Improved treatment of COVID-19 as a result of new guidelines?
There are new guidelines for the treatment of people with COVID-19, which are so ill that they need to be treated in an intensive care unit. In these guidelines a number of recommendations were given to improve the treatment of affected persons.
Researchers of McMaster University created guidelines to improve intensive care treatment of people with severe cases of COVID-19. The results of the study were published in the English-language journals “Critical Care Medicine” and “Intensive Care Medicine” together.
Researchers create 53 recommendations
The new guidelines are designed to ensure improved treatment of persons in the ICU with COVID-19. For 54 recommendations were created, which include, for example, topics such as infection control, laboratory diagnosis and sample, the dynamics of the blood flow support and ventilation support.
Guideline was created in 18 days
Previously, there were limited guidelines for the acute treatment of critically ill persons with COVID-19. Normally it takes a year or two, to large new clinical practice develop guidelines like this, report the researchers. In view of the urgency, an international Team was put together, which is formulated within only 18 days, the recommendations.
Researchers from many areas worked together
The panel of researchers, experts for the development of guidelines, infection control, infectious diseases and Microbiology, intensive care, emergency medicine, nursing, and public health module. The members of the panel were from Australia, Canada, China, Denmark, Italy, Korea, the Netherlands, the United Arab Emirates, the United Kingdom, the United States and Saudi Arabia.
53 important questions should be clarified
The panel suggested that first of all, 53 of the important questions they had for the administration of COVID-19 in intensive care is relevant. Then the Team in the literature researched for direct and indirect References to the handling of COVID-19 in intensive care units. They found relevant and up-to-date systematic reviews to most of the questions in the context of supportive treatment.
Security of the evidence was rated
The group assessed after the security of the evidence with the help of an approach developed by McMaster University. This provides the opportunity for the evaluation of previous Work, is a transparent framework for the development and presentation of summaries of the evidence and provides a systematic approach for the drafting of recommendations.
On six questions, the researchers found no suitable answer
Resulting 54 recommendations for employees in the health sector resulted in a total of. Six questions could not be answered clearly. Four recommendations based on high quality evidence.
It should be used with the correct protective equipment
Employees of the health system, the aerosol stuff to perform procedures such as Intubation, bronchoscopy, or open Suctioning of patients with COVID-19, should wear instead of surgical masks customized respiratory protection masks. In addition, other personal protective equipment should be worn, such as gloves, gowns and eye protection.
Use of negative pressure rooms is recommended
Aerosol generating procedures should be performed in patients in the ICU with COVID-19 in a negative pressure room, if possible. Under pressure spaces are constructed in such a way that the spread of infectious pathogens from room to room is prevented.
Only qualified personnel should perform endotracheal Intubation
The endotracheal Intubation of COVID-19-Concerned should be carried out by healthcare professionals with experience in airway management, in order to minimize the number of Attempts and the risk of Transmission.
When should be intubated?
Adults with COVID-19 treated with non-invasive positive pressure ventilation or nasal cannula with high flow, should be monitored for a deterioration in the respiratory status and need for early intubation.
Further guidance will be published when needed
The researchers announced that the issuance of further guidance, it is planned to update the recommendations if needed, or to formulate new recommendations. (as)