Archival Material - No Longer Maintained
The Critical Care Primer was developed in March 2020 to provide educational support for non-ICU clinicians who might be called to provide critical care support during the COVID-19 pandemic. The primer is a result of collaboration between medicine and library faculty to provide access to educational resources including training videos created by Babak Sarani, MD and Katrina Hawkins, MD. The project has now concluded and this information is no longer maintained. The material in this research guide is provided for informational purposes only.
Recommended Education
Free Online Training
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Critical Care for Non-ICU CliniciansThe Society of Critical Care Medicine (SCCM) is providing free education to inform, prepare, and equip healthcare clinicians during the coronavirus disease 2019 (COVID-19) pandemic.
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NEJM: COVID-19 Interactive Primer Part II Severe-CriticalPurpose: Introduces new internal medicine interns and other providers to some of the basic concepts of managing critically ill patients with COVID-19.
Objectives: Understanding of the basics of mechanical ventilation and management of acute respiratory distress syndrome in patients with COVID-19.
Time to Complete: ~25 minutes -
NEJM Covid-19 Rx Treatment SimulationsYou are a health care provider in a developed country. Several patients await your care. These patients are suspected of having Covid-19 and have been triaged by severity of illness. Select Severe Case if interested in managing severe Covid-19 in an intensive care setting; select Critical and Expert Cases if interested in managing severe Covid-19 and its complications in an intensive care setting.
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ICU Primer (YouTube 37:14)Katrina Hawkins, MD, Assistant Professor of Anesthesiology and Critical Care Medicine; Assistant Professor of Medicine, The George Washington University
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Just in Time: Basic Management of a Ventilator (YouTube 21:18)Babak Sarani, MD, FACS, FCCM Professor of Surgery, The George Washington University Chief of Trauma and Acute Care Surgery, The GW Medical Faculty Associates & George Washington University Hospital
Key Articles
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Just-In-Time Tools for Training Non-Critical Care Providers: Basics of Respiratory FailureLee, J. D., Albert, T. J., Carmona, H. D., Johnson, N. J., Luks, A. M., Steinbach, T. C., & Kritek, P. A. (2020). Just-In-Time Tools for Training Non-Critical Care Providers: Basics of Respiratory Failure. ATS Scholar, (ja).
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Just-In-Time Tools for Training Non-Critical Care Providers: Troubleshooting Problems in the Ventilated PatientSteinbach, T. C, .Albert, T. J., Carmona, H. D., Johnson, N. J., , Lee, J. D, and Luks, A. M., , & (2020). Just-In-Time Tools for Training Non-Critical Care Providers: Troubleshooting Problems in the Ventilated Patient. ATS Scholar, (ja).
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Acute respiratory distress syndromeMeyer NJ, Gattinoni L, Calfee CS. Acute respiratory distress syndrome. Lancet. 2021 Aug 14;398(10300):622-637. doi: 10.1016/S0140-6736(21)00439-6. Epub 2021 Jul 1. PMID: 34217425; PMCID: PMC8248927.
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Complications of critical COVID-19: Diagnostic and therapeutic considerations for the mechanically ventilated patientMaslove DM, Sibley S, Boyd JG, Goligher EC, Munshi L, Bogoch II, Rochwerg B. Complications of critical COVID-19: Diagnostic and therapeutic considerations for the mechanically ventilated patient. Chest. 2021 Oct 13:S0012-3692(21)04094-0. doi: 10.1016/j.chest.2021.10.011. Epub ahead of print. PMID: 34655568; PMCID: PMC8511547.
Key Resources for Education
Critical Care for Non-Intensivists
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Critical Care for Non-ICU CliniciansThe Society of Critical Care Medicine (SCCM) is providing free education to inform, prepare, and equip healthcare clinicians during the coronavirus disease 2019 (COVID-19) pandemic.
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NEJM: COVID-19 Interactive Primer Part II Severe-CriticalPurpose: Introduces new internal medicine interns and other providers to some of the basic concepts of managing critically ill patients with COVID-19.
Objectives: Understanding of the basics of mechanical ventilation and management of acute respiratory distress syndrome in patients with COVID-19.
Time to Complete: ~25 minutes -
NEJM Covid-19 Rx Treatment SimulationsYou are a health care provider in a developed country. Several patients await your care. These patients are suspected of having Covid-19 and have been triaged by severity of illness. Select Severe Case if interested in managing severe Covid-19 in an intensive care setting; select Critical and Expert Cases if interested in managing severe Covid-19 and its complications in an intensive care setting.
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ACP Critical Care Video ShortsACP's collection of 50+ white board videos (2-5 mins each), currently available for free access during the pandemic. View in any order; mobile friendly. Topics include: ABG, acid/base, hypoxemia, ARDS, hypercarbic failure, mechanical ventilation, sepsis, vasopressors, preventive measures in the ICU.
