Critical Care Resources

• AANA: Guidelines Regarding the Role of the Certified Registered Nurse Anesthetist in Mass Casualty Incident Preparedness and Response
• PHE: COVID-19 Healthcare Planning Checklist 
• CDC: Resources for Hospitals and Healthcare Professionals Preparing for Patients with Suspected or Confirmed COVID-19
• SCCM: ICU Microcosm Within Disaster Medical Response
• SCCM: Augmenting Critical Care Capacity During a Disaster
• SCCM: Disaster Triage and Allocation of Scarce Resources
• SCCM: Biohazard Disasters: Natural and Intentional Outbreaks
• CHEST Consensus Statement: Care of the Critically Ill and Injured During Pandemics and Disasters
• How should U.S. hospitals prepare for coronavirus disease 2019 (COVID-19)? Annals of Internal Medicine, 2020

• Harvard Medical School: A Look at Operational Implications from COVID-19
• Setup of a Dedicated Coronavirus Intensive Care Unit: Logistical Aspects, Anesthesiology, 2020
• SCCM: COVID-19 Emergency Resources
• SCCM: ICU Preparedness Checklist 
• CDC: Interim Clinical Guidance for Management of Patients with Confirmed Coronavirus Disease (COVID-19)
• CHEST: Critical Care Guidelines and Expert Panel Reports
• CHEST: Indicators and Triggers for Potential Movement to Crisis Care
• CHEST: Essential Institutional Supply Chain Management in the Setting of COVID-19 Pandemic
• Practical Recommendations for Critical Care and Anesthesiology Teams Caring for COVID-19 Patients, Can J Anesth, 2020
• Shared Decision Making in ICUs: An American College of Critical Care Medicine and American Thoracic Society Policy Statement
• Critical Care Utilization for the COVID-19 Outbreak in Lombardy, Italy: Early Experience and Forecast During an Emergency Response, JAMA, 2020

• CDC: COVID-19 Printable Patient Education Fact Sheets
• UpToDate: Patient Education: Acute Respiratory Distress Syndrome (The Basics) 
• The following patient education resources are available on UpToDate with subscription:
  • Patient education: Sepsis in adults (The Basics)
  • Patient education: Pneumonia in adults (The Basics)
  • Patient education: Going home from the hospital (The Basics)
  • Patient education: Pneumonia in adults (Beyond the Basics)
  • Patient education: Pneumonia prevention in adults (Beyond the Basics)

• AANA: Informed Consent for Anesthesia Care, Policy and Practice Considerations
• AANA: Reconsideration of Advance Directives, Practice Guidelines and Policy Considerations
• UpToDate: Patient education: Advance directives (The Basics) (available with subscription)

• Baseline Characteristics and Outcomes of 1591 Patients Infected With SARS-CoV-2 Admitted to ICUs of the Lombardy Region, Italy, JAMA, 2020
• Harvard Medical School: Lessons Learned from Around the World in Dealing with COVID-19
• CDC COCA Webinar: Underlying Medical Conditions and People at Higher Risk for Coronavirus Disease 2019 (COVID-19)
• Initial Clinical Impressions of the Critical Care of COVID-19 Patients in Seattle, New York City, and Chicago, Anesthesia & Analgesia, 2020
• Clinical features and short‑term outcomes of 18 patients with corona virus disease 2019 in intensive care unit, Intensive Care Med, 2020
• Characteristics of and Important Lessons From the Coronavirus Disease 2019 (COVID-19) Outbreak in China, JAMA, 2020
• Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China, Lancet, 2020
• Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study, Lancet, 2020
• A Novel Coronavirus from Patients with Pneumonia in China, 2019, NEJM, 2020
• CDC: Are You at Risk for Severe Illness? 
• UpToDate: Coronavirus disease 2019 (COVID-19) 

