Evidence map›Paper›PMID 36934044›Full record

Observational studyAustralian critical care : official journal of the Confederation of Australian Critical Care Nurses2023

The PhLIP team: Feasibility of a physiotherapy-led intensive prone positioning team initiative during the COVID-19 pandemic.

Thomas C Rollinson, Joleen Rose, Luke A McDonald, Cara Green, Michelle Topple, Stephen Warrillow, Lucy Modra, Rahul Costa-Pinto, Sue Berney

Abstract readObservational Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in Australian critical care : official journal of the Confederation of Australian Critical Care Nurses, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Thomas C RollinsonDepartment of Physiotherapy, Division of Allied Health, Austin Health, Victoria, Australia; Department of Physiotherapy, The University of Melbourne, Victoria, Australia; Institute for Breathing and Sleep, Victoria, Australia. Electronic address: thomas.rollinson@austin.org.au.
Joleen RoseDepartment of Physiotherapy, Division of Allied Health, Austin Health, Victoria, Australia.
Luke A McDonaldDepartment of Physiotherapy, Division of Allied Health, Austin Health, Victoria, Australia.
Cara GreenDepartment of Intensive Care, Austin Health, Victoria, Australia.
Michelle ToppleDepartment of Intensive Care, Austin Health, Victoria, Australia.
Stephen WarrillowDepartment of Critical Care, The University of Melbourne, Victoria, Australia; Department of Intensive Care, Austin Health, Victoria, Australia.
Lucy ModraDepartment of Critical Care, The University of Melbourne, Victoria, Australia; Department of Intensive Care, Austin Health, Victoria, Australia.
Rahul Costa-PintoDepartment of Critical Care, The University of Melbourne, Victoria, Australia; Department of Intensive Care, Austin Health, Victoria, Australia.
Sue BerneyDepartment of Physiotherapy, Division of Allied Health, Austin Health, Victoria, Australia; Department of Physiotherapy, The University of Melbourne, Victoria, Australia; Institute for Breathing and Sleep, Victoria, Australia.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe coronavirus disease 2019 (COVID-19) pandemic resulted in a surge of patients with refractory hypoxaemic respiratory failure being admitted to the intensive care unit (ICU). Prone positioning can improve oxygenation but requires a team of skilled personnel to complete safely. Critical care physiotherapists (PTs) are ideally suited to lead proning teams, due to their expertise in moving critically unwell, invasively ventilated patients.

objectivesThe aim of this study was to describe the feasibility of implementing a physiotherapy-led intensive proning (PhLIP) team to support the critical care team during surges.

methodsThis study involves descriptive evaluation of feasibility and implementation of the PhLIP team, a novel model of care, during the Delta wave of the COVID-19 pandemic, through a retrospective, observational audit of PhLIP team activity, ICU clinical activity, and a description of clinical outcomes.

resultsBetween 17 September and 19 November 2021, 93 patients with COVID-19 were admitted to the ICU. Fifty-one patients (55%) were positioned prone, a median [interquartile range] 2 [2, 5] times, for a mean (±standard deviation) duration of 16 (±2) h, across 161 episodes. Twenty-three PTs were upskilled and deployed to the PhLIP team, adding 2.0 equivalent full time to the daily service. Ninety-four percent of prone episodes (154) were led by the PhLIP PTs with a median 4 [interquartile range: 2, 8] turns per day. Potential airway adverse events occurred on three occasions (1.8%) and included an endotracheal tube leak, displacement, and obstruction. Each incident was promptly managed without prolonged impact on the patient. No manual handling injuries were reported.

conclusionThe implementation of a physiotherapy-led proning team was safe and feasible and can release critical care-trained medical and nursing staff to other duties in the ICU.

Indexed as

COVID-19Feasibility StudiesHumansPandemicsPatient PositioningPhysical Therapy ModalitiesProne PositionRetrospective StudiesSARS-CoV-2ARDSCOVIDCOVID-19Critical careProneProne positioningRespiratory failure

Identifiers

PMID36934044
PMCPMC9922573

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.