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Questions from social media, blogs and the various discussion forums, including the new SCCM COVID-19 Discussion Group, were answered. This microlearning content was taken from the COVID-19 Critical Care for Non-ICU Clinicians: Expert Panel Series held on July 8th, 2020.
Montefiore Medical Center in the Bronx, New York, USA, quickly converted a children's hospital to an adult COVID-19 hospital. Hear Margaret M. Parker, MD, MCCM, talk with H. Michael Ushay, MD, PhD, FAAP, FCCM, about the process, challenges with staffing and personal protective equipment, and more.
Clinicians are working to understand and formulate an effective treatment for COVID-19-associated acute respiratory distress syndrome (Marini J. Crit Care Med. 2020 May 13; Epub ahead of print).
This report provides guidance on how to innovate your existing intensive care unit (ICU) or convert other spaces into an ICU to improve workflow, manage capacity, and minimize healthcare professionals’ exposure to COVID-19 based on the evolving experiences from more than a dozen hospitals and their healthcare professionals on the front lines.
From Pediatric Critical Care Medicine. In this report, the authors describe the use and impact of a targeted strategy for international collaboration and rapid information dissemination on Twitter among members of the pediatric critical care community during a global pandemic.
From Critical Care Medicine. The authors share the following opinions on the recruitment-response COVID-19 ARDS patients, 1) bronchiolitis, in a histologic context, is a plausible pathophysiological mechanism, and 2) a simple bedside physiologic test could potentially determine recruitment potential in resource-limited settings.
From Critical Care Medicine. The authors look at Sprung et al. article ("Adult ICU Triage During the Coronavirus Disease 2019 Pandemic: Who Will Live and Who Will Die? Recommendations to Improve Survival" and the question: Is it ever ethical to remove a ventilator from a patient in order to reallocate it to another we believe would derive more benefit from it?
From Critical Care Medicine. The editors of Critical Care Medicine discuss the challenge during current pandemic of discerning data from anecdote, information from observation, and ultimately signal amidst noise.
From Critical Care Explorations. The combination of a novel disease, resource limitations, and risks to medical personnel health have created new barriers to implementing the ABCDEF Bundle, a proven ICU care approach that reduces delirium, shortens mechanical ventilation duration, prevents post-ICU syndrome, and reduces healthcare costs.
From Critical Care Explorations. Supportive treatment and immunomodulators have a critical place in the treatment of severe patients until effective antivirals are developed. Interleukin-6 antagonists, one of the immunomodulating agents, appears to be effective in the treatment of cytokine storm, but some patients continue to have severe lymphopenia and immunosuppression.
From Critical Care Explorations. This brief report describes the rapid deployment of a real-time electronic tracking board for all hospitals in the state of Oregon.
From Critical Care Explorations. The authors report a case of peripheral arterial thrombosis associated with COVID-19, resulting in acute limb ischemia of the right lower extremity.
From Critical Care Explorations. This commentary discussed how fear (both rational and irrational) influences application of evidence-based data in the ICU during pandemics.
From Critical Care Explorations. The authors illustrate a proof of concept application of teleguidance to ultrasound-guided bedside procedures as an example of an innovative solution that has been used at their institution to maximize patient and provider safety in the COVID-19 era.
From Pediatric Critical Care Medicine. A foreword from the editors of PCCM about COVID-19 and the journal.
From Critical Care Medicine. The editorial authors discuss the role of mainstream and social media in creating the narrative that intubation and mechanical ventilation were "the cause of suboptimal outcomes" for critically ill COVID-19 patients, without accounting for hospital staffing and equipment shortages.
From Pediatric Critical Care Medicine. Using their experience in a pediatric intensive care unit, the authors surveyed the shortcomings of current visitation restrictions.
From Pediatric Critical Care Medicine. The authors discuss the immediate need to become quickly prepared for overwhelming patient care and health system needs, and the usefulness of simulation.
From Critical Care Medicine. Authors write regarding article by Bohman et al "Approach to Adult Extracorporeal Membrane Oxygenation Patient Selection" and note that a formal approach to decision making is key for the appropriate use of this labori ntensive rescue therapy.
