To quickly disseminate the latest knowledge and guide diagnosis, care and treatment of critically ill COVID-19 patients during the rapidly evolving pandemic, guidelines were released today by the Surviving Sepsis Campaign, a joint initiative of the Society of Critical Care Medicine (SCCM) and the European Society of Intensive Care Medicine (ESICM).
The evidence-based guidelines will be updated regularly online on the Surviving Sepsis Campaign website as new evidence becomes available. They also seek to help protect patients and healthcare workers from further spreading the disease.
A recent report from the Chinese Center of Disease Control and Prevention described 72,314 cases of COVID-19 from China. Among laboratory-confirmed cases, 1,716 (3.8%) were healthcare workers. The report describes that 14.8% (247) of infected healthcare workers had severe or critical illness, and that five died.
The Surviving Sepsis Campaign COVID-19 subcommittee panel (36 experts from 12 countries) issued 53 statements based on the available evidence, four of which are best practices based on high-quality evidence:
- For healthcare workers performing aerosol-generating procedures on patients with COVID-19 in the ICU, use fitted respirator masks (N95 respirators, FFP2, or equivalent), as opposed to surgical/medical masks, in addition to other personal protective equipment (i.e., gloves, gown, and eye protection, such as a face shield or safety goggles).
- Aerosol-generating procedures should be performed on ICU patients with COVID-19 in a negative pressure room, if available. Negative pressure rooms are engineered to prevent the spread of contagious pathogens from room to room.
- For healthcare workers providing usual care for non-ventilated COVID-19 patients, use surgical/medical masks, as opposed to respirator masks, in addition to other personal protective equipment (i.e., gloves, gown, and eye protection, such as a face shield or safety goggles)
- For healthcare workers who are performing non-aerosol-generating procedures on mechanically ventilated (closed circuit) patients with COVID-19, use surgical/medical masks, as opposed to respirator masks, in addition to other personal protective equipment (i.e., gloves, gown, and eye protection, such as a face shield or safety goggles)
- For healthcare workers performing endotracheal intubation on patients with COVID-19, use video-guided laryngoscopy, over direct laryngoscopy, if available.
- For COVID-19 patients requiring endotracheal intubation, endotracheal intubation should be performed by the healthcare worker who is most experienced with airway management in order to minimize the number of attempts and risk of transmission.