COVID-19 Part 02 - Care of the ICU Patient - #132
Join moderators Drs. Matt Martin, Carrie Valdez and Red Hoffman as they speak with Drs. Nick Mark, Sheldon Teperman and Alex Guerrero about the management of the critically ill patient during the COVID-19 Pandemic. Nick shares his experience in Seattle and Sheldon and Alex share what is currently going on in New York City, the current epicenter of the pandemic. They discuss the management of hypoxemia (including high flow nasal cannula, ventilator strategies and proning- including a discussion of the "burrito" technique), clinical pearls regarding extubation and the role of CPR in these critically ill patients.
Our experts also discuss the importance of establishing communication channels both within your hospital and within your region and the importance of caring for and protecting both ourselves and all those we work with while "leading from the front." This is a longer episode, but definitely worth a listen, filled with real life clinical pearls that will assist you and your hospital in preparing for and caring for COVID patients.
This episode is dedicated to neurosurgeon Dr. James Goodrich, who died on Monday, March 30, 2020 from complications of the Coronavirus.
Resources discussed within this episode:
-EAST COVID-19 Resources and Information is available here: https://www.east.org/education/covid-19-resources-and-information. This is meant to be a clearinghouse of information and protocols from various societies and institutions throughout the world.
-Dr. Nick Mark's OnePager guide to the care of critically ill patients with COVID can be found here: https://www.onepagericu.com/.
-Fair allocation of scarce medical resources in the time of COVID-19 (NEJM March 23, 2020) can be found at: https://www.nejm.org/doi/pdf/10.1056/NEJMsb2005114?articleTools=true
-A framework for rationing ventilators and critical care beds during the COVID-19 pandemic (JAMA March 27, 2020) can be found at: https://jamanetwork.com/journals/jama/fullarticle/2763953
-The COVID Ready Communication Playbook by Vital Talk can be found at: https://www.vitaltalk.org/guides/covid-19-communication-skills/
-The proning protocol currently in use at NYC Health + Hospitals can be found here - Proning Protocol
-The burrito technique for proning is also demonstrated at: https://www.youtube.com/watch?v=qx2z26IL6g8&feature=youtu.be