COVID-19 Hospital Resources Collection
Topic Collection
September 15, 2022
Topic Collection: COVID-19 Hospital Resources Collection
This Resource Collection consolidates the contents of the COVID-19 Critical Care Surge, COVID-19 Emergency Department, and COVID-19 Hospital Triage/Screening Collections prior to January 2021. ASPR TRACIE combined those Collections to enable users to locate hospital-specific COVID-19 resources in one location. Hospital planners and other personnel should also refer to the Hospital Operations Toolkit for COVID-19. Additional resources that apply to hospitals and other healthcare settings may be found in other COVID-19 Resource Collections.
Please refer to the NIH Coronavirus Disease 2019 (COVID-19) Treatment Guidelines and CDC’s Coronavirus Disease 2019 webpage for the most up-to-date guidance on COVID-19 outbreak management.
If you have COVID-19 best or promising practices, plans, tools, or templates to share with your peers, please visit the ASPR TRACIE Information Exchange COVID-19 Information Sharing Page (registration required) and place your resources under the relevant topic area.
Capacity
This tip sheet identifies 10 actions for hospitals to consider related to the blood supply during the COVID-19 pandemic.
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This report suggests a range of strategies that may be used to increase hospital critical care surge capacity. The report is accompanied by an online Interactive Critical Care Surge Response Tool that allows users to estimate current surge capacity and see the effects of various user inputs.
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This page includes information on the Ventilator Training Alliance, a mobile app with video tutorials, instruction manuals, and other training materials provided by manufacturers to inform use of ventilators during the COVID-19 pandemic. The free app for iOS and Android may be accessed from the page.
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This plan identifies the emergency department capabilities required for effective management of the COVID-19 pandemic. It provides background information, risk awareness considerations, response recommendations, and a management strategy. It also includes an annex table of key actions needed indicating responsibilities of emergency management nationally, the federal government, state and local government, state and local public health, emergency departments, and hospitals.
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This frequently updated online guide compiles resources helpful to emergency physicians in the evaluation and treatment of COVID-19. Topics include personal safety, work safety, emergency medical services, triage, patient presentation, assessment, diagnosis, risk stratification, treatment, special populations, business, regulations and liability, personal well-being and resilience, and impact on education, licensure, and credentialing.
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This frequently updated web page collects resources to assist physicians in their response to COVID-19. It includes background information on coronaviruses; clinical response information (transmission, presentation, diagnosis, treatment, infection control); and links to additional resources, including clinical care resources, telehealth, patient education, coding, ethics, and physician well-being.
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The American College of Surgeons offers recommendations on maintaining the emergency care system for common, time-sensitive medical and surgical emergencies during the COVID-19 pandemic.
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This page features clinical issues and guidance on management of non-emergent operations and triage of elective procedures. Topics covered include non-emergent operations, cancer care, licensing and certification, trauma care, workforce, personnel protection, and patient information.
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The resources linked from this page are categorized as: recovery, protecting and enabling health care workers, caring for patients and communities, addressing health care disparities, telehealth and virtual care, and cybersecurity resources. Links to AHA’s professional membership groups are also provided.
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This page includes a diagram and equipment relocation checklist to aid healthcare facilities in moving IV pumps outside of patient rooms to reduce personal protective equipment requirements during the COVID-19 pandemic.
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This downloadable, Excel-based tool allows users to estimate medical air and oxygen capacity while providing six different types of therapies to COVID-19 patients.
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This resource page offers considerations related to patient placement in airborne infection isolation rooms. It includes a table of air change clearance rates, unit conversion considerations with examples, and high-efficiency particulate air considerations with diagrams.
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These resources jointly developed by the American Society of Anesthesiologists and Anesthesia Patient Safety Foundation guide the safe and effective use of anesthesia machines as intensive care unit (ICU) ventilators should supply be insufficient during the COVID-19 pandemic. Resources include a guidance document on purposing anesthesia machines as ICU ventilators, a quick reference bedside tool on setup and monitoring instructions, guidance on use of volatile anesthetic for sedation of ICU patients, and a procedural checklist for supporting patients during the anesthesia machine power up test.