From Critical Care Explorations. This articles describes the outcomes with use of a combination of tocilizumab and 34 methylprednisolone administered around the time of endotracheal intubation in patients with 35 confirmed COVID-19-associated hypoxemic respiratory failure requiring mechanical ventilation.
From Critical Care Explorations. As the SARS-CoV-2 pandemic develops, assays to detect the virus and infection caused by it are needed for diagnosis and management. In this article, the authors describe to clinicians how each assay is performed, what each assay detects, and the benefits and limitations of each assay.
From Critical Care Explorations. The authors provide a description of the design, dissemination, and implementation of an ICU surge provider staffing algorithm, focusing on physicians, advanced practice providers, and certified registered nurse anesthetists, at a system-wide level.
From Criticial Care Explorations. The authors report on the use of corticosteroids in mechanically ventilated patients with SARSCoV-2 related acute respiratory distress syndrome.
From Critical Care Explorations. To do better understand the risk factors associated with pulmonary embolism in patients with COVID-19, the authors performed a post hoc analysis from the COVADIS project, a multicenter observational study gathering 21 ICUs from France and Belgium.
From Critical Care Explorations. This review article investigates how gender difference can affect the disease severity of COVID-19 infection.
From Critical Care Explorations The authors profiled plasma inflammatory analytes to help understand the host response to COVID19.
From Critical Care Medicine. Mechanical ventilation (MV) is life-saving for respiratory distress; this study was designed to delineate the clinical features of the COVID-19 patients with MV from a national cohort in China.
In this question and answer webcast, attendees had the opportunity to post questions about managing critically ill patients with COVID-19 and other issues. Questions from social media, blogs and the various discussion forums, including the new SCCM COVID-19 Discussion Group, were also addressed. Webcast held on June 19, 2020
This resource details how manage falls of COVID-19 patients. This is SCCM curated COVID-19 microlearning content.
This resource details how to assess the altered mental status of COVID-19 patients. This is SCCM curated COVID-19 microlearning content.
Questions from social media, blogs and the various discussion forums, including the new SCCM COVID-19 Discussion Group, were answered. This microlearning content was taken from the COVID-19 Critical Care for Non-ICU Clinicians: Expert Panel Series held on June 10th, 2020.
This webcast series engages a panel of critical care experts who will address questions from non-ICU clinicians caring for critically ill patients during the COVID-19 pandemic. Participants are encouraged to ask about any related topics at the time of registration or live during the session.
This webinar debate will cover immunomodulatory therapies and approaches to anticoagulation in patients with COVID-19. Each debate will be moderated by the Society of Critical Care Medicine (SCCM) and American Society of Health-System Pharmacists (ASHP) Presidents.
This presentation discusses how to best organize a pharmacy at an alternate care site. This is SCCM curated COVID-19 microlearning content.
This presentation provides an overview of strategies for triaging analgesic, sedative, and paralytic agents patients with COVID-19. This is SCCM curated COVID-19 microlearning content.
This study describes a simple and safe protocol of anticoagulation with low molecular weight heparin (LMWH) in combination with bedside sustained low efficiency hemodialysis (SLED) in COVID-19 patients.
Cytokine release syndrome (CRS) mediated by IL-6 is a critical driver of COVID-19 mortality. The authors review and discuss key immunologic effects of direct IL-6 blockade, downstream non-selective JAK inhibition, and selective JAK2 suppression to treat COVID-19-related CRS.
This presentation provides an overview of the types of strategies for enhancing sleep in patients with COVID-19. This is SCCM curated COVID-19 microlearning content.
This presentation provides an overview of the types of strategies for approaching the B Element (Spontaneous Breathing Trials: STBs) of the ICU Liberation Bundlein patients with COVID-19. This is SCCM curated COVID-19 microlearning content.
This presentation provides an overview of the types of strategies for approaching the A Element (Pain) of the ICU Liberation Bundle in patients with COVID-19. This is SCCM curated COVID-19 microlearning content.
This presentation provides an overview of the types of strategies for approaching the B Element (Spontaneous Awakening Trials: SATs) of the ICU Liberation Bundle in patients with COVID-19. This is SCCM curated COVID-19 microlearning content.
