Episode three already! And a bit of a longer one this time...

In a bit of a one-off, I got in touch with Ben Paul, student Critical Care Paramedic and Senior Lecturer, about COVID-19 in pre-hospital critical care. You're probably sick of hearing about it, but on the off-chance you're not we put together this episode to try and provide some clarity to those of us working outside of hospital.

To be clear... Neither of us are experts and clearly the knowledge of COVID-19 is changing daily but we have managed to muddle through the wealth of literature out there to bring a summary of what we think is useful for people to know. Our discussion encompassed R-nought, pathophysiology, diagnosis, treatment of respiratory failure and OHCA, and (of course) PPE. 

Hopefully you find this useful. And if you do, please subscribe / rate / share - you know the drill!  Thanks, 

--

Silas

 

References

• Background and pathophysiology:
  • Coronavirus Disease 2019 (COVID-19) overview (Medscape, 2020)
  • COVID-19 risk factors (NHS, 2020)
  • COVID-19 Insights: cytokine storm / massive immunomodulation (Drbeen, 2020)
  • COVID-19 (Internet Book of Critical Care, 2020) #Pulmcrit
  • Innate vs adaptive immunity (Khan Academy)
  • Cytokine storm and sepsis disease pathogenesis (Chousterman et al, 2017)
  • Berlin Criteria for Acute Respiratory Distress Syndrome (MDCalc)
• Diagnosis:
  • COVID-19: guidance for ambulance trusts (Public Health England, 2020)
  • Anosmia in COVID-19 (ENT UK, 2020)
  • COVID:Diabetes (Diabetes UK, 2020)
  • Binding of SARS coronavirus to its receptor damages islets and causes acute diabetes (Yang et al, 2010)
  • Presenting Characteristics, Comorbidities, and Outcomes Among 5700 Patients Hospitalized With COVID-19 in the New York City Area (Richardson et al, 2020)
• Aerosol Generating Procedures:
  • TBC
• Treatment (respiratory failure):
  • CPAP for COVID-19 (NHS England / Improvement, 2020)
  • Guidance for Prone Positioning of the Conscious COVID Patient (Intensive Care Society, 2020)
  • Treatment of ARDS With Prone Positioning (Scholten et al, 2017)
  • Prone Position and Mechanical Ventilation (Nickson, 2020) #LITFL
  • Effects of vertical positioning on gas exchange and lung volumes in acute respiratory distress syndrome (Richard et al, 2006)
  • Endocrinology in the time of COVID-19: Management of adrenal insufficiency (European Society of Endocrinology, 2020)
• Treatment (cardiac arrest):
  • Resuscitation Council UK Statements on COVID-19 (Coronavirus), CPR and Resuscitation (RCUK, 2020)

 

Sound recordist

• Jack Neuman

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