Glossary entry

Spanish term or phrase:

usando posición prono vigil intermitente

English translation:

using the intermittent awake prone position

Added to glossary by liz askew
Jul 29, 2020 11:01
3 yrs ago
32 viewers *
Spanish term

usando posición prono vigil intermitente

Spanish to English Medical Medical: Health Care COVID-19
This phrase occurs several times in a flowchart for the treatment of COVID-19 patients in the context below. My first thought is that "usando posición prono" means 'with patient in prone position' and "vigil intermitente" is a separate thought meaning 'check intermittently' - but now I'm wondering if it's some kind of setting on the oxygen equipment. I'd be grateful to hear what you guys think.

Si continúa aumentado el distrés respiratorio del paciente o SpO2 es menor a 90% y se presentan señales de alarma:

Utilizar máscara de oxígeno con reservorio
Aumento el flujo de oxígeno de 10 a 15 L/min
Utilizar puntas nasales **usando posición prono vigil intermitente**
Asegurarse que la bolsa se infle
Buscar ayuda de un clínico experto por interconsulta virtual o presencial
Evaluar remisión al segundo nivel de atención
Change log

Sep 22, 2020 10:59: liz askew changed "Edited KOG entry" from "<a href="/profile/62649">Muriel Vasconcellos's</a> old entry - "usando posición prono vigil intermitente"" to ""using the intermittent awake prone position""

Discussion

Chema Nieto Castañón Jul 30, 2020:
Thanks for the feedback, Muriel.
I guess I should have cleared that up also, but your source listing shows some inconsistencies -I guess to avoid exposing the original text- and so I did not want to get into too much detail. It is clear though that "evaluar remisión a segundo nivel" conveys that we are in an emergency situation on a first healthcare level setting, where prone positioning (& nasal cannula) would be contraindicated on a severe respiratory distress with loss of consciousness (and that is why it is important to stress here that the patient must be awake when proning). Nothing to do with an ICU setting where a patient in severe distress will be sedated, as your cardiologist points out. In an emergency situation on a primary healthcare setting you might shift from proning to sitting/supine position in cases like this -rather than to lateral position, as they might do in an ICU.
Muriel Vasconcellos (asker) Jul 29, 2020:
More info I'm just back from seeing my cardiologist, who treats covid-19 patients in the hospital. He explained that they shift the patient's position intermittently from one side to prone to the other side - which could slightly alter the wording here. On the other hand, he added that the patients he sees are sedated. I clarified that my text refers to the outpatient situation (which I should have mentioned here), in which case, being awake might change what he described.
Muriel Vasconcellos (asker) Jul 29, 2020:
@All I'm sure glad I posted this question - grateful for your contributions to my knowledge!
Chema Nieto Castañón Jul 29, 2020:
With Jane
Intermittent awake proning (i.e. here: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7251409/#__ffn_... )

There are different protocols so as to how best to do this (i.e. prone position for a duration of 1-2 hours, every 4 hours, while awake), but they all refer to keeping the patient facing down at given intervals while the patient is awake.
Dr Jane Marshall Jul 29, 2020:
maybe something like intermittent awake proning?? I have not read much about this, but have come across "awake proning" which could be the "vigil" part? Poosibly worth looking into...

Proposed translations

1 hr
Selected

using the intermittent awake prone position

Search Results
Web results

Protocol for awake prone positioning in COVID-19 patients: to ...ccforum.biomedcentral.com › articles
23 Jun 2020 - Prone position (PP) ventilation is usually used as a salvage treatment for COVID-19 in critical cases. In our study, awake PP was applied early ...
by G Bower - ‎2020

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Note added at 1 hr (2020-07-29 12:54:12 GMT)
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HSE Library » What is the evidence to support prone ...hselibrary.ie › what-is-the-evidence-to-support-prone-p...
What is the evidence to support prone positioning of awake COVID-19 ... adopting the awake prone position in novel coronavirus pneumonia patients ... Nonetheless, all cases describe generally short periods of intermittent proning that is well ...

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Note added at 1 hr (2020-07-29 12:55:07 GMT)
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or

if you prefer

intermittent awake prone positioning

Awake Proning in COVID-19 Patients With Hypoxemic ...clinicaltrials.gov › show › NCT04408222
29 May 2020 - The prone position improves oxygenation in intubated patients with ... Awake prone positioning was implemented based on the health care ...
Note from asker:
Thank you Liz! Much appreciated.
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4 KudoZ points awarded for this answer. Comment: "Thank you so much, Liz. I really appreciate your help!"
10 hrs

using an intermittent vigil prone position

"In the case of a patient's continued increasing distress (or Sp O2 less than 90%), and if there are signs of alarm:
Use an oxygen mask with reserve
Increase flow of oxygen from 10 to 15 L/min
Use nasal points 'using an intermittent vigil prone position'
Make sure that the bag is inflating
Seek help from a clinical expert by virtual consultation or in person.
Evaluate referral to the second level for attention."
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Reference comments

30 mins
Reference:

I think your intial thoughts are in the right direction

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1 hr
Reference:

a clinical trial on the subject

clinical trial
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