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Palliative Care During the Pandemic (Podcast)

Top officials for the American Hospital Association and the Center to Advance Palliative Care (CAPC) convened virtually for a fireside chat to discuss the impact and importance of palliative care practices during the pandemic and share stories from experts in the field. 


Center to Advance Palliative Care: Online Clinical Training Courses For All Clinicians

All specialties and disciplines can strengthen their care of patients living with a serious illness. For CAPC members, CAPC’s online training curriculum provides free continuing education credits for physicians, nurses, social workers, and case managers at member organizations. Free ABIM MOC (Maintenance of Certification) credits are also available for physicians.


Center to Advance Palliative Care: COVID-19 Response Hub

Whether your organization is in the middle of a COVID-19 surge or planning forward, Center to Advance Palliative Care (CAPC) has tools, technical assistance, clinical training, and convening opportunities to help. 


Center to Advance Palliative Care: CAPC Toolkits

Drawn from best practices, CAPC toolkits are curated, proven resources for improving the care of people living with serious illness. Toolkits include technical assistance and tools for palliative care teams; serious illness strategies for health systems, health plans, and ACOs; resources for skill-building among clinicians from all specialties and disciplines; and much more.


Effectiveness of High-Flow Nasal Cannula in Coronavirus Disease 2019 Pneumonia: A Retrospective Cohort Study

From Critical Care Medicine. In this Clinical Observation, the authors aimed to assess time to discharge and time to death in severe coronavirus disease 2019 in patients treated with high-flow nasal cannula compared with matched controls.


What are your recommendations for patients on high-flow nasal cannula or noninvasive positive-pressure ventilation who are not adherent with treatment because of anxiety or agitation?

Questions from social media, blogs and the various discussion forums, including the new SCCM COVID-19 Discussion Group, were answered. This microlearning content was taken from the COVID-19 Critical Care for Non-ICU Clinicians: Expert Panel Series held on September 8, 2021


Regarding fluid management, inotropes, and vasopressors in critically ill patients, which drugs are concerning with excessive fluid volume?

Questions from social media, blogs and the various discussion forums, including the new SCCM COVID-19 Discussion Group, were answered. This microlearning content was taken from the COVID-19 Critical Care for Non-ICU Clinicians: Expert Panel Series held on September 8, 2021


Are there any nutritional requirements or recommendations for COVID-19?

Questions from social media, blogs and the various discussion forums, including the new SCCM COVID-19 Discussion Group, were answered. This microlearning content was taken from the COVID-19 Critical Care for Non-ICU Clinicians: Expert Panel Series held on June 9th, 2021


Which markers or patient features would cause you to choose noninvasive or high-flow nasal cannula over intubation for early management of COVID-19 respiratory failure?

Questions from social media, blogs and the various discussion forums, including the new SCCM COVID-19 Discussion Group, were answered. This microlearning content was taken from the COVID-19 Critical Care for Non-ICU Clinicians: Expert Panel Series held on March 10, 2021


ABCDEF Bundle and Supportive ICU Practices for Patients With Coronavirus Disease 2019 Infection: An International Point Prevalence Study

From Critical Care Explorations. This point prevalence study showed low implementation of the ABCDEF bundle for patients with COVID-19.


High-Flow Nasal Cannula (HFNC) Use in COVID-19 Respiratory Failure

This presentation is an overview of HFNC use for COVID-19 patients. This is SCCM curated COVID-19 microlearning content.


If a patient reports shortness of breath but has an oxygen saturation of 95%, is this patient a candidate for dexamethasone?

Questions from social media, blogs and the various discussion forums, including the new SCCM COVID-19 Discussion Group, were answered. This microlearning content was taken from the COVID-19 Critical Care for Non-ICU Clinicians: Expert Panel Series held on November 4, 2020.


Is tracheostomy a possibility in some COVID-19 patients? What is the longest time a patient has been on mechanical ventilation?

Questions from social media, blogs and the various discussion forums, including the new SCCM COVID-19 Discussion Group, were answered. This microlearning content was taken from the COVID-19 Critical Care for Non-ICU Clinicians: Expert Panel Series held on November 4, 2020.


How would a nonintensivist manage a patient who needs high-flow oxygen or noninvasive ventilation but does not require immediate intubation who is admitted to the ward because no ICU beds are available?