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Internet Book of Critical Care (IBCC)Created and maintained by Josh Farkas, attending intensivist at the University of Vermont.
Treatment Guidelines
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NIH Treatment Guidelines: Care of Critically Ill Adult Patients With COVID-19Link to archived website; NIH website no longer available
Airway Management / Noninvasive respiratory support
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Coronavirus COVID-19 Airway Management ChecklistIntubation during the COVID-19 outbreak is one of the more dangerous procedures for our teams; approach designed to keep patients and providers as safe as possible during pandemic.
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COVID-19 Airway & Management GuidelinesContent no longer available online
GW Department of Anesthesiology & Critical Care Medicine Updated 3/18/2020
Mechanical Ventilation
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Mechanical ventilation in COVID-19: A physiological perspectiveCronin JN, Camporota L, Formenti F. Mechanical ventilation in COVID-19: A physiological perspective. Exp Physiol. 2021 Sep 19:10.1113/EP089400. doi: 10.1113/EP089400. Epub ahead of print. PMID: 34541721; PMCID: PMC8667647.
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Mechanical Ventilation And Extracorporeal Membrane Oxygenation Considerations In COVID-19Sinha A, Deshwal H, Vashisht R. Mechanical Ventilation And Extracorporeal Membrane Oxygenation Considerations In COVID-19. 2021 Sep 11. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021 Jan–. PMID: 34283476.
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COVID-19 Airway & Management GuidelinesContent no longer available online
GW Department of Anesthesiology & Critical Care Medicine Updated 3/18/2020 -
Weaning from mechanical ventilationMcConville JF, Kress JP. Weaning patients from the ventilator. N Engl J Med. 2012;367(23):2233–2239. doi:10.1056/NEJMra1203367
ECMO
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The role of extracorporeal membrane oxygenation in critically ill patients with COVID-19Huang S, Zhao S, Luo H, Wu Z, Wu J, Xia H, Chen X. The role of extracorporeal membrane oxygenation in critically ill patients with COVID-19: a narrative review. BMC Pulm Med. 2021 Apr 8;21(1):116. doi: 10.1186/s12890-021-01479-6. PMID: 33832474; PMCID: PMC8027981.
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Bedside troubleshooting during ECMOPatel B, Arcaro M, Chatterjee S. Bedside troubleshooting during venovenous extracorporeal membrane oxygenation (ECMO). J Thorac Dis. 2019;11(Suppl 14):S1698–S1707. doi:10.21037/jtd.2019.04.81
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Mechanical Ventilation And Extracorporeal Membrane Oxygenation Considerations In COVID-19Sinha A, Deshwal H, Vashisht R. Mechanical Ventilation And Extracorporeal Membrane Oxygenation Considerations In COVID-19. 2021 Sep 11. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021 Jan–. PMID: 34283476.
COVID-19 Evidence Base Care
Guidelines
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NIH COVID-19 Treatment Guidelines: Critical CareLink to archived website; NIH website no longer available
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COVID-19 Airway & Management GuidelinesContent no longer available online
GW Department of Anesthesiology & Critical Care Medicine Updated 3/18/2020 -
Surviving Sepsis Campaign COVID-19 GuidelinesThe SSC COVID-19 subcommittee panel (36 experts from 12 countries) issued 53 statements based on the available evidence, four of which are best practices based on high-quality evidence. Updated as new evidence becomes available
Point-of-Care Summaries
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DynaMed: Coronavirus (COVID-19) Clinical SummaryIncludes diagnostic, management, and epidemiological information and resources
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StatPearls: Coronavirus (COVID-19) Clinical SummaryUpdated weekly
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epocrates+: Coronavirus (COVID-19) Clinical SummaryIncludes information on diagnosis, treatment, follow-up.
GW Infectious Disease Updates
Provided by Tara Palmore, MD, FACP, FIDSA, GW Division of Infectious Diseases
Provided by Hana Akselrod, MD, MPH, GW Division of Infectious Diseases from 3/17/2020 to 1/19/2022
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Clinical Update 3/26/2020With thanks to Rachel Harold, MD and Saghar Saber, MD
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Clinical Update 3/19/2020With thanks to Rachel Harold, MD and Saghar Saber, MD
Contributors
Babak Sarani, Courtney Paul, Danielle Davison, Hana Akselrod, Jalil Ahari, Laura Abate & Philip Zapanta
Questions or comments? Please email Laura Abate (leabate@gwu.edu)
GW Updates
We have developed COVID-19: GW Health Updates and a daily digest email to minimize the number of emails our providers and staff are getting daily. By going to this page, you will be able to access the latest information in your area in real time and will try to minimize blast emails for urgent information.