The ICU liberation Bundle (formerly known as the A-F bundle) is more important than ever in the COVID-19 era. While the pandemic has changed much inside intensive care units (ICUs), the commitment to provide multiprofessional, high-quality care is unwavering.
This presentation covers how to ethically manage shortages and resource allocations. This is SCCM curated COVID-19 microlearning content.
This resource is an infographic that details intubation medications and sedation requirement for intubating COVID-19 patients. This is a community developed COVID-19 microlearning resource.
In this question and answer webcast series, attendees had an opportunity to pose questions about managing critically ill patients with COVID-19 and other issues. Questions from social media, blogs and the various discussion forums, including the new SCCM COVID-19 Discussion Group, were also answered. Recorded on: Friday, May 22, 2020
This resource details how compassion in healthcare has changed with COVID-19. This is a community developed COVID-19 microlearning resource.
This resource details a pediatric ICU dashboard sample for tracking COVID-19. This is a community developed COVID-19 microlearning resource.
Questions from social media, blogs and the various discussion forums, including the new SCCM COVID-19 Discussion Group, were answered. This microlearning content was taken from the COVID-19 Critical Care for Non-ICU Clinicians: Expert Panel Series held on May 27th, 2020.
This resource details how manage hypotension. This is SCCM curated COVID-19 microlearning content.
Because all of us are learning as we go and hungry for insights from other healthcare professionals and facilities that have been treating patients who are critically ill with COVID-19, SCCM has created the report Configuring ICUs in the COVID-19 Era.
This presentation covers endotracheal intubation confirmation with POCUS. This is SCCM curated COVID-19 microlearning content.
This presentation covers central veneous confirmation with POCUS. This is SCCM curated COVID-19 microlearning content.
This presentation covers how to manage neuromuscular blocking agent (NMBA) shortages. This is SCCM curated COVID-19 microlearning content.
Questions from social media, blogs and the various discussion forums, including the new SCCM COVID-19 Discussion Group, were answered. This microlearning content was taken from the COVID-19 Critical Care for Non-ICU Clinicians: Expert Panel Series held on May 13th, 2020.
From Critical Care Medicine. Recent studies have reported a high incidence of thrombotic events in COVID-19. However, the significance of thromboembolic complications has not been widely appreciated. The purpose of this review is to provide current knowledge of this serious problem.
From Pediatric Critical Care Medicine. This study aims to describe a series of children admitted to a pediatric intensive care unit in Spain, one of the countries severely affected by the coronavirus. disease 2019 (COVID-19).
From Pediatric Critical Care Medicine. Integration of table-top planning, in situ simulations, and debriefing of real COVID19 cases can enhance planning, training, job aids, and feasible policies/procedures that address human factors, team communication, equipment choice, and patient/provider safety in the COVID19 pandemic era.
From Pediatric Critical Care Medicine. An editorial in response to an article by Killien et al. on resource "Prediction of Pediatric Critical Care Resource Utilization for Disaster Triage," noting that, although uniform use of the version of PELOD-2 proposed by Killien et al. won’t eliminate all variation from resource allocation strategies, finding any common ground in resource triage schemes is an important first step.
From Critical Care Medicine. The authors sought to determine the frequency of venous thromboembolism in critically ill coronavirus disease 2019 patients and associate a degree of inflammatory marker elevation to venous thromboembolism development. They found that routine chemical venous thromboembolism prophylaxis may be inadequate in preventing venous thromboembolism in severe coronavirus disease 2019.
From Critical Care Medicine. The authors report on their experience from their first 44 cases of 95 COVID-19 critically ill patients and analyze the link between obesity and this new form of 96 ARDS caused by the SARS-CoV-2 with its potential implications for patients' management.
From Critical Care Medicine. To help address the growing concern that critical illness, and specifically mechanical ventilation, are associated with a high risk of death, the authors conducted a retrospective cohort study of critically ill patients with COVID-19 across their academic health system.
From Pediatric Intensive Care Medicine. In this letter to the editor, the authors explore the role of pediatric intensivists, as highly-skilled professionals, in the care of critically ill adults. With adequate guidance by professional societies and adult intensivists, pediatric critical care physicians can provide valuable assistance in the current pandemic and in potential COVID-19 epidemic waves to come.
