Guidelines on Hypoxic COVID-19 Patients (SCCM, 2020)
What your doctor is reading on Medscape.com:
APRIL 24, 2020 — Clinical practice guidelines on the management of hypoxic COVID-19 patients have been released by the Society of Critical Care Medicine and the European Society of Intensive Care Medicine.[1]
Hypoxic Patients With COVID-19
If there is an indication for endotracheal intubation, do the following:
Perform the intubation.
Ensure an airway expert performs the intubation.
Use N-95/FFP-2 or equivalent respirator masks and other personal protective equipment and infection control precautions.
Minimize staff presence in the room.
Consider using videolaryngoscopy if available
If endotracheal intubation is not indicated and the patient is tolerating supplemental oxygen, do the following:
Closely monitor the patient for worsening.
Target peripheral capillary oxygen saturation (SpO2) at 92-96%.
Ensure appropriate infection control precautions are in place.
Do not delay endotracheal intubation should the patient’s condition worsen.
If endotracheal intubation is not indicated and the patient is not tolerating supplemental oxygen, consider using high-flow nasal cannula. If this is tolerated, do the following:
Closely monitor the patient for worsening.
Target SpO2 at 92-96%.
Ensure appropriate infection control precautions are in place.
Do not delay endotracheal intubation should the patient’s condition worsen.
If endotracheal intubation is not indicated, the patient is not tolerating supplemental oxygen, and the patient is not tolerating high-flow nasal cannula (or it is not available), do the following:
Consider noninvasive positive-pressure ventilation.
Closely monitor the patient at short intervals.
Do not delay endotracheal intubation should the patient’s condition worsen.
Medscape Medical News
Sources
Society of Critical Care Medicine, European Society of Intensive Care Medicine, Surviving Sepsis Campaign. COVID-19 Resources: Summary of recommendations on the initial management of hypoxic COVID-19 patients. Society of Critical Care Medicine. Accessed April 21, 2020. Available at: https://journals.lww.com/ccmjournal/Documents/Combined%20COVID-19%20Infographics.pdf.
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