Critical care crisis and some recommendations during the COVID-19 epidemic in China

Managing COVID-19 in Low- and Middle-Income Countries

“…At the height of the Chinese COVID-19 outbreak, the number of patients that required ventilatory support out-numbered the available intensive care unit (ICU) beds. 6 General beds were rapidly converted to ICU beds and general hospitals were converted to critical care hospitals; additional physicians and nurses trained in critical care medicine were transferred to the most affected area. In Africa, ICU beds and personnel trained in critical care are limited to tertiary hospitals, as assessed in the Republic of The Gambia; therefore, mortality associated with COVID-19 is likely to exceed the reported case fatality rate of 2.3%.…”

Recomendaciones de «hacer» y «no hacer» en el tratamiento de los pacientes críticos ante la pandemia por coronavirus causante de COVID-19 de los Grupos de Trabajo de la Sociedad Española de Medicina Intensiva, Crítica y Unidades Coronarias (SEMICYUC)

“…Es necesario planificar de manera proactiva los recursos disponibles (estructurales, equipos y profesionales), prestando especial atención en la descripción de zonas de expansión viables que permitan la Page 23 of 52 J o u r n a l P r e -p r o o f utilización de dispositivos de terapia y soporte respiratorio, así como los habituales de la Medicina Intensiva. Siempre se debe contar con la logística necesaria para agrupar pacientes y equipos de profesionales de acuerdo a las necesidades, intentando evitar el colapso del SMI y del centro hospitalario (91).…”

“…Igualmente se deben establecer circuitos que permitan transportar equipamiento tecnológico, EPI, etc., desde aquellos SMI donde exista un excedente, hacia otros SMI donde exista escasez (91). Para ello, se debe crear La relajación muscular es necesaria en pacientes con SDRA, sobre todo en los casos graves para poder conseguir una ventilación protectora adecuada (104).…”

Physiotherapy management for COVID-19 in the acute hospital setting: clinical practice recommendations

“…4 Based on emerging data, individuals at highest risk of developing severe COVID-19 disease requiring hospitalisation and/or ICU support are those who are older, male, have at least one co-existing comorbidity, higher severity of illness scores (measured via SOFA scores), elevated D-dimer levels and/or lymphocytopenia. 2,4,[9][10][11] Purpose This document has been prepared to provide information to physiotherapists and acute care healthcare facilities about the potential role of physiotherapy in the management of hospital-admitted patients with confirmed or suspected COVID- 19. Physiotherapists who work in primary healthcare facilities are likely to have a role in the management of patients admitted to hospital with confirmed or suspected COVID-19. Physiotherapy is an established profession throughout the world.…”