• Understanding pathways to death in patients with COVID-19, Lancet, 2020
• Intensive care management of coronavirus disease 2019 (COVID-19): challenges and recommendations, Lancet, 2020
• Clinical course and outcomes of critically ill patients with SARS-CoV-2 pneumonia in Wuhan, China: a single-centered, retrospective, observational study, Lancet, 2020
• COVID-19: consider cytokine storm syndromes and immunosuppression, Lancet, 2020
• Harvard Medical School: Managing Vulnerable Populations and COVID-19
• Harvard Medical School: Managing COVID-19 in the ICU
• Care for Critically Ill Patients With COVID-19, JAMA, 2020
• Massachusetts General Hospital: Treatment Guidance for Critically Ill Patients with COVID-19 
  • Treatment Guide Figure
• SCCM: Recognition and Assessment of the Seriously Ill Patient
• SCCM: Critical Care for Older Adults 
• SCCM: Diagnosis and Management of Shock
• CDC COCA Webinar: Clinical Management of Critically Ill Adults with Coronavirus Disease 2019 (COVID-19)
• CDC: Interim Clinical Guidance for Management of Patients with Confirmed Coronavirus Disease (COVID-19)
• NephJC: The Coronavirus Conundrum: ACE2 and Hypertension Edition. 
• ACC: COVID-19 Guidance for the Cardiovascular Care Team 
• The Hospitalists: Treating Covid-19 in Patients with Diabetes 
• Laboratory Testing
  • WHO: Laboratory testing for coronavirus disease 2019 (COVID-19) in suspected human cases
  • Clinical predictors of mortality due to COVID-19 based on an analysis of data of 150 patients from Wuhan, China, Intensive Care Medicine, 2020
  • Clinical Characteristics of Coronavirus Disease 2019 in China, NEJM, 2020
  • Clinical Characteristics of 138 Hospitalized Patients With 2019 Novel Coronavirus–Infected Pneumonia in Wuhan, China, JAMA 2020
  • Characteristics and Outcomes of 21 Critically Ill Patients with COVID-19 in Washington State, JAMA, 2020
• Respiratory
  • SCCM: Diagnosis and Management of Acute Respiratory Failure
  • WHO: Clinical management of severe acute respiratory infection (SARI) when COVID-19 disease is suspected. Interim guidance, 13 March 2020
  • Risk Factors Associated with Acute Respiratory Distress Syndrome and Death in Patients With Coronavirus Disease 2019 Pneumonia in Wuhan, China, JAMA Internal Medicine, 2020
  • The clinical characteristics of pneumonia patients co‐infected with 2019 novel coronavirus and influenza virus in Wuhan, China, J Medical Virology, 2020
  • COVID-19 patients often infected with other respiratory viruses, preliminary study reports, Stanford Medicine, 2020
• Cytokine storm
  • Don’t Forget the Host: COVID-19 Cytokine Storm, Rheumatologist, 2020
• Radiology
  • Radiology Perspective of Coronavirus Disease 2019 (COVID-19): Lessons From Severe Acute Respiratory Syndrome and Middle East Respiratory Syndrome, Cardiopulmonary Imaging Review, 2020
  • Chest CT Findings in Coronavirus Disease-19 (COVID-19): Relationship to Duration of Infection, Radiology, 2020
  • Sensitivity of Chest CT for COVID-19: Comparison to RT-PCR, Radiology, 2020
  • Chest Imaging Appearance of COVID-19 Infection, Radiology, 2020
  • Chest radiograph
  • CT chest
• Point of Care Ultrasound
  • Point-of-Care Lung Ultrasound findings in novel coronavirus disease-19 pnemoniae: a case report and potential applications during COVID-19 outbreak, European Review for Medical and Pharmacological Sciences, 2020
  • Point-of-Care Ultrasound (POCUS) COVID-19 Resources
  • Lung Ultrasound for Pulmonary COVID-19
  • Imaging COVID-19 With Point-of-Care Ultrasound (POCUS)
  • Point-of-Care Ultrasound in COVID-19

• Using the Anesthesia Workstation as a Ventilator for Critically Ill Patients: Technical Considerations, AANA Journal, 2020
• Ventilator Simulator
• Preliminary Observations on the Ventilatory Management of ICU COVID-19 Patients, Experience from Lombardy Italy, 2020. 
• Practical recommendations for critical care and anesthesiology teams caring for novel coronavirus (2019-nCoV) patients, Can J Anesth 2020.
• PSMF: Running Out of Ventilators? Adapting Anesthesia Machines for Use in Critical Care
• APSF ASA Guidance on Purposing Anesthesia Machines as ICU Ventilators
• APSF FAQ on Anesthesia Machine Use, Protection, and Decontamination During the COVID-19 Pandemic
• HHS: Optimizing Ventilator Use during the COVID-19 Pandemic
• FDA: Ventilator Supply Mitigation Strategies: Letter to Health Care Providers
• FDA OKs Anesthesia Gas Machines as Ventilators Amid Coronavirus Shortage Fears, MedTechDive, 2020
• Manufacturer Letters
  • Drager: Usage of Dräger anaesthesia devices for long-term ventilation, 2020
  • Getinge: Customer Notification Letter - COVID-19 Pandemic Ventilating ICU patients using Flow-i, Flow-c and Flow-e anesthesia machines, 2020 
  • GE Healthcare: COVID-19 - Requests for information regarding the off-label use of GE Healthcare anesthesia devices for ICU ventilation, 2020
  • Mindray: Mindray A-Series Anesthesia Delivery System Consideration for use as a Ventilator, 2020

