Performing Percutaneous Tracheostomy in a Viral Pandemic
Published November 3, 2020
In this new infographic from CHEST's Bronchoscopy Domain Task Force, learn about patient selection, necessary equipment and personnel, steps of the procedure, and posttracheostomy care during the COVID-19 pandemic.
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Bronchoscopy in the Era of COVID-19
Published October 20, 2020
CHEST's Bronchoscopy Domain Task Force has created an infographic with key information on how to provide timely care while minimizing exposures during bronchoscopy in the era of COVID-19. Get information on indications, recommendations for testing, and tips for performing bronchoscopy in suspected or COVID-19-positive patients as well as COVID-19-negative patients.
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The Intensivists’ Dilemma: Extra-Step or No-Step for Extracorporeal Support in Patients With COVID-19
Published September 1, 2020
COVID-19 has magnified ethical and clinical dilemmas in the ICU. Determining whether it is appropriate to cannulate a patient and start extracorporeal membrane oxygenation (ECMO) needs to be carefully weighed against the availability of resources, team support, and the patient’s goals of care.
Pleural Drainage During COVID-19
Published June 18, 2020
Learn how to create a closed pleural drainage system using stocked items with these step-by-step instructions from Swedish Medical Center in Seattle, WA.
Focused Lung and Cardiac Ultrasound Exams in COVID-19 Patients
Published May 5, 2020
A daily lung and cardiac ultrasound exam is performed on COVID-19 patients. Four lung zones that roughly correspond with the upper, middle (or lingula), and lower lobes are examined on the anterior, lateral, and posterior chest walls, respectively. The lung findings are coded with the highest number in each zone as normal (0), discrete B-lines (1), fused B-lines (2), subpleural consolidations (3), or lobar consolidation (4). At least one cardiac view, usually the parasternal long-axis view, is obtained daily to assess left ventricular systolic function. Any suspected abnormal findings warrant obtaining additional cardiac views for further investigation. The summary of findings sheet (page 2) can be laminated, placed in the patient’s room, and updated daily. The daily exam tracking sheet (page 3) is for clinicians to keep track of their patients’ findings while rounding.
Ultrasound Cleaning Protocol
Published May 4, 2020
View general procedures for the cleaning and disinfection of ultrasound equipment.
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Airway Management
Published April 9, 2020
All three documents provide consensus expert opinion from the CHEST Difficult Airway Management faculty members for teams conducting emergency airway management (endotracheal intubation) for suspected or confirmed COVID-19 patients. These documents are adapted from the Difficult Airway Management course materials, highlighting considerations in balancing effectiveness and safety of the procedure for patients and the health-care team.
CHEST Emergent Airway Management for Suspected or Confirmed COVID-19 Patients: Provides equipment, personnel, and planning considerations for ICU and airway team leaders who are planning for or engaged in airway management of COVID-19 patients.
CHEST APPROACH to Airway Management- COVID-19 Highlights: Adapts the CHEST APPROACH framework for difficult airway management with key considerations for procedural safety in the COVID-19 setting. Airway teams can use the APPROACH framework to create a shared mental model of the procedure.
CHEST Airway Checklist with APPROACH with COVID-19 Highlights: A companion checklist for the CHEST APPROACH framework for difficult airway management. A team member positioned outside of the room can manage the checklist to support the team's ability to be prepared and maintain situational awareness.
COVID-19 Precautions During Airway Management
Published March 31, 2020
Download this helpful guide for clinicians on COVID-19 precautions during airway management.