Clinical Practice Guidelines on the Management of Hypoxic COVID-19 Patients (SCCM, 2020)

Society of Critical Care Medicine and the European Society of Intensive Care Medicine

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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