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CORONAVIRUS
WORCESTERSHIRE INTENSIVE CARE GUIDELINES AND RESOURCES
COMMUNICATION WITH PATIENTS & FAMILIES
DIFFICULT PHONE CONVERSATIONS
Local guideline on communicating to relatives over the phone, and links to trust, and national support facilities
Chelsea and Westiminster Hospitals infographic on how to approach difficult phone calls with relatives of critically ill
This link from 'vitaltalk' provides more advice on difficult phone conversations, including in resource limited situations
Instructions on using skype or facetime to allow relatives to see patients in ICU using ICU IPADs. Code for accessing Ipads in handover folder, along with unredacted document with icu login details.
VENTILATORS
Worcestershire uses Evita 500s and Savina ICU ventilators on ICU, along with Oxylog 3000 transport ventilators in ED and ICU. Anaesthetic machines have advanced ventilators (Maquet Flowi)
INITIAL VENTILATOR SETUP
initial vent setup including where viral filters should be attached
Drager Oxylog
We have a number of Drager oxylogs across site, more may become available from central government. If repurposed to ventilate for long periods - refer to these instructions
MAQUET FLOWi ANAESTHETIC MACHINES
Worcestershire set up and troubleshooting guide to using the Maquet anaesthetic machines for ICU patients
Hamilton T1 transfer ventilators (on transfer trolleys)
VG70 Ventilators
VG70 Ventilator
MANAGEMENT OF RESPIRATORY FAILURE
PRONE POSITIONING
Video detailing Worcestshire method to move patient to prone position with only three staff members
POSITIONING FROM PRONE TO SUPINE
Video detailing Worcestshire method to move patient back to supine position with only three staff members
LUNG ULTRASOUND IN COVID-19
Lung ultrasound is probably one of the most useful imaging modalities, and can be done at the bedside - here is a guide to what you may see
Got some more time on your hands..... follow this link to a LITFL video tutorial on lung Ultrasound in COVID - it is sensational!
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Here is the link to the lung US documentation form
Psychological support
Events are likely to be extremely stressful. In addition to psycholocical support from friends, family, and colleagues, professional support can be sought - further information in download.
For online resources/downloads/self help, follow this link to unmind - free to NHS workers dealing with COVID-19 crisis
NHS 'Pandemic Working Together Hoodies'
Our very own, talented Dr. Ben Coombs has designed a crest to represent the coming together of numerous NHS specialties to support patients during the COVID-19 pandemic. You can buy your own at a reduced rate by following the link
Delivery is to the anaesthetic dept unless you pay for delivery to home address
Crest
Birds - watching over patients by day and night
Lantern - Royal College Nursing crest (Florence Nightingale lady of the lamp)
Strong arm holding healing light (Chartered Society Physiotherapists)
Rod of Asclepius - healing professions
Opium poppy - analgesia
Curare vine - muscle relaxation
Mandrake - sedation
Coca leaf - local anaesthetic
Open book - new learning and knowledge
Helmet - battle
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OTHER USEFUL RESOURCES
Useful sites providing information relevant to patient management
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Guidance Hub for UK bodies information (FICM,AAGBI,RCOA, ICS)
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Guideline NICE re: COVID-19 Critical Care
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Surviving Sepsis Campaign Guidelines for Covid-19
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Resus Council Infographic on CPR in COVID-19
Succinct review of what is currently known and management advice from EMCrit
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Kings Hospital Clinical Evidence Summary COVID-19
Useful information from Northampton Critical Care group
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Haematologitcal/Thromboprophylaxis considerations webinar (ISTH) 9/4/20
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West Midlands Network critical care Transfer Service (phone Tel – 0300 200 1100)
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