Questions from social media, blogs and the various discussion forums, including the new SCCM COVID-19 Discussion Group, were answered. This microlearning content was taken from the COVID-19 Critical Care for Non-ICU Clinicians: Expert Panel Series held on November 4, 2020.


What treatments are available for both intubated and nonintubated COVID-19 patients?

Questions from social media, blogs and the various discussion forums, including the new SCCM COVID-19 Discussion Group, were answered. This microlearning content was taken from the COVID-19 Critical Care for Non-ICU Clinicians: Expert Panel Series held on August 12, 2020.


Can you discuss basic ICU management for COVID-19 patients in terms of gastrointestinal prophylaxis, venous thromboembolism prophylaxis, fluid monitoring, dietary requirements, sedation, and vasopressors?

Questions from social media, blogs and the various discussion forums, including the new SCCM COVID-19 Discussion Group, were answered. This microlearning content was taken from the COVID-19 Critical Care for Non-ICU Clinicians: Expert Panel Series held on August 12, 2020.


What are the criteria for extubation? I have noticed that when COVID-19 patients are extubated using the same criteria used for other patients, they seem to have a tremendous air hunger and don't do as well. What has been your experience?

Questions from social media, blogs and the various discussion forums, including the new SCCM COVID-19 Discussion Group, were answered. This microlearning content was taken from the COVID-19 Critical Care for Non-ICU Clinicians: Expert Panel Series held on August 12, 2020.


Regarding respiratory support of COVID-19 patients both in and outside the ICU, can you discuss noninvasive ventilation, BiPAP, CPAP, and high-flow nasal cannula versus intubation? What are the indications for intubation? Intubate early or later?

Questions from social media, blogs and the various discussion forums, including the new SCCM COVID-19 Discussion Group, were answered. This microlearning content was taken from the COVID-19 Critical Care for Non-ICU Clinicians: Expert Panel Series held on August 12, 2020.


Did you manage any acutely ill patients on the ward with noninvasive ventilation and proning? Did you prone nonintubated patients?

Questions from social media, blogs and the various discussion forums, including the new SCCM COVID-19 Discussion Group, were answered. This microlearning content was taken from the COVID-19 Critical Care for Non-ICU Clinicians: Expert Panel Series held on August 12, 2020.


Timing of Intubation and Its Implications on Outcomes in Critically Ill Patients With Coronavirus Disease 2019 Infection

From Critical Care Explorations. In this Letter to the Editor, the authors report their findings from an observational study aimed to compare the difference in outcomes of critically ill patients with coronavirus disease 2019 who were intubated early versus later in the disease course.


Improving Survival of Critical Care Patients With Coronavirus Disease 2019 in England: A National Cohort Study, March to June 2020

From Critical Care Medicine. The authors measured temporal trends in survival over time in people with severe coronavirus disease 2019 requiring critical care (high dependency unit or ICU) management, and assessed whether temporal variation in mortality was explained by changes in patient demographics and comorbidity burden over time.


What is the best way to determine when mechanically ventilated patients should be transitioned to noninvasive ventilation?

Questions from social media, blogs and the various discussion forums, including the new SCCM COVID-19 Discussion Group, were answered. This microlearning content was taken from the COVID-19 Critical Care for Non-ICU Clinicians: Expert Panel Series held on September 9, 2020.


Letter to the Editor: Barrier Techniques to Reduce Aerosolization During Extubation

From Critical Care Explorations. The authors describe a barrier technique during extubation which contained aerosolized particulates into a non-rebreather mask at time of extubation. The authors believe their protocol allows providers to perform extubations while minimizing exposure to aerosolized particles.


Pediatric Resuscitation Practices During the Coronavirus Disease 2019 Pandemic

From Pediatric Critical Care Medicine. The authors conducted a survey and found that most U.S. pediatric institutions rapidly adapted their resuscitation systems and practices in response to the coronavirus disease 2019 pandemic.


Venous Thromboembolism Events Following Venovenous Extracorporeal Membrane Oxygenation for Severe Acute Respiratory Syndrome Coronavirus 2 Based on CT Scans

From Critical Care Medicine. The authors report a 100% occurrence of venous thromboembolism in critically ill patients supported by venovenous extracorporeal membrane oxygenation for severe acute respiratory syndrome coronavirus 2-related acute respiratory distress syndrome using CT scan imaging despite a high target and close monitoring of anticoagulation.


