Numbers at Mount Sinai
Numbers in New York City
Guidelines
CDC |
Who To Test
Clinical Care - Summary of clinical presentation, course, and treatment Disposition of COVID-19 Patients Guidance on Infection Control PPE Recommendations |
Department of Defense |
DoD COVID-19 Clinical Guidelines - 51-pages, 2.9 MB |
WHO |
Clinical management of COVID-19 positive patients
21-pages, 1.5 MB PulmCrit critique of WHO guidelines |
Department of Health |
COVID-19 Testing
Hospital Update - March 12, 2020 Confirmed Cases by County |
Infectious Disease Society |
ID Society Guidelines for Treatment and Management |
UK ICS |
UK Intensive Care Society - Clinical Guidance
Includes guidance on airway and crit care |
SCCM |
Surviving Sepsis - Guidelines on Management of Critically Ill with COVID-19
101-page PDF |
Protocols
UW Medicine |
COVID-19 Protocols
UW ID Treatment Guidlines - March 19, 2020 - 11 pages UW Guide for EDs and ICUs UW Testing Criteria |
Evergreen (Seattle) |
Lessons Learned (Mar 26, 2020)
|
Brigham and Women's |
CovidProtocols.org
7 Chapters, basic science heavy BWH ICU Care PDF |
Yale |
Treatment Algorithm - 13-page PDF, flowcharts and tables |
Zhejian Uni |
Handbook of COVID-19 Prevention and Treatment - Assembled by First Affliated Hospital, Zhejian University School of Medicine based on their treatment 104 confirmed cases
PDF Download - 68-pages, 28 MB |
Handbooks |
Coronavirus Tech Handbook
Probably the most comprehensive Google Doc with links, clinical info, and protocols Frontline Covid Guide Good consolidation of resources with well-annotated sources CovidReference.com 110-page PDF, also includes Top 10 papers daily |
SCCM |
Critical Care for the Non-ICU Clinician
8 learning modules on critical care (e.g. airway and mechanical ventilation) plus 5 additional modules on disaster preparedness |
Basic Science Resources
EMCrit.org - Internet Book of Critical Care - COVID-19
HMS - Medical Student COVID-19 Curriculum
International Pulmonologist’s Consensus on COVID-19 - 43-page PDF, 2MB
Critical Care Refresher - 5-page PDF
CanCOVID Wiki - Canadian wiki page consolidating clinical information and guidelines
Presentations
Allen Zhong - Team IV - 3/17/20
Peter Liu - Elmhurst - 3/18/20
Michael Plietz - COVID Acquired Immunity 4/22/20
Society of Hospital Medicine |
Resources for Hospitalists
Free Courses: Fluid Management - 1.25 hrs Mechanical Ventilation Pt 1 - The Basics - 1 hr Mechanical Ventilation Pt 2 - Beyond The Basics - 1 hr Mechanical Ventilation Pt 3 - ARDS - 45 min |
Sinai-Specific Resources
General Surgery Training Program Changes, in effect March 23, 2020
Mount Sinai Health System Pre-Surgical COVID-19 Testing. March 25, 2020.
NYC DOH Advisory (Mar 20, 2020) - Controversial advisory to stop testing non-hospitalized and asymptomatic HCWs despite exposure
Mount Sinai Staff Resource Website
Sinai Together - med and grad student volunteers who may be able to help with childcare, pet care, errands, and more.
For Surgeons
National University of Singapore’s OR preparation and guidance
Converting ORs to ICUs
Canadian Anesthesiologist Society Intra-op Recommendations
Perioperative Considerations for COVID-19 - by the Anesthesia Patient Safety Foundation
Stanford Mitigation Protocol for Endoscopy - provides framework for risk stratifying of COVID-19 patients
University of Michigan Intra-op Recommendations
MIS Task Force Algorithm for Surgery
SAGES - How to do laparoscopy in a COVID patient
AAO - When to trach COVID patients
ACS |
American College recommendations to cancel elective surgeries
ACS Resources Page |
SAGES |
SAGES recommendations on cancelling elective surgeries
SAGES Updates Page |
SSO |
Society of Surgical Oncology recommendations for how to manage malignancies during COVID-19 pandemic
SSO Resources Page |
NHS |
British clinical guide for COVID-19 patients |
Podcasts:
Behind The Knife:
COVID-19 Essentials for Surgeons
COVID19 Special - Ventilator Management Refresher for Surgeons
Hippocratic Hustle:
Ep 102. 6 COVID-19 Legal Questions answered with Attorny Ann Bittinger
Statistics / Tracking
What if I need to take a suspected, high-risk or COVID-19 positive patient to the OR?
See the paper published from the Department of Anesthesia at the National University of Singapore. Ti et al. What we do when a COVID-19 patient needs an operation: operating room preparation and guidance. Can J Anesth. 2020.
PPE:
Almost universally the use of N95 masks is recommended when operating, including patients, this includes on COVID19 high risk, but not confirmed patients (in some instances use of N95 mask is recommended in all instances)
N95 and more aggressive PPE* is recommended for any patients under going an aerosolized procedure. It remains unclear if laparoscopic surgery is included.
(*PAPR are recommended by UMichigan when indicated and Wuhan document recommends Level III (highest level of protection) for all surgical interventions)SAGES currently recommends against laparoscopic surgery if clinically indicated
*** Note: in general, there is not much information / hard data regarding if laparoscopic surgery causing viral dissemination, but many speculate it is given it is an aerosolized procedure
OR Workflow/Locations:
Negative pressure operating rooms should be used
No one should leave the room or come in during the case (this includes breaks for nursing and anesthesia staff), required equipment should be delivered by an outsider runner to the room
Disinfection protocols for these operating rooms are significantly more stringent than for normal OR cases (some recommend up to 1 hours of cleaning of all surfaces in the room)