New Initiative Aims to Improve Treatment of COVID-19 Patients in Hospitals, Health Systems

^{By Julie Gould}  

Richard Levitan, MD, Prone2Help, discusses a recent effort he began with his brother that was aimed at supporting US hospitals and health care workers through the use of proning, and explains how other professionals can get involved with this initiative as health systems are continuing to navigate the winding roads of COVID-19.

I’d like to showcase your effort to support US hospitals and health care workers. Can you talk a little about how you and your brother are doing that?

At the end of March 2020, as a crush of COVID-19 patients overwhelmed hospitals in New York City, I volunteered to spend 10 days at Bellevue, the hospital where I trained. Over the course of my volunteer period and following my colleagues and I found that placing patients with COVID-19 in the prone position, paired with high flow nasal oxygen delivery, allowed for effective oxygenation with the ability to avoid mechanical ventilation in two out of every three cases.

When I shared these insights with my brothers, Robert and Dan, they were compelled to take action. Together, we founded Prone2Help—a [501c3] non-profit organization that donates proning cushions to hospitals and health care workers in the US treating patients with COVID-19. In the months since, we’ve raised over $140,000 and donated 1,100+ cushions to 430+ hospitals in 49 states, including areas with historically underserved populations.

By donating cushions to any US hospital that requests them, we strive to ensure as many patients with COVID-19 as possible can be proned comfortably and are able to breathe more easily.  

What is proning? How has it positively impacted patients with COVID-19?

Proning, or prone positioning, is the act of lying on one’s stomach. This relatively simple act has proven effective in helping to get oxygen into the lungs and ultimately helping patients with COVID-19 avoid being put on ventilators. While research is underway to determine the full benefit of proning in patients with COVID-19, a study out of New York City showed that when nasal oxygen administration is combined with positioning maneuvers like proning, the majority (64%) of hospitalized patients can avoid a breathing tube. This has a tremendous benefit – improving patient outcomes, saving countless lives and dramatically reducing hospital resource demands. 

Why is there a need for proning cushions in the United States and how can local hospitals request proning cushions? 

In the absence of a proning cushion, health care providers prone patients using sheets, towels and other items in the hospital. This can limit the effectiveness of the procedure, cause discomfort or simply be intolerable for certain patients, including those who are pregnant. To request a cushion for your hospital or clinic, please visit www.prone2help.org/request.

Prone2Help is working quickly – alongside our partners – to produce proning cushions made specifically for patients with COVID-19 and ship them to health care providers around the US. These cushions include headrests and other features intended to optimize the functionality and impact of oxygenation devices used while proning, while keeping patients comfortable.

As health systems are continuing to navigate the winding roads of COVID-19—How can others get involved with this initiative?

Our progress is reflective of the impact that can be made when individuals join together and support a common cause – for every request received, from medical professionals around the US, Prone2Help ships a cushion, free of charge. Donations fund the manufacturing of proning cushions and nationwide shipment to local hospitals. The cost to purchase and ship one cushion is $200, but every dollar counts.

At the end of the day, we believe we’re all Prone2Help. To join us in responding to this evolving pandemic, visit us at Prone2Help.org.  

Is there anything else you would like to add?

Unfortunately, the fight against COVID-19 is far from over. That said, simple treatment interventions have been a significant factor in reducing mortality among patients with COVID-19. The challenge now is ensuring these interventions are widely known and implemented.

About Dr Levitan

Dr Levitan is an airway specialist who has practiced emergency medicine for over 30 years. In 1994 he invented an imaging system for teaching intubation, the procedure of inserting breathing tubes. This led him to perform research into this procedure, and subsequently teach airway procedure courses to physicians worldwide for the last two decades. Based on his experience, throughout the COVID-19 pandemic, he has been an advocate for incorporating simple, but impactful, actions into patient care that can help improve outcomes. For example, the use of pulse oximetry to monitor oxygen levels, and prone positioning to help patients breathe and avoid more significant interventions.