Editorial: Lessons Learned From the Front Line: Outcomes of Noninvasive Ventilation for Coronavirus Disease 2019 Pneumonia in China

From Critical Care Medicine. In this Editorial, the authors look at the study by Wang et al. (Clinical Features of Coronavirus Disease 2019 Patients With Mechanical Ventilation: A Nationwide Study in China)


Does your hospital use any inflammatory markers besides D-dimer? Would you advocate for any other inflammatory marker? Do you check D-dimer or other markers on admission, daily, or weekly? What is your rationale for your approach?

Questions from social media, blogs and the various discussion forums, including the new SCCM COVID-19 Discussion Group, were answered. This microlearning content was taken from the COVID-19 Critical Care for Non-ICU Clinicians: Expert Panel Series held on July 8th, 2020.


What training was provided to nurses and advanced practice providers in your institution on proning and other COVID-19-related issues?

Questions from social media, blogs and the various discussion forums, including the new SCCM COVID-19 Discussion Group, were answered. This microlearning content was taken from the COVID-19 Critical Care for Non-ICU Clinicians: Expert Panel Series held on July 8th, 2020.


SCCM Pod-417 COVID-19-Associated Acute Respiratory Distress Syndrome

Clinicians are working to understand and formulate an effective treatment for COVID-19-associated acute respiratory distress syndrome (Marini J. Crit Care Med. 2020 May 13; Epub ahead of print).


Online Letter to the Editor: Bronchiolitis and Potential Pathophysiological Implications in Coronavirus Disease 2019 ARDS Patients With Near-Normal Respiratory Compliance

From Critical Care Medicine. The authors share the following opinions on the recruitment-response COVID-19 ARDS patients, 1) bronchiolitis, in a histologic context, is a plausible pathophysiological mechanism, and 2) a simple bedside physiologic test could potentially determine recruitment potential in resource-limited settings.


Mechanical Ventilation During the Coronavirus Disease 2019 Pandemic: Combating the Tsunami of Misinformation From Mainstream and Social Media

From Critical Care Medicine. The editorial authors discuss the role of mainstream and social media in creating the narrative that intubation and mechanical ventilation were "the cause of suboptimal outcomes" for critically ill COVID-19 patients, without accounting for hospital staffing and equipment shortages.


How can patients be weaned off high doses of multiple sedatives to which they have become tolerant?

In this question and answer webcast, attendees had the opportunity to post questions about managing critically ill patients with COVID-19 and other issues.

Questions from social media, blogs and the various discussion forums, including the new SCCM COVID-19 Discussion Group, were also addressed.

Webcast held on June 19, 2020


How would you describe the overall big picture of oxygen therapies?

In this question and answer webcast, attendees had the opportunity to post questions about managing critically ill patients with COVID-19 and other issues. Questions from social media, blogs and the various discussion forums, including the new SCCM COVID-19 Discussion Group, were also addressed. Webcast held on June 19, 2020


What is the optimal timing of prone positioning? Do some patients transition from proning to extracorporeal membrane oxygenation?

In this question and answer webcast, attendees had the opportunity to post questions about managing critically ill patients with COVID-19 and other issues. Questions from social media, blogs and the various discussion forums, including the new SCCM COVID-19 Discussion Group, were also addressed. Webcast held on June 19, 2020


Do you use proning beds or manual proning?

Questions from social media, blogs and the various discussion forums, including the new SCCM COVID-19 Discussion Group, were answered. This microlearning content was taken from the COVID-19 Critical Care for Non-ICU Clinicians: Expert Panel Series held on June 10th, 2020.


What are the benefits of delaying intubation in COVID-19 patients?

Questions from social media, blogs and the various discussion forums, including the new SCCM COVID-19 Discussion Group, were answered. This microlearning content was taken from the COVID-19 Critical Care for Non-ICU Clinicians: Expert Panel Series held on June 10th, 2020.


What is your opinion about treating patients with COVID-19 and pulmonary disease by limiting fluid volume, similar to treatment of lung transplant patients?

Questions from social media, blogs and the various discussion forums, including the new SCCM COVID-19 Discussion Group, were answered. This microlearning content was taken from the COVID-19 Critical Care for Non-ICU Clinicians: Expert Panel Series held on June 10th, 2020.