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This toolkit highlights lessons learned related to executive emergency orders, drug utilization, pharmacy workforce management, facility surge, and pharmacy service lines along with resources created in response to COVID-19.
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This toolkit provides information for perianesthesia nurses working in extreme situations due to the COVID-19 pandemics. It includes information on nurse self-care as well as strategies for caring for COVID-19 patients.
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This webpage shares information on the Arizona Surge Line, a 24/7 call line that facilitates the interfacility transfer of patients during a healthcare surge. Included is a link to an operating manual describing the planning, execution, and outcomes of the Arizona Surge Line during the response to COVID-19 and its applicability to future emergencies. Other resources include webinars introducing the service; process flow maps; protocols and other resources for participating hospitals, post-acute care facilities, and volunteer critical care and palliative care physicians; the executive order establishing the service; and news articles describing the Arizona Surge Line.
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This updated, illustrated guidance for healthcare settings provides background information on the COVID-19 pandemic; identifies life safety and other goals; and categorizes information by suggested engineering approaches, specific "how-to" and unique areas, surge areas, facilities/maintenance, and medical gas/vacuum systems.
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This updated, illustrated guidance for healthcare settings provides background information on the COVID-19 pandemic; identifies life safety and other goals; and categorizes information by suggested engineering approaches, specific "how-to" and unique areas, surge areas, facilities/maintenance, and medical gas/vacuum systems.
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In May 2020, ASPR TRACIE hosted the webinar COVID-19: Healthcare System Operations
Strategies and Experiences to highlight pandemic response experiences from some of the hardest
hit hospitals at the time. Commander Sara Jager, M.D., Chief Medical Officer with Tuba City
Regional Health Care Corporation (Arizona), shared her experiences from a tribal hospital that
serves Navajo Nation; she updated some of the information from the webinar in July 2020.
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The resources on this page can help healthcare and emergency management planners prepare for surges of COVID-19 patients.
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Speakers from some of the hardest hit hospitals across the U.S. discuss their COVID-19 experiences in this webinar.
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Between September 9, 2020 and October 20, 2020, the ASPR TRACIE team interviewed decision makers and lead physicians at four designated COVID-19 hospitals. The interviews focused on the facilities’ decision-making processes, operations and logistics (space, staff, stuff), and general lessons learned. These facilities were already operational or existing hospitals; they were not “Alternate Care Sites.” Additionally, the entire facility was designated to solely treat COVID-19 positive patients; all other patients were transferred or directed to nearby hospitals.
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This toolkit can help hospital emergency managers and planners manage large numbers of patients during the COVID-19 pandemic.
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Imperial County, located in southeastern California, has a population of approximately 181,000, and shares borders with Arizona and Mexico. El Centro serves as the county seat, and the county’s economy is based primarily on agriculture. Two hospitals serve the county: El Centro Regional Medical Center and Pioneers Memorial Healthcare District. Imperial County has been a COVID-19 “hot spot,” and in May 2020, Mexicali’s hospitals reached capacity and announced that they would divert American patients to El Centro, creating a near-instant patient surge, and necessitating the movement of over 625 patients. This article details that process.
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COVID-19 patients have specific critical care and isolation needs and many hospitals across the country were not prepared or built to treat the significant patient surge in 2020. Erica Kuhlmann, DO, COVID ICU Medical Director, M Health Fairview (MN), shared her experiences transforming the system’s Bethesda facility to a dedicated COVID-19 hospital in 2020.
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COVID-19 patient surges have prompted healthcare facilities to be innovative in record time, updating and creating new plans as lessons were learned. In this article, ASPR TRACIE highlights how four healthcare executives from different states and settings collaborated and used data to manage patient surge statewide.
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This toolkit offers flexible and modifiable guidance, developed by the U.S. government, aimed to assist regional, state, local, tribal and territorial governments to ensure load-balancing across healthcare facilities and systems so that the highest possible level of care can be provided to each patient during the COVID-19 pandemic.
