Response:

Cotton et al note that at baseline a minority of nurses in our study thought prone position ventilation would be beneficial for patients with acute respiratory distress syndrome (ARDS), as opposed to a majority of physicians. We agree that this reflects a potential disconnect between providers within the intensive care unit (ICU). We viewed this as an opportunity to use interprofessional simulation-based training to improve collaboration within the ICU before implementation. The coronavirus disease 2019 (COVID-19) pandemic has emphasized the importance of effective communication as institutions have had to rapidly implement new protocols and procedures (such as prone ventilation) and repurpose staff and areas to accommodate patient surges. We applaud Cotton et al for their efforts during this pandemic to evaluate the unclear need for neuromuscular blockade during prone ventilation, implement further safety measures, and improve communication among staff regarding the benefits of prone ventilation.