• Medications
  • ASHP: Assessment of Evidence for COVID-19-Related Treatments. 
  • NSAIDs
    • Science Alert: Updated: WHO Now Doesn’t Recommend Avoiding Ibuprofen for COVID-19 Symptoms, March 17, 2020.
    • Science Media Center: Expert Reaction to Reports that the French Health Minister Recommended Use of Paracetamol for Fever from COVID-19 Rather than Ibuprofen or Cortisone, March 16, 2020.
    • COVID-19: Ibuprofen Should Not be Used for Managing Symptoms, Say Doctors and Scientists, BMJ, 2020.
      • Update: COVID-19: European Drugs Agency to Review Safety of Ibuprofen, BMJ, 2020
  • Angiotensin Converting Enzyme (ACE) Inhibitors and Angiotensin Receptor Blockers (ARBs)
    • American College of Cardiology: HFSA/ACC/AHA Statement Addresses Concerns Re: Using RAAS Antagonists in COVID-19, 2020
    • NephJC: ACE2 and Hypertension, 2020
    • Are Patients with Hypertension and Diabetes Mellitus at Increased Risk for COVID-19 infection? The Lancet, 2020
    • Angiotensin II for the Treatment of COVID-19-Related Vasodilatory Shock, Anesthesia & Analgesia, 2020
• Intubation
  • Consensus statement: Safe Airway Society principles of airway management and tracheal intubation specific to the COVID-19 adult patient group, Med J Aust, 2020
  • SCCM: Airway Management
  • SCCM: Airway Assessment and Management
  • Recommendations for Endotracheal Intubation of COVID-19 Patients, Anesthesia & Analgesia, 2020
  • Intubation and Ventilation amid the COVID-19 Outbreak: Wuhan’s Experience, Anesthesiology, 2020
  • Perioperative care provider’s considerations in managing patients with COVID-19 infections, Transl Perioper Pain Med, 2020
  • Practical recommendations for critical care and anesthesiology teams caring for novel coronavirus (2019-nCoV) patients, Can J Anaesth 2020
  • Staff safety during emergency airway management for COVID-19 in Hong Kong, Lancet Respir Med, 2020.
  • Outbreak of a new coronavirus: What anaesthetists should know, Br J Anaesth, 2020
• IV Fluid Management
  • SCCM: Surviving Sepsis Campaign: Guidelines on the Management of Critically Ill Adults with Coronavirus Disease 2019 (COVID-19) 
  • European Society of Intensive Care Medicine Surviving Sepsis Campaign: Guidelines on the Management of Critically Ill Adults with COVID-19 Guidelines
  • Liberal versus conservative fluid therapy in adults and children with sepsis or septic shock, Cochrane Systematic Review, 2018
  • Colloids versus crystalloids for fluid resuscitation in critically ill people, with sepsis or septic shock, Cochrane Systematic Review, 2018
• Mechanical Ventilation
  • SCCM:Mechanical Ventilation I
  • SCCM: Mechanical Ventilation II
  • SCCM: Sustained Mechanical Ventilation Outside Traditional Intensive Care Units
  • SHM: Non-Invasive Positive Pressure Ventilation For the Hospitalist
  • SHM: Mechanical Ventilation Part I: The Basics
  • SHM: Mechanical Ventilation Part II: Beyond the Basics
  • SHM: Mechanical Ventilation Part III: ARDS
  • Merck Manual: Overview of Mechanical Ventilation
  • LSUHSC New Orleans: Basic Mechanical Ventilation
  • NIH NHLBI ARDS Clinical Network: Mechanical Ventilation Protocol Summary
  • Critical Care Fundamentals: Basics of Mechanical Ventilation Part 1, REBEL EM, 2019
  • Top 10 care essentials for ventilator patients, American Nurse 2012
• Prone Positioning
  • Prone Positioning in Severe Acute Respiratory Distress Syndrome, NEJM, 2013
  • Lung ventilation and perfusion in prone and supine postures with reference to anesthetized and mechanically ventilated healthy volunteers, Anesthesiology, 2010
  • The Prone Position Eliminates Compression of the Lungs by the Heart, Am J Respir Crit Care Med, 2000
  • Effects of prone positioning on lung protection in patients with acute respiratory distress syndrome, Am J Respir Crit Care Med, 2013
• Empirical Early Antibiotics
  • Diagnosis and Treatment of Adults with Community-acquired Pneumonia. An Official Clinical Practice Guideline of the American Thoracic Society and Infectious Diseases Society of America, American Journal of Respiratory and Critical Care Medicine, 2019
• Acute Respiratory Distress Syndrome
  • Management of COVID-19 Respiratory Distress, JAMA, 2020
  • Covid-19 Does Not Lead to a “Typical” Acute Respiratory Distress Syndrome, ARJCCM, 2020
  • Treatment for severe acute respiratory distress syndrome from COVID-19, Lancet, 2020
  • CHEST: Acute Respiratory Distress Syndrome (ARDS)
  • CHEST: Hypoxemic Respiratory Failure
  • UpToDate: Acute respiratory distress syndrome: Clinical features, diagnosis, and complications in adults
  •  UpToDate: Acute respiratory distress syndrome: Supportive care and oxygenation in adults
  • UpToDate: Acute respiratory distress syndrome: Epidemiology, pathophysiology, pathology, and etiology in adults
  • UpToDate: Ventilator management strategies for adults with acute respiratory distress syndrome
  • UpToDate: Prone ventilation for adult patients with acute respiratory distress syndrome
• Extracorporeal Membrane Oxygenation
  • UpToDate: Extracorporeal membrane oxygenation (ECMO) in adults
  • Planning and provision of ECMO services for severe ARDS during the COVID-19 pandemic and other outbreaks of emerging infectious diseases, Lancet, 2020
  • Coronavirus epidemic: preparing for extracorporeal organ support in intensive care, Lancet, 2020
  • Preparing for the most critically ill patients with COVID-19: the potential role of extracorporeal membrane oxygenation, JAMA, 2020.
  • Coronavirus: intensive care techniques prove vital to saving lives, South China Morning Post
  • ICU Management and Practice: Coronavirus and the Potential Role of ECMO
  • ELSO: ECMO in COVID-19
    • ELSO Guidance Document: ECMO for COVID-19 Patients with Severe Cardiopulmonary Failure 
• Sedation in ICU
  • Sedation and Delirium in the Intensive Care Unit, NEJM, 2014
  • San Diego Patient Safety Council: ICU Sedation Guidelines of Care
• Nutrition in Critically Ill Patients
  • SCCM ASPEN: Nutrition Therapy in the Patient with COVID-19 Disease Requiring ICU Care
  • How does enteral nutrition compare with parenteral nutrition (with or without enteral nutrition) for adults admitted to the intensive care unit (ICU)? Cochrane Systematic Review, 2018

