Dr. Gerald Diaz @GeraldMD
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Board Certified Internal Medicine Hospitalist, GrepMed Editor in Chief 🇵🇭 🇺🇸 - Sign up for an account to like, bookmark and upload images to contribute to our community platform. Follow us on IG: https://www.instagram.com/grepmed/ | Twitter: https://twitter.com/grepmeded/
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Noninvasive Positive Pressure Ventilation (NIPPV)

Expiratory & Inspiratory Positive Airway Pressure
Both increase intrathoracic pressure, which can decrease
and decreases respiratory ... exacerbation (cardiogenic pulmonary ... Pt is DNI with indication ... #indications #criticalcare ... #management
COVID-19: ICU Guidelines for the Non-Intensivist
Infection Control
Risk Factors for Severe Disease
Initial Laboratory Workup
COVID-19 Specific Medications
Respiratory
Cardiac
Hematologic
Neuro/Sedation

#COVID19 #ICU
COVID-19: ICU Guidelines ... -19 Specific Medications ... Respiratory Cardiac ... #ICU #criticalcare ... NonIntensivist #diagnosis #management
Non-Invasive Ventilation (BiPAP) Algorithm - Indications and Contraindications
Indications for NIV:
 • COPD - pH <7.35, pCO2
Non-Invasive Ventilation (BiPAP ... ) Algorithm - Indications ... Neuromuscular disease - Respiratory ... #Algorithm #criticalcare ... #management #indications
COVID-19 Hypoxia Management

Indication for endotracheal intubation?
Tolerating supplemental oxygen?
Consider HFNC
Not tolerating HFNC or HFNC is not available?
Consider
COVID-19 Hypoxia ... Management Indication ... Guidelines #respiratory ... #criticalcare # ... hypoxia #failure #algorithm
Approach to Selecting Respiratory Support:
-The role of noninvasive respiratory support is generally to reduce the patient's
of noninvasive respiratory ... -The choice of BiPAP ... #Management #CriticalCare ... #BiPAP #BiLevel ... RespiratorySupport #Selection #Algorithm
Proposed Respiratory Support Algorithm in COVID19

The ‘intubate early’ paradigm, where patients who “fail” low flow oxygen
Proposed Respiratory ... Support Algorithm ... @emupdates #respiratory ... #management #schema ... #criticalcare #
Non-Invasive Positive Pressure Ventilation
Indications: 
 • COPD exacerbation (↓ intubation, ↓ mortality), Cardiogenic pulmonary edema (↓
), Cardiogenic pulmonary ... Other causes of respiratory ... a.k.a BiLevel, BiPAP ... Ventilation #diagnosis #management ... #indications #pulmonary
General schema for respiratory support in patients with COVID-19
Low flow nasal cannula
 • Typically set at
General schema for respiratory ... patients with COVID ... #management #schema ... #criticalcare # ... hypoxia #failure #algorithm
COVID-19 Intubation Checklist

Personal protective equipment (PPE)
 • Standard PPE
   • N95 or PAPR.
COVID-19 Intubation ... include: • BiPÅP ... • If using BiPÅP ... Checklist #SARSCoV2 #Management ... #CriticalCare #
Shock - Differential Diagnosis Framework
 - MAP <65. SBP <90, drop in SBP > 40
 -
Failure, Toxins/Medications ... • Obstructive: Pulmonary ... Differential #Diagnosis #criticalcare ... #algorithm #treatment ... #management