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Mass General Hospital COVID19 Critical Care Treatment Guide

#COVID19 #CriticalCare #Treatment #MGH #Management #Coronavirus #SARSCOV2
Mass General Hospital ... Guide #COVID19 #CriticalCare
Mask Oxygen Delivery Devices

Simple Mask aka Hudson's Mask:
 • Flow 6-10 LPM
 • FiO2 35-50%
Face Tent:
Mask Oxygen Delivery ... Devices Simple Mask ... aka Hudson's Mask ... tight-fitting mask ... management #pulmonary #criticalcare
Oxygen Delivery Devices - Comparison
Low Flow:
 • Nasal cannula (1-6L, 24-40% FiO2)
 • Face mask (5-10L,
FiO2) • Face mask ... Face tent/shovel mask ... FiO2) • Venturi mask ... table #pulmonary #criticalcare
Difficult Airway Algorithm

1. Assess the likelihood and clinical impact of basic management problems: 
 • Difficulty
• Difficult mask ... Anesthesiology #Anesthesia #CriticalCare
THROMBOELASTOGRAPHY (TEG)
General Principle
• A small cuvette is rotated to simulate sluggish venous flow and stimulate clot
rotation due to the mass ... Diagnosis #Management #CriticalCare
Chest Tube Placement Checklist
PREPARATION
 o Consent
 o Position Patient
 o Monitoring
 o Time Out
 o Review
Lidocaine o Caps, masks ... Procedure #Management #CriticalCare
General schema for respiratory support in patients with COVID-19
Low flow nasal cannula
 • Typically set at
filter • N95 mask ... management #schema #criticalcare
COVID-19 patient Extubation
Objective: Extubation of a suspected COVID-19 patient whilst minimising aersolisation of virus particles. Orly
facemask • Hudson mask ... Checklist #Supplies #CriticalCare
COVID-19 Intubation Checklist

Personal protective equipment (PPE)
 • Standard PPE
   • N95 or PAPR.
using BVM: Hold mask ... SARSCoV2 #Management #CriticalCare
Mechanical ventilation in obese patients according to the i-STAR Algorithm
Intubate
 • Anticipate difficult airway management and
and difficult mask ... obese #Management #CriticalCare