Critical Care for Non-ICU Clinicians: Expert Panel Series

This webcast series engages a panel of critical care experts who will address questions from non-ICU clinicians caring for critically ill patients during the COVID-19 pandemic. Participants are encouraged to ask about any related topics at the time of registration or live during the session.


Intubation Medications/Sedation Requirements for Intubating COVID-19 Patient - Infographic

This resource is an infographic that details intubation medications and sedation requirement for intubating COVID-19 patients. This is a community developed COVID-19 microlearning resource.


What is the latest data or anecdotal evidence on ventilation modes for patients with acute respiratory distress syndrome?

In this question and answer webcast series, attendees had an opportunity to pose questions about managing critically ill patients with COVID-19 and other issues. Questions from social media, blogs and the various discussion forums, including the new SCCM COVID-19 Discussion Group, were also answered. Recorded on: Friday, May 22, 2020


What strategies do you use to prevent ventilator-induced lung injury and avoid refractory hypoxemia?

Questions from social media, blogs and the various discussion forums, including the new SCCM COVID-19 Discussion Group, were answered. This microlearning content was taken from the COVID-19 Critical Care for Non-ICU Clinicians: Expert Panel Series held on May 27th, 2020.


How should awake patients be placed in a prone position

Questions from social media, blogs and the various discussion forums, including the new SCCM COVID-19 Discussion Group, were answered. This microlearning content was taken from the COVID-19 Critical Care for Non-ICU Clinicians: Expert Panel Series held on May 13th, 2020.


What strategies are used for fluid resuscitation and intubation timing?

Questions from social media, blogs and the various discussion forums, including the new SCCM COVID-19 Discussion Group, were answered. This microlearning content was taken from the COVID-19 Critical Care for Non-ICU Clinicians: Expert Panel Series held on May 13th, 2020.


Just-in-Time Simulation to Guide Workflow Design for Coronavirus Disease 2019 Difficult Airway Management

From Pediatric Critical Care Medicine. Integration of table-top planning, in situ simulations, and debriefing of real COVID19 cases can enhance planning, training, job aids, and feasible policies/procedures that address human factors, team communication, equipment choice, and patient/provider safety in the COVID19 pandemic era.


ICU and Ventilator Mortality Among Critically Ill Adults With Coronavirus Disease 2019

From Critical Care Medicine. To help address the growing concern that critical illness, and specifically mechanical ventilation, are associated with a high risk of death, the authors conducted a retrospective cohort study of critically ill patients with COVID-19 across their academic health system.


Percutaneous Tracheostomy With Apnea During Coronavirus Disease 2019 Era: A Protocol and Brief Report of Cases

From Critical Care Explorations. The authors sought to modify their current procedure for performing percutaneous tracheostomy to minimize aerosolization in hopes that it would help reduce exposure to staff involved. They concluded that percutaneous tracheostomy performed with apnea protocol may help minimize aerosolization, reducing risk of exposure of COVID19 to staff.


What are your recommendations for ventilation of patients with COVID-19?

In this question and answer webcast series, attendees had an opportunity to pose questions about managing critically ill patients with COVID-19 and other issues.


SCCM/AARC: Maximizing the Respiratory Team Dynamic: Effective Patient Care During a Pandemic

This expert panel representatives from Society of Critical Care Medicine (SCCM) and the American Association for Respiratory Care (AARC) teamed up to discuss how ICU respiratory care teams can work together more cohesively when caring for COVID-19 patients. Recorded on: Thursday, May 14, 2020


Comparing the Surviving Sepsis Campaign (SSC) and National Institutes of Health (NIH) COVID-19 Guidelines

This webcast was an SCCM COVID-19 expert panel discussion comparing the Surviving Sepsis Campaign COVID-19 Guidelines with the newly released National Institutes of Health Coronavirus (COVID-19) Treatment Guidelines.


Time Course of Evolving Ventilator-Induced Lung Injury: The "Shrinking Baby Lung"

From Critical Care Medicine. This paper introduces and highlights several important and /or novel concepts seldom considered by the practicing intensivist.


How long should patients be kept on noninvasive ventilation?

Questions from social media, blogs and the various discussion forums, including the new SCCM COVID-19 Discussion Group, were answered.