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COVID-19 challenged every aspect of healthcare facilities across the country. From patient care to engineering, environmental health & safety, public safety, and food & nutrition—every department and specialty was affected somehow by the virus. ASPR TRACIE interviewed Michael Fiore, CIH, Corporate Senior Director for Environmental Health and Safety and Clinical Operations for NorthShore University HealthSystem in Illinois. In this role, he oversees the environment of care, including nonclinical areas that support clinical operations that promote a safe, comfortable and healing environment.
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This protocol describes how to support two patients on a single ventilator when there is a critical shortage. The protocol is accompanied by a training video.
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This resource page includes written and video educational materials related to managing COVID-19 patients. Resources are categorized under: ICU Ventilation and Pulmonary, ECMO, Gastrointestinal/Nutrition, Ethics, Renal/Fluids, Endocrine/Steroids, Musculoskeletal/Hematomology/Prophylaxis/ICU, Infectious Diseases, Cardiovascular, and Neurology.
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Centers for Disease Control and Prevention. (2020).
COVID-19 Surge.
(Added 4/23/2020.) U.S. Department of Health and Human Services.
This spreadsheet-based tool calculates estimates of the number of persons needing hospitalizations, intensive care unit care, and ventilator support compared to existing and expanded hospital capacity. Users can also simultaneously see the outputs of three mitigation strategies versus no interventions.
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This updated guidance is intended to assist healthcare facilities manage their operations during the COVID-19 pandemic.
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The authors of this article recommend four key actions for health systems preparing for a surge of COVID-19 patients: 1) develop a strategy for patient volume and complexity, 2) protect and support health care workers on the front lines, 3) define a strategy to allocate health care resources, and 4) develop a robust, transparent, and open communication policy.
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The speakers provide an overview of the "Surge Roadmap" and related COVID-19 patient management strategies.
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This series of videos provides training to non-respiratory therapists on basic respiratory care and ventilator management to increase healthcare surge capacity during a mass casualty incident. The videos cover topics including infection control, terms and definitions, manual and mechanical ventilation, and airway maintenance and suctioning. The training is intended for non-respiratory health care providers to be cross-trained as extenders delivering care to adult patients.
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This document describes a project to cross-train non-respiratory therapists to provide basic respiratory care and ventilator management to provide surge staffing capacity during mass casualty incidents. The authors reviewed the literature and legal and regulatory requirements, identified competencies, developed a curriculum, pilot tested the training, conducted exercises, and provided recommendations.
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The authors list 22 suggestions specific to surge capacity and mass critical care under the following topics: stockpiling of equipment, supplies, and pharmaceuticals; staff preparation and organization; patient flow and distribution; deployable critical care services; and using transportation assets to support surge response. The document includes supply and equipment lists (Tables 3, 4, 5, and 6) and staffing recommendations that may help inform a hospital’s COVID-19 response.
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This figure depicts the proportion of critical care, intermediate care and telemetry unit, and general hospital ward patients during routine operations and during a medical surge. The proportion of critical care patients increases during a medical surge incident as lower acuity patients are directed to community-based care.
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This document - updated as needed - provides information on configuring ICUs based on lessons learned by hospitals that have cared for COVID-19 patients. Topics include increasing and managing ICU capacity, adapting various aspects of critical care delivery and the care environment, communicating with patients, providing emotional support to staff, and adjusting operations in other areas of the hospital.
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This online course prepares licensed non-intensive care unit clinicians to support hospital critical care teams. The course covers: principles and physiology of mechanical ventilation, initial ventilator setting and adjustments, troubleshooting the ventilator, and ventilating patients in special circumstances.
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This supplement to the Medical Operations Coordination Cells (MOCC) Toolkit (https://files.asprtracie.hhs.gov/documents/fema-mocc-toolkit.pdf) provides information on emergency medical services (EMS) and transportation issues. It includes information on coordination and planning with partners before, during, and after transport; medical oversight; standard operating procedures; personnel; infection control; ambulance preparation and configuration; and patient preparation.