From Critical Care Explorations. The authors sought to modify their current procedure for performing percutaneous tracheostomy to minimize aerosolization in hopes that it would help reduce exposure to staff involved. They concluded that percutaneous tracheostomy performed with apnea protocol may help minimize aerosolization, reducing risk of exposure of COVID19 to staff.
From Critical Care Explorations. In this letter to the editor, the authors recommend universal preprocedural testing and other interventions to safeguard healthcare personnel and patients.
From Critical Care Medicine. This study aims to summarize the clinical features, ECMO characteristics, and outcomes of patients with SARS-CoV-2 pneumonia receiving ECMO. The authors conclude ECMO might be an effective salvage treatment for patients with SARS27 CoV-2 pneumonia associated with severe ARDS. Severe CO2 retention and acidosis 28 prior to ECMO indicated a poor prognosis.
From Critical Care Medicine. An editorial associated with Sprung et al. article ("Adult Intensive care unit triage during the COVID-19 pandemic - Who will live and who will die? Recommendations to improve survival"), stating that the concept of the triage committee has disturbing flaws.
From Pediatric Critical Care Medicine. In this letter to the editor, the authors respond to an article by Ong et al. and recommend lung ultrasound in children with COVID-19 as a means of improving outcomes.
From Pediatric Critical Care Medicine. The authors describe current hospital guidelines and the opinions of extracorporeal membrane oxygenation leaders at U.S. children’s hospitals concerning the use of extracorporeal membrane oxygenation for coronavirus disease 2019–positive pediatric patients.
From Critical Care Explorations. The authors reviewed the available literature to understand the frequency of continuous renal replacement therapy use among patients with coronavirus disease 2019 who required intensive care.
In a situation where ventilators are in short supply, multiple patients on a single ventilator could be a strategy of last resort.
This presentation provides an overview of the types of strategies for approaching the E Element (Early Mobility) of the ICU Liberation Bundle in patients with COVID-19. This is SCCM curated COVID-19 microlearning content.
There is no doubt we are living in a new world. The COVID-19 pandemic is challenging organizations and individuals to react quickly and adapt overnight.
In this question and answer webcast series, attendees had an opportunity to pose questions about managing critically ill patients with COVID-19 and other issues.
This presentation covers treating COVID-19 in pediatric patients. This is SCCM curated COVID-19 microlearning content.
The SCCM Ethics Committee prepared a guide entitled, Standard of Care Recommendations for Triaging Resources During the COVID-19 Pandemic.
This presentation cover dermatological conditions seen in COVID-19 patients. This is SCCM curated COVID-19 microlearning content.
This expert panel representatives from Society of Critical Care Medicine (SCCM) and the American Association for Respiratory Care (AARC) teamed up to discuss how ICU respiratory care teams can work together more cohesively when caring for COVID-19 patients. Recorded on: Thursday, May 14, 2020
Clinicians are sharing early findings about an emerging critical illness predominantly affecting school-aged children and young adults. The Centers for Disease Control and Prevention (CDC) has defined criteria, calling it Multisystem Inflammatory Syndrome in Children (MIS-C) Associated with COVID-19.
Resources for healthcare professionals from the COVID-19 pandemic
Questions from social media, blogs and the various discussion forums, including the new SCCM COVID-19 Discussion Group, were answered. This microlearning content was taken from the COVID-19 Critical Care for Non-ICU Clinicians: Expert Panel Series held on May 13, 2020.
This study queried United States (U.S.) ICU clinician perspectives on ICU preparedness and concerns regarding delivering COVID-19 patient care.
From Critical Care Explorations. A letter to the editor in response to Villar et al. article on corticosteroids and COVID-19.
From Critical Care Explorations. During a pandemic, with limited resources, we should provide the safest and most effective care, while protecting caregivers.The authors propose ways to do that.
From Pediatric Critical Care Medicine. The authors outline an approach to practically initiating supportive strategies within the PICU using a well-being approach to improving baseline resilience alongside an acute rescue strategy utilising a peer-support network.
From Critical Care Medicine. An editorial associated with the Mauri et al. article on personalized ventilation for COVID-19 ARDS patients.