Should a patient have a negative COVID-19 test before undergoing a tracheostomy?

Questions from social media, blogs and the various discussion forums, including the new SCCM COVID-19 Discussion Group, were answered.


What is the standard of care for the timing of a tracheostomy?

Questions from social media, blogs and the various discussion forums, including the new SCCM COVID-19 Discussion Group, were answered.


Can chest radiograph findings change the indication for either intubation or extubation?

Questions from social media, blogs and the various discussion forums, including the new SCCM COVID-19 Discussion Group, were answered.


What strategies can be used to start hemodynamically unstable patients on mechanical ventilation?

Questions from social media, blogs and the various discussion forums, including the new SCCM COVID-19 Discussion Group, were answered.


What strategies can be used to reduce rates of reintubation?

Questions from social media, blogs and the various discussion forums, including the new SCCM COVID-19 Discussion Group, were answered.


At what saturation levels should a patient be intubated and what strategies can be used to avoid intubation?

Questions from social media, blogs and the various discussion forums, including the new SCCM COVID-19 Discussion Group, were answered.


What are the benefits of proning protocols and the recommendations for timing of proning?

Questions from social media, blogs and the various discussion forums, including the new SCCM COVID-19 Discussion Group, were answered.


Does high-flow nasal cannula increase the risk of aerosolization more than a patient coughing?

Questions from social media, blogs and the various discussion forums, including the new SCCM COVID-19 Discussion Group, were answered.


Can you comment on the use of nebulizers for chronic obstructive pulmonary disease and other diseases that may respond to bronchodilators?

Questions from social media, blogs and the various discussion forums, including the new SCCM COVID-19 Discussion Group, were answered.


If heated high-flow nasal cannula is not available, can continuous positive airway pressure with nasal pillows be used instead?

Questions from social media, blogs and the various discussion forums, including the new SCCM COVID-19 Discussion Group, were answered.


ICU Guide for Airway Management in COVID-19 Patients

This is a quick airway management resource guide for treating COVID-19 patients . This is a community developed COVID-19 microlearning resource.


What are the current recommendations for COVID-19 patients undergoing tracheostomy

Questions from social media, blogs and the various discussion forums, including the new SCCM COVID-19 Discussion Group, were answered.


How should airways be secured when proning intubated patients?

Questions from social media, blogs and the various discussion forums, including the new SCCM COVID-19 Discussion Group, were answered.


Which ventilator strategies are appropriate for a patient with COVID-19 who is on extracorporeal membrane oxygenation?

Questions from social media, blogs and the various discussion forums, including the new SCCM COVID-19 Discussion Group, were answered.


How should a COVID-19 patient who is recovering from acute respiratory distress syndrome be weaned off the ventilator?

Questions from social media, blogs and the various discussion forums, including the new SCCM COVID-19 Discussion Group, were answered.


Can you discuss the range and ceiling of permissive hypercapnia?

Questions from social media, blogs and the various discussion forums, including the new SCCM COVID-19 Discussion Group, were answered.


What are some general recommendation for noninvasive ventilation for moderate respiratory distress (not acute respiratory distress syndrome)?

Questions from social media, blogs and the various discussion forums, including the new SCCM COVID-19 Discussion Group, were answered.


Are patients self-proning and are benefits resulting from it?

Questions from social media, blogs and the various discussion forums, including the new SCCM COVID-19 Discussion Group, were answered.


Potential for Lung Recruitment and Ventilation-Perfusion Mismatch in Patients With the Acute Respiratory Distress Syndrome From Coronavirus Disease 2019

From Critical Care Medicine. Severe cases of coronavirus disease 2019 develop the acute respiratory distress syndrome, requiring admission to the ICU. This study aims to describe specific pathophysiological characteristics of acute respiratory distress syndrome from coronavirus disease 2019.


Intubated and Nonintubated Patients: Which COVID-19-Positive Patients Should be Treated With Corticosteroids?

Steve Pastores, MD, co-author of the Critical Care Explorations article "Rationale for Prolonged Corticosteroid Treatment in the Acute Respiratory Distress Syndrome Caused by Coronavirus Disease 2019," answers question regarding the use of corticosteriod treatment for ARDS caused by COVID-19. This is SCCM curated COVID-19 microlearning content.


What types of nursing considerations are involved in the management of respiratory failure in patients with COVID-19?