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The General Surge Capacity Model provides one to thirty day ahead projections of an individual hospital's demand for medical and intensive care unit beds, ventilators, personal protective equipment, medication, and staffing. The Advanced Model offers expanded functionality.
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This two-pager summarizes critical care planning for COVID-19. It includes a figure depicting the expansion of critical care from conventional to contingency/crisis levels. The document offers key points to operationalize the concept in terms of space, staffing, supplies and to provide critical care.
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This article presents 10 suggestions pertaining to the principles that should guide surge capacity and capability planning for mass critical care in disasters or pandemics.
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This figure depicts a framework for how critical care expands from conventional to contingency to crisis based on morbidity and incident demands and operating conditions. The goal is 200% expansion of critical care capacity during a crisis.
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This document offers recommendations on the following issues to prepare for additional waves of COVID-19: personal protective equipment and other medical supplies, testing capacity, physical distancing and wearing masks/face coverings, contact tracing, telehealth, workforce capacity, access to care and treatment, health disparities, antimicrobial resistance, increasing immunization rates, preparing for a COVID-19 vaccine, minimizing viral spread during large gatherings, safe elections, comprehensive data collection, protections for frontline workers, and global cooperation.
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This 11-page checklist focuses on systems and processes for monitoring and improvement. Topics include staffing, space, supplies, infection control, staff well-being, and structures for planning, decision-making, and communications.
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The authors assessed the effects of hospital surge on COVID-19 mortality through a retrospective cohort study of administrative hospital data. They found an association between surge and mortality risk and suggested that nearly one in four COVID-19 deaths studied could be attributed to hospital surge.
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This playbook follows a space, stuff, staff strategy to rapidly expand inpatient and critical care capacity. It includes an overview of surge capacity concepts, checklists, tables, decision trees, diagrams, and supply and equipment lists.
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This downloadable document describes one hospital's effort to separate patients with respiratory symptoms or complaints from non-infectious patients before their entry to the facility by using a tent outside the building to eliminate/minimize possible transmission of COVID-19.
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This article lists considerations related to identifying alternate staffing resources, developing a team-based approach to patient management, and addressing administrative concerns on staffing, nursing leadership concerns, and nurse safety and resilience while planning for COVID-19 critical care surge.
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This document outlines a process states can use to gather hospital data needed to identify where ventilators are needed and deliver them directly to receiving hospitals.
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This toolkit can help healthcare organizations plan and respond to the COVID-19 pandemic. It includes: patient screening algorithms, sample signage, assessment criteria, infection prevention guidance, a visitor screening tool, personal protective equipment doffing checklists, and specimen collection instructions.
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This expert panel report by the Task Force for Mass Critical Care and the American College of Chest Physicians offers a framework to equitably meet the clinical needs of the greatest number of COVID-19 patients when resources are scarce.
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This page provides links to information related to engineering and construction related planning for healthcare facilities in Minnesota during the COVID-19 pandemic. Categories include Minnesota Department of Health COVID-19 information; temporary negative pressure and HVAC; temporary tent structures; medical gas and oxygen information; design guidelines; and water protection systems.
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This report documents key events throughout the first 18 months of the response to the COVID-19 pandemic by Missouri hospitals. In addition to statewide data, the report highlights examples of how specific hospitals managed various aspects of the response.
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The authors review the characteristics of COVID-19 and the present challenges with staff, stuff and space in healthcare facilities during the pandemic, and propose 10 steps to take when establishing healthcare facilities that would treat only COVID-19 patients.
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This webinar features presentations about how three hospitals adapted staffing during the COVID-19 pandemic. Presentations include photos, recommended practices, sample online forms, and screenshots of dashboards. The page provides a link to the video recording of the webinar, presentation slides, and a link to a version of the course that allows continuing education credit.
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This planning guide from New York City Health + Hospitals provides high-level planning information for frontline hospital multidisciplinary teams to support planning and training for the initial care of suspected special pathogen patients while determining whether and when they will be transferred to another facility for further assessment and treatment.
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This toolkit provides resources to surge critical care skills to respond to COVID-19 via a team-based care approach.
