COVID-19 interventions
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COVID-19 Microchapters |
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Diagnosis |
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Treatment |
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Case Studies |
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COVID-19 interventions On the Web |
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American Roentgen Ray Society Images of COVID-19 interventions |
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Risk calculators and risk factors for COVID-19 interventions |
Overview
Interventions
Airway management
Non-invasive ventilation (NIV) and High Flow Nasal Oxygen (HFNO)
NIV and HFNO must be avoided as they present a high risk of aerosol transmissibility
Mechanical Ventilation
Mechanical ventilation can be used in patients who have labored breathing and are unable to maintain adequate gaseous excange leading to hypoxemia and/or hypercapnia. Common clinical indications of mechanical ventilation include moderate to severe dyspnea, respiratory rate (RR) > 24-30/min, signs of increased breathing, accessory muscle use for breathing and abdominal paradox. It may also be used in patients who have inadequate arterial partial pressure of oxygen or critically low PaO2 (PaO2 < 70 mm Hg), hypercapnia PaCO2 > 45 mm Hg and PaO2/FiO2 < 200.
Special Considerations
In patients suffering from COVID-19, airways management can be high-risk due to aerosol-based transmission for the following reasons:
- Combative or agitated patient secondary to hypoxia
- Personal protective equipment may need to be removed
- Clinicians in close proximity to the patient's airway may be at risk
- Larygoscopy and intubation may become high risk secondary to aerosol generation
Aerosol Generation Risk Factors and Protective Measures
| Route of Aerosol Generation | Protective Measures |
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| Coughing | |
| Face Mask Seal Leak | |
| Inadequate Seal With Positive Pressure Ventilation | |
| High Flow Nasal Oxygen |