Questions from social media, blogs and the various discussion forums, including the new SCCM COVID-19 Discussion Group, were answered. This microlearning content was taken from the COVID-19 Critical Care for Non-ICU Clinicians: Expert Panel Series held on April 15, 2020.


How should respiratory failure be treated in patients with COVID-19 in terms of ventilator management?

Questions from social media, blogs and the various discussion forums, including the new SCCM COVID-19 Discussion Group, were answered. This microlearning content was taken from the COVID-19 Critical Care for Non-ICU Clinicians: Expert Panel Series held on April 15, 2020.


SCCM Pod-409 SSC COVID-19 Guidelines

Explore the Surviving Sepsis Campaign’s Guidelines on the Management of Critically Ill Adults with Coronavirus Disease 2019 (COVID-19) (Alhazzani W, et al. Crit Care Med. 2020 Mar 27; Epub ahead of print) with host Kyle B. Enfield, MD, and authors Mitchell M. Levy, MD, MCCM, and Waleed Alhazzani, MD, MSc, FRCPC.


Mechanical Ventilation

Point of Care (PoC) Refresher Training


Diagnosis and Management of Acute Respiratory Failure

Point of Care (PoC) Refresher Training. While current recommendations for respiratory support in COVID-19 support the use of the high-flow nasal cannula for hypoxia, oxygen supplementation strategies vary by institution. Make sure to follow your institution's protocols.


Do ICU patients with COVID-19 require a high amount of sedation or paralysis?

Questions from social media, blogs and the various discussion forums, including the new SCCM COVID-19 Discussion Group, were answered. This microlearning content was taken from the COVID-19 Question and Answer Webcast Series - Webcast 2 held on April 10, 2020.


Pediatric concerns: Symptoms, diagnosis and mortality

This presentation is an overview of symptoms, diagnosis and mortality concerns seen when treating pediatric patients with COVID-19. This is SCCM curated COVID-19 microlearning content.


Surviving Sepsis Campaign COVID-19 Guidelines: Ventilation Recommendations Chart

COVID-19 - - Quick Reference Chart. This chart is to be used as a rapid resource when choosing ventilation options for managing COVID-19 patients.


Surviving Sepsis Campaign COVID-19 Guidelines: Hemodynamics Recommendations Chart

COVID-19 - - Quick Reference Chart. This chart is to be used as a rapid resource when choosing hemodynamic options for managing COVID-19 patients.


Consensus Statement on Multiple Patients Per Ventilator

COVID-19 - SCCM Joint Statement. This joint society consensus statement provides advice to clinicians considering placing multiple patients on a single mechanical ventilator.


Initial Management of Hypoxic COVID-19 Patients

COVID-19 SSC Guidelines Infographic. This rapid resource is aligned with the SSC COVID-19 Guidelines.


SCCM-ASA Joint Statement to Address the COVID-19 Pandemic

COVID-19 - SCCM Joint Statement. The Society of Critical Care Medicine (SCCM) and the American Society of Anesthesiologists (ASA) announce their plans to collaborate to address the COVID-19 crisis.


How is ECMO being used in patients with COVID-19?

Questions from social media, blogs and the various discussion forums, including the new SCCM COVID-19 Discussion Group, were answered.


Because patients with COVID-19 seem to remain intubated for long periods of time, do you have any recommendations regarding early versus late tracheostomy?

It seems COVID-19 patients remain intubated for a long period of time. Do you have any recommendations for early vs. late tracheostomy?


Do you have any comments on airway management, instrumentation, or intubation protocols?

Questions from social media, blogs and the various discussion forums, including the new SCCM COVID-19 Discussion Group, were answered.


What are the recommendations for proning in patients with COVID-19 and how early should proning be instituted?

Questions from social media, blogs and the various discussion forums, including the new SCCM COVID-19 Discussion Group, were answered.


What are the limits of PEEP and plateau pressure?

Questions from social media, blogs and the various discussion forums, including the new SCCM COVID-19 Discussion Group, were answered.


Surviving Sepsis Campaign: Guidelines on the Management of Critically Ill Adults with Coronavirus Disease 2019 (COVID-19)

Webcast participants were able to learn more about the recommendations included in the guidelines regarding infection control, laboratory diagnosis and specimens, hemodynamic support, ventilatory support