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NYC Health + Hospitals/Harlem and NYC Health + Hospitals/System Special Pathogens. (2020).
Surge Unit Checklist.
Hospital planners can use this checklist to prepare for and manage patient surge. It includes directions for operationalizing a surge unit and goals/items for the first 24-48 hours, 48-72 hours, and after 72 hours.
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This document outlines the statewide hospital plan for a surge of COVID-19 patients. The regionally-based plan defines four tiers of operations based on the amount of surge.
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This six-part webinar series offers information on managing patient surge during the COVID-19 pandemic. Topics include managing incident command, the emergency department, elective and urgent surgery, nurse staffing, patient discharge, and telehealth. Recordings and summary reports are available for each webinar.
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ASPR, Project ECHO, NETEC, and other public-private partners host a national series of weekly clinical rounds. This peer-to-peer learning network focuses on critical care, emergency department, and emergency medical services patient care and operations. Videos and slides are available following each session.
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This consensus statement issued by the Society of Critical Care Medicine (SCCM), American Association for Respiratory Care (AARC), American Society of Anesthesiologists (ASA), Anesthesia Patient Safety Foundation (APSF), American Association of Critical-Care Nurses (AACN), and American College of Chest Physicians (CHEST) recommends that mechanical ventilators not be shared by multiple COVID-19 patients.
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These free, online modules provide training for non-intensive care unit clinicians to provide care during a surge of critically ill patients.
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This web page offers a variety of sample resources for hospitals, including triage algorithms, communication scripts, facility access and visitation guidance, staff information, and personal protective equipment guidance.
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The COVID Staffing Project unites collaborators from Vanderbilt University Medical Center, Michigan Medicine, the Department of Learning Health Sciences, and the Center for Healthcare Engineering and Patient Safety, and the Procedural Learning and Safety Collaborative. The tools developed support hospitals in projecting frontline workforce needs, redeploying clinical teams, and protecting the health and well-being of providers.
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This frequently updated page provides recommendations for preparing emergency departments for a surge of COVID-19 patients. Information is categorized under the topics of staff, space, stuff, and systems.
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Hospital/Health System Landing Pages
This web page includes frequently updated COVID-19 information for healthcare workers. Resources include: testing and patient evaluation algorithms, clinical guidance, operational guidance, personal protective equipment information, resources for patients and their caregivers, symptom screening tools, and sample signage.
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These COVID-19 guidelines are based on current available evidence and continually updated based on feedback from practitioners. Included are one-page quick guides and information organized under: non-ICU management, triage, and transfers; respiratory support; therapies and clinical trials; cardiac complications; shock; thrombotic and coagulation manifestations; renal manifestations; and other related issues. A COVID ICU Bundle Checklist is included as an addendum.
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This frequently updated page offers resources for clinicians caring for COVID-19 patients. It includes information on transmission, presentation, personal protective equipment, testing, healthcare worker exposures, imaging, clinical course, patient management, and discharge.
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Cleveland Clinic. (2020).
COVID-19.
(Added 5/14/2020.)
This frequently updated page provides resources to assist medical professionals responding to the COVID-19 pandemic. Resources are organized under the following topic areas: overview, detection, personal protective equipment recommendations, protecting against the spread, care considerations, workforce redeployment, caregiver, ambulatory, bioethics, virtual visits, emergency department, intensive care unit, managerial, operating room, and research.
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This frequently updated web page assists clinicians responding to COVID-19. The page includes information on screening, testing, and caring for patients as well as resources to support staff.
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This web page features clinical pathways to assist providers in evaluating, diagnosing, and triaging patients possibly infected with COVID-19 while following appropriate infection prevention protocols. Algorithms exist for primary care, ancillary services, subspecialty ambulatory, and emergency department and inpatient settings.
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This frequently updated page hosts patient management protocols and resources for medical professionals caring for COVID-19 patients. Topics include care protocols and guidelines (general, venous thromboembolism, renal replacement therapy, radiology and imaging, and ethics, palliative, and end-of-life care), personal protective equipment, and telemedicine (training, policy and implementation guides, and technology support).