• Identifying intensive care unit discharge planning tools: protocol for a scoping review, BMJ, 2013
• A Scoping Review of Patient Discharge From Intensive Care: Opportunities and Tools to Improve Care, Chest, 2015
• Wolters Kluwer: COVID-19 Discharge Instructions 

• Fair Allocation of Scarce Medical Resources in the Time of COVID-19, The New England Journal of Medicine, 2020. 
• The Toughest Triage – Allocating Ventilators in a Pandemic, The New England Journal of Medicine, 2020. 
• Potential Legal Liability for Withdrawing or Withholding Ventilators During COVID-19: Assessing the Risks and Identifying Needed Reforms, JAMA, 2020. 
• Using Chloroquine to Treat COVID-19: Q&A with Raghu Chivukula, MD, PHD, Massachusetts General Hospital. 
• Harvard Medical School: Ethical and Psychosocial Issues in Management of COVID-19
• ANA: Webinar -  Nurses, Ethics, and the Response to the COVID-19 Pandemic 
• ANA: How to Respond to Ethical Challenges and Moral Distress during the COVID-19 Pandemic
• Clinical Ethics Recommendations for the Allocation of Intensive Care Treatments, in Exceptional, Resource-limited Circumstances, Società Italiana di Anestesia Analgesia Rianimazione e Terapia Intensiva (SIAARTI), 2020.
• COVID-19 Ethics Resource Center, AMA Journal of Ethics, 2020.

Policy Templates

• Department of Defense: COVID-19 Practice Management Guide
• UIC College of Medicine: ICU Guidebook
• UW Medicine: COVID-19 Protocols
• Brigham and Women’s Hospital: COVID-19 Critical Care Clinical Guidelines
  • BWH/MGH Guidelines for the Respiratory Care of Patients on Strict Isolation
• Massachusetts General Hospital: Treatment Guidance for Critically Ill Patients with COVID-19
  • Treatment Guide Figure
• A Seattle Intensivist’s One-pager on COVID-19

PPE, N95 Masks, and Respirators

• See AANA: Practice Resources – Coronavirus Disease (COVID-19)
• UCSF: Donning and Doffing PPE Videos

Other Resources

• Life in the Fastlane: Critical Care Compendium