The National Institutes of Health has released Coronavirus Disease 2019 (COVID-19) Treatment Guidelines.
Discovery, the Critical Care Research Network's Viral Infection and Respiratory Illness Universal Study creates a real-time COVID-19 registry of current ICU and hospital care patterns.
This webcast was an SCCM COVID-19 expert panel discussion comparing the Surviving Sepsis Campaign COVID-19 Guidelines with the newly released National Institutes of Health Coronavirus (COVID-19) Treatment Guidelines.
This joint webinar was moderated by the Society of Critical Care Medicine (SCCM) and the American College of Emergency Physicians (ACEP) Presidents, along with invited experts from both societies, to address difficult questions regarding managing COVID-19 patients.
From Pediatric Critical Care Medicine. The authors sought to determine whether currently available pediatric illness severity scores can predict duration of critical care resource use.
From Critical Care Medicine. In this article, APACHE II score was identified to be an effective clinical tool to predict mortality in COVID-19 patients compared with SOFA score and CURB65 score.
From Critical Care Medicine. This paper introduces and highlights several important and /or novel concepts seldom considered by the practicing intensivist.
From Critical Care Medicine. The authors discuss the major issues related to ICU triage and try to give recommendations where appropriate but also give different choices for certain issues for countries based on what is best for them.
From Pediatric Critical Care Medicine. Editorial in response to Ong et al. article ("A comprehensive narrative review on the impact and implications of COVID-19 in children"), focusing on the management of those most severely affected, as well as providing some practical suggestions for pediatric intensive care clinicians to prepare should COVID-19 become more virulent in children.
From Pediatric Critical Care Medicine. Editorial by authors that led the Pediatric Emergency Mass Critical Care Task Force and 2014 Task Force for Mass Critical Care.
This presentation covers acute kidney injury seen in COVID-19 patients. This is SCCM curated COVID-19 microlearning content.
From Pediatric Critical Care Medicine. Although pediatric intensivists are well versed in the care of ARDS from viral pneumonia, the care of an differing aged adult populations presents some unique challenges.
Critical care teams should consider using remdesivir to treat patients with severe acute SARS-CoV-2 infection, but supply of the drug is limited and best practices for maximizing its effectiveness are not completely understood.
This Concise Critical Appraisal explores a Lancet Respiratory Medicine article by Ramanathan et al, which outlines how to plan for extracorporeal membrane oxygenation (ECMO) for patients with severe acute respiratory distress syndrome (ARDS) related to COVID-19. ECMO is a complex therapy usually restricted to specialized centers. World Health Organization guidelines suggest that carefully selected patients with ARDS may benefit. The authors explore how good planning can help during outbreaks of emerging infectious diseases.
This resource is a quick training guide on labor pool deployment workflow and inpatient competency. This is a community developed COVID-19 microlearning resource.
This resource is a quick guide on medical nutrition therapy for COVID-19 patients. This is a community developed COVID-19 microlearning resource.
This resource covers strategies to consolidate workflow to improve ICU efficiency and reduce COVID-19 infection risks. This is a community developed COVID-19 microlearning resource.
This resource covers cardiac arrest codes for PUI and COVID-19 patients. This is a community developed COVID-19 microlearning resource.
This resource covers breastfeeding concerns with COVID-19. This is a community developed COVID-19 microlearning resource.
This resource covers managing stress and coping strategies during the COVID-19 pandemic. This is a community developed COVID-19 microlearning resource.
Questions from social media, blogs and the various discussion forums, including the new SCCM COVID-19 Discussion Group, were answered.
This presentation covers atrial fibrillation COVID-19 patients. This is SCCM curated COVID-19 microlearning content.
This is a quick airway management resource guide for treating COVID-19 patients . This is a community developed COVID-19 microlearning resource.
In a follow-up to the April 7, 2020 webinar on Managing Mental Health During the COVID Crisis, Dr. Jim Jackson and Dr. Megan Hosey discussed the uncertainty of the next phase of the COVID-19 pandemic and ways to cope with the ambiguity of the duration and severity of the situation. Recorded on: Tuesday, May 5, 2020
Explore the need for randomized COVID-19 clinical trials and the difficulties and potential consequences of misinformation (Ingraham N, et al. Crit Care Explor. 2020;2:e0108) with host Ashish K. Khanna, MD, FCCP, FCCM, and Nicholas E. Ingraham, MD.