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This frequently updated page includes operational support, clinical resources, and thought leadership resources to support clinicians responding to the COVID-19 pandemic. Resources include COVID-19: Interim Adult Treatment Guidance.
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This frequently updated webpage provides COVID-19 microbiology, clinical, sites of infection, treatment, and follow up information.
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This frequently updated page includes both inpatient and outpatient care recommendations as well as fast literature updates. Documents include: treatment and critical care guidance, algorithms, protocols, workflows, figures, frequently asked questions, and supporting literature.
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This frequently updated page includes operational and patient care information for employees responding to COVID-19. Resources are focused on staff safety and well-being, operations policies and signage, job aids, procedural guidelines, and inpatient and ambulatory care clinical guidelines.
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This page includes COVID-19 testing guidance as well as emergency department, inpatient, and outpatient treatment guidelines.
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This frequently updated page includes numerous resources to guide the management of COVID-19 patients including treatment guidelines for adults and pediatric patients, information on personal protective equipment, information on respiratory support, palliative care resources, scripts, and information about the convalescent plasma program.
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This page - updated frequently - provides protocols and resources for providers during the COVID-19 pandemic. Included are patient care resources (ambulatory triage and workflow, discharge guidelines, worker protections, guidelines and treatments, reopening of services), information for practices (forms, guidance, signage), communications and provider resources, and links to additional information.
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This frequently updated page includes information on use, donning and doffing, and decontamination of personal protective equipment; protocols and checklists; inpatient, ambulatory, surgical, special patient populations, treatment, and patient transport guidance; and other related resources for healthcare providers.
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This frequently updated page includes information on clinical and administrative policies and protocols. It includes information on personal protective equipment; a dashboard on testing, virtual visits, and hospitalized patients; and testing, inpatient, and emergency department clinical pathways.
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This resource page - updated as needed - is a collaborative statewide effort to collect best practices on managing COVID-19 patients.
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This page - updated frequently - offers resources to assist medical professionals managing patients with COVID-19. The page includes protocols, procedures, processes, and checklists for patient treatment; blood product utilization; medication conservation; room, equipment, and transport; and surgical and procedural issues.
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This frequently updated page of one health system's clinical practice documents includes: an airway management safety diagram, an acute respiratory distress syndrome bedside card, an intubation checklist, a pharmacotherapy flowsheet, a tidal volume per IBW table, intubation precautions, code blue guidance, and intensive care unit care guidelines.
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These frequently updated guidelines offer: 1) information on personal protective equipment, 2) algorithms, 3) other clinical information and announcements, 4) control plan and testing, 5) signage in multiple languages, 6) forms, 7) staff education materials, 8) provider and staff training resources, 9) patient education, 10) email digests, and 11) external resources.
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This frequently updated page includes resources to assist healthcare workers managing patients with COVID-19. Resources include: COVID-19 symptoms, a treatment guide with therapeutic guidance and an azithromycin discontinuation protocol, testing information, clinical guidelines and codes, clinical processes and workflows, telemedicine information, home monitoring resources, and patient education materials.
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This page includes several clinical procedures for COVID-19 including: a fact sheet for providers, an airway management job aid, a respiratory pathway algorithm, a referral to a respiratory diagnostic center guide and process workflow, and a psychiatric express clinic plan.
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This page includes policies and protocols developed by the University of Washington health system and its partners to address COVID-19. Frequently updated, the page includes: 1) patient care protocols and algorithms, 2) other inpatient clinical guidance, 3) neonatal care protocols, 4) policy statements on personal protective equipment, patient care, post-acute and long term care, operations and facilities, staff, and other (autopsy, information technology, and vendor and delivery driver access).
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This frequently updated web page includes clinical resources for staff including: 1) clinical resources, 2) links to daily briefs, 3) information on personal protective equipment, 4) #CRUSHCOVID (vaccination) toolkit, and 5) ways to support caregivers.
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Treatment
This article provides an update to the recommendations of the Surviving Sepsis Campaign Coronavirus Disease 2019 Panel related to infection control and testing, hemodynamics, ventilation, and therapy.
