuscitation (CPR) or beginning CPR while prone. Prone CPR has not had a widely accepted use so far. In this article, we narrate the process of protocol development and staff education at our hospital for the initiation of prone CPR and review the literature related to it. Prone CPR is an effective technique with good outcomes and involves a learning curve. Appropriate training needs to be done before implementing the protocol, and adequate quality control measures need to be set to ensure that the skill set is maintained.

Keywords: cardiac arrest; cardiac resuscitation; cardiopulmonary resuscitation; in hospital cardiac arrest; prone cpr; prone position; quality improvement and patient safety; resuscitation education.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Figure 1
Figure 1. Hand Position During Prone CPR: Over the T7-T10 Vertebral Bodies or 0-2 Vertebral Segments Below the Inferior Angle of the Scapula
Pictures were taken by the marketing department of Salem hospital on a volunteer to show the position of hand placement.
Figure 2
Figure 2. Defibrillator Pad Placement in the Side-to-Side Position: Under Both Armpits
Pictures were taken by the marketing department of Salem hospital on a volunteer to show the position of defibrillator pad placement.
Figure 3
Figure 3. Defibrillator Pad Placement in Left Shoulder-Right Axilla Position
Pictures were taken by the marketing department of Salem hospital on a volunteer to show the position of the defibrillator pad placement.
See this image and copyright information in PMC

References

    1. Prone positioning for acute respiratory distress syndrome (ARDS) Hadaya J, Benharash P. JAMA. 2020;324:1361. - PubMed
    1. Interim guidance for basic and advanced life support in adults, children, and neonates with suspected or confirmed COVID- 19: from the emergency cardiovascular care committee and get with the guidelines-resuscitation adult and pediatric task forces of the American Heart Association. Edelson DP, Sasson C, Chan PS, et al. Circulation. 2020;141:0–43. - PMC - PubMed
    1. Johns Hopkins Nursing Evidence-Based Practice: Appendix D. [ Sep; 2022 ]. 2017. https://www.mghpcs.org/eed/ebp/Assets/documents/pdf/2017_Appendix%20D_Ev... https://www.mghpcs.org/eed/ebp/Assets/documents/pdf/2017_Appendix%20D_Ev...
    1. Optimizing prone cardiopulmonary resuscitation: identifying the vertebral level correlating with the largest left ventricle cross-sectional area via computed tomography scan. Kwon MJ, Kim EH, Song IK, Lee JH, Kim HS, Kim JT. Anesth Analg. 2017;124:520–523. - PubMed
    1. Cardiopulmonary resuscitation in the prone position in the operating room or in the intensive care unit: a systematic review. Anez C, Becerra-Bolaños Á, Vives-Lopez A, Rodríguez-Pérez A. Anesth Analg. 2021;132:285–292. - PMC - PubMed

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