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MUST WATCH Video: Thinking CC COVID-19 Respiratory Management - A Physiological Approach via @emcrit https://emcrit.org/emcrit/covid-respiratory-management/ #COVID19FOAM
Includes @drlauraduggan @cameronks @PulmCrit @adamdavidthomas @ThinkingCC @EMNerd_ @emcrit
My take away messages to follow in tweetorial
Includes @drlauraduggan @cameronks @PulmCrit @adamdavidthomas @ThinkingCC @EMNerd_ @emcrit
My take away messages to follow in tweetorial
General Principles:
All convos start with appropriate PPE
This is not a one size fits all dz
“Stop doing dumb shit”
Try not to intubate early where possible
Consider HFNC/NIV early instead of intubation
HFNC/NIV pts need to be monitored frequently as they become O2 dependent
All convos start with appropriate PPE
This is not a one size fits all dz
“Stop doing dumb shit”
Try not to intubate early where possible
Consider HFNC/NIV early instead of intubation
HFNC/NIV pts need to be monitored frequently as they become O2 dependent
Mechanical Ventilation:
Currently, the O2 threshold to intubate pts is unclear
When intubating pts O2 sats will drop, but they will come back up over 1 – 2hrs
Push should be for O2 1st, & pressure 2nd strategy
Uncouple PEEP from FiO2 (Don’t follow ARDSnet in high compliance pts)
Currently, the O2 threshold to intubate pts is unclear
When intubating pts O2 sats will drop, but they will come back up over 1 – 2hrs
Push should be for O2 1st, & pressure 2nd strategy
Uncouple PEEP from FiO2 (Don’t follow ARDSnet in high compliance pts)
Mechanical Ventilation contd:
Use an opiates 1st, & sedation 2nd strategy to help control respiratory drive
Keep PEEP at 8 – 10cmH20 in high compliance dz
Use an opiates 1st, & sedation 2nd strategy to help control respiratory drive
Keep PEEP at 8 – 10cmH20 in high compliance dz
Other Things to Consider:
Keep pts dry, but not too dry
Awake proning – move pts frequently but with alternating sides and sitting up (This is not just on stomach
Awake proning is not a recruitment strategy, but a strategy to shift blood supply to buy time
Keep pts dry, but not too dry
Awake proning – move pts frequently but with alternating sides and sitting up (This is not just on stomach
Awake proning is not a recruitment strategy, but a strategy to shift blood supply to buy time