Gain valuable insight on the clinical management of COVID-19 and its relevance to the pediatric critical care provider (Ong J, et al. Pediatr Crit Care Med. 2020 Apr 7; Epub ahead of print) with host Elizabeth H. Mack, MD, MS, FCCM, and Jacqueline Ong, MB BChir, MMed (Paeds), MRCPCH.
Critical care clinicians are feeling increased personal stress about COVID-19 and are especially worried about infecting loved ones, while also expressing continued concern about personal protective equipment (PPE) and staffing shortages, according to a rapid-cycle survey from SCCM.
From Critical Care Explorations. The authors discuss the neurologic manifestations of severe viral respiratory infections including coronavirus, influenza, respiratory syncytial virus, metapneumovirus, and enterovirus.
From Pediatric Critical Care Medicine. In this article the authors review available literature on COVID019 in critically ill children and provide valuable insight into the clinical management of this disease, as well as information on preparedness activities that every PICU should perform.
From Critical Care Explorations. This review summaries the many potential sources of information that clinicians turn to during pandemic illness, the challenges associated with performing methodologically sound research in this setting and potential approaching to conducting well done research during a health crisis.
From Critical Care Explorations. A letter to the editor of Critical Care Explorations about SSC COVID-19 Guidelines and the need to update these guideines and others regularly to help universally optimize sepsis care due to COVID-19 and help flatten the briskly rising morbidity and mortality curve.
From Critical Care Explorations. This commentary uses a recent study of hydroxychloroquine to demonstrate the dire need for randomized clinical trials, but more importantly, to explore the potential consequences of misinformation, how fear fuels its impact, and offer guidance to maintain scientific integrity without relinquishing hope.
From Critical Care Explorations. This article addresses health care capacity strains and provides a framework for considering key resources during an acute surge event and an adaptable approach to the most common domains that should be addressed during the preparation for and response to acute surge events.
From Critical Care Explorations. This article examines the clinical presentation and important immunology of viral pneumonia with a focus on severe acute respiratory syndrome coronavirus 2 (coronavirus disease 2019).
From Critical Care Explorations. The authors state that inconclusive clinical evidence should not be a reason for abandoning CST in COVID-19-associated ARDS.
From Critical Care Medicine. Severe cases of coronavirus disease 2019 develop the acute respiratory distress syndrome, requiring admission to the ICU. This study aims to describe specific pathophysiological characteristics of acute respiratory distress syndrome from coronavirus disease 2019.
From Critical Care Explorations. This article describes the conception and implementation of an intensive care database rapidly developed and designed to meet data analytic needs in response to the coronavirus disease 2019 pandemic - the multicenter, international Society of Critical Care Medicine Discovery Network Viral Infection and Respiratory Illness Universal Study.
From Critical Care Explorations. In this commentary, the authors provide specific recommendations for the rapid implementation of clinical distancing techniques.
From Pediatric Critical Care Medicine. The authors sought to determine whether currently available pediatric illness severity scores can predict duration of critical care resource use. A pediatric disaster triage algorithm that includes both likelihood for survival and for requiring critical care resources could minimize subjectivity in resource allocation decision-making.
This webcast addressed the legal, social and logistical challenges in communicating with families during the pandemic. Topics covered included a conceptual and practical framework for remote family communication, the importance of having a coordinated interdisciplinary effort in these communications, and updates on CMS regulations for communications.
Steve Pastores, MD, co-author of the Critical Care Explorations article "Rationale for Prolonged Corticosteroid Treatment in the Acute Respiratory Distress Syndrome Caused by Coronavirus Disease 2019," answers question regarding the use of corticosteriod treatment for ARDS caused by COVID-19. This is SCCM curated COVID-19 microlearning content.
SCCM's president-elect Greg S. Martin, MD, MSc, FCCM, is among the experts tapped to lead a national effort to super-charge the innovation, development, and commercialization of a COVID-19 testing by fall 2020.