What other providers are suggesting to help w #COVID19. Courtesy of many from Facebook.
1. Reduce RN trips into rooms. Move IV pumps outside of rooms and run lines inside. Foleys. Cluster med admin times. Inflatable mattresses to turn pts who don’t have to be prone. 1/10
1. Reduce RN trips into rooms. Move IV pumps outside of rooms and run lines inside. Foleys. Cluster med admin times. Inflatable mattresses to turn pts who don’t have to be prone. 1/10
2. Consolidate others entering room (visitors, consults, meals, registration, phlebotomy, rad techs). Better yet, have ppl already going in room bring tray/do labs. Telemedicine consults, telestroke. Use room phone to staff after pre-rounds. And decrease labs and imaging! 2/10
3. Intubate, A-Line, and C-line all at once (that means orders and consent all at once)
5. Don’t repeat exams trainees or midlevels already did; do first stroke exam in front of telestroke, which should already be located in the ICU. 3/10
5. Don’t repeat exams trainees or midlevels already did; do first stroke exam in front of telestroke, which should already be located in the ICU. 3/10
6. Nebs, bipap, intubation are high risk. Save neg pressure rooms for these patients if poss. Consider having a team for these. NO Bronch except immunocompromise, suspect PCP or fungal infection. If must Bronch, use disposable as much as possible 4/10
7. OR: Save the extra gowns that are opened, but not used during surgical procedures. Keep sterile, transport to other open fields in other rooms. Reduce nonessential OR staff. Allow scrub techs only one gown (don’t break after setup). Uncomfy but this is a pandemic. 5/10
8. Adjust standard admission practices once covid reaches a critical point. Cards admits chest pain rather than medicine.
9. Contact security to clear path prior to transfer to negative pressure rooms.
10. Have PPE "go packs" for codes, etc. 6/10
9. Contact security to clear path prior to transfer to negative pressure rooms.
10. Have PPE "go packs" for codes, etc. 6/10
11. Use a trained spotter while donning and more importantly doffing isolation gear.
12. Make a ventilator for dummies guideline so non ICU providers can put in initial orders with optimization by crit care shortly after. 7/10
12. Make a ventilator for dummies guideline so non ICU providers can put in initial orders with optimization by crit care shortly after. 7/10
13. Assign a computer for each RN and MD q shift, stop sharing. Consultants chart outside ICU.
14. Add cleaning duties to housekeeping/EVS, clean keyboards and counters and screens 2-3x daily. Hire more ppl if needed. There is a lot of available workforce right now... 8/10
14. Add cleaning duties to housekeeping/EVS, clean keyboards and counters and screens 2-3x daily. Hire more ppl if needed. There is a lot of available workforce right now... 8/10
15. Reduce time it takes to do procedures. EXAMPLE: cut all unnecessary views from level II OB ultrasounds. Use more sweeps so that MFMs can read things like digits and extremities at leisure later. 9/10
16. Develop remote ventilator adjustment or vents outside room. 3D print parts to use 1 ventilator for multiple patients w similar settings.
2 FREE CRIT CARE CMEs
shmlearningportal.org/content/critic…
sccm.org/covid19 10/10
2 FREE CRIT CARE CMEs
shmlearningportal.org/content/critic…
sccm.org/covid19 10/10
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