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This document reflects the guidance of the Surviving Sepsis Campaign COVID-19 panel, composed of 36 experts from 12 countries. The panel issued 54 statements on: 1) infection control, 2) laboratory diagnosis and specimens, 3) hemodynamic support, 4) ventilatory support, and 5) COVID-19 therapy. Of the 54 statements, four are best practices, nine are strong recommendations, 35 are weak recommendations, and six questions have no recommendations. Accompanying infographics depict a summary of recommendations on managing patients with acute respiratory distress syndrome and COVID-19 and a summary of recommendations on the initial management of hypoxic COVID-19 patients.
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This page includes several resources including guidance on basic and advanced life support, infographics, resuscitation algorithms, training courses, and podcasts.
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This page features links to the report of the Scarce Resources Roundtable and to shared resources from the ASN/HHS roundtable that was held on July 28 and July 30, 2020. Participants were clinicians working in acute in-hospital nephrology settings during a surge in the COVID-19 pandemic.
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These frequently asked questions - expected to be updated as additional information becomes available - provide details about the diagnosis and treatment of vaccine-induced thrombotic thrombocytopenia (VITT) occurring following COVID-19 vaccination.
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This ASPR TRACIE technical assistance response details palliative care during the COVID-19 pandemic.
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This ASPR TRACIE TA response includes links to guidance and clinical resources on high-flow nasal cannulas, and other relevant materials.
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Dr. Prachand shares how healthcare providers used the "MeNTS" scoring process to balance the COVID response against the need to provide care to non-COVID patients in this brief webinar.
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The goal of occupational therapy is to be able to get patients back to where they want to be, via a mix of physical rehabilitation, cognitive activity analysis, and improving safety, function, and independence. ASPR TRACIE interviewed Jamie Wilcox, OTD, OTR/L, Kelsey Peterson, OTD, OTR/L, Neuro-IFRAH® Certified, and Carnie Lewis, OTD, OTR/L, Neuro-IFRAH® Certified, who work in acute care settings at the Keck Medical Center of the University of Southern California to learn more about the impact the COVID-19 pandemic had on their jobs. Heather Parsons, the Vice President of Federal Affairs for the American Occupational Therapy Association, also participated in the interview.
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Respiratory therapists (RT) are key members of healthcare teams in a variety of settings. Over the past year, they have played a significant role in the treatment and management of COVID-19 patients. ASPR TRACIE interviewed Katie Mattare, BS, RRT, Clinical Coordinator for the Adult Respiratory Therapy Department at Johns Hopkins Hospital in Maryland to gain insight into the RT experience during the pandemic.
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Physical therapists (PTs) are an integral component of healthcare teams in a variety of settings (e.g., emergency departments, acute care settings, home health care, and outpatient settings). In hospitals (i.e., acute care and/or inpatient rehabilitation), they may help develop treatment plans, teach patients how to use exercise techniques, and provide hands-on manual therapy to help with healing and improve function. The COVID-19 pandemic significantly affected the way PTs were able to provide care, while the number of patients who needed both inpatient and outpatient physical therapy increased. ASPR TRACIE met with Lindsay Harmon-Matthews, PT, DPT, MPH, J.J. Kuczynski, PT, DPT, OCS, Anthony Ganim, PT, MPT, MBA, and Michael Martin, PT, MPT (The Ohio State University Wexner Medical Center and other affiliations) to learn more about their experiences caring for COVID-19 patients during and after hospitalization.
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This webpage includes clinical care guidelines, clinical flowcharts, a list of evidence under review, and infection prevention recommendations related to COVID-19.
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These guidelines provide critical care recommendations and suggestions for a pandemic setting. They are intended as a living document based on previous experience and are updated as the evidence base for COVID-19 clinical care grows. The document includes three sections: 1) Planning for a Pandemic – An Operational Guide, 2) Providing a Safe Working Environment – Staff Protection and Sustainability, and 3) Identification and Treatment of Patients with COVID-19 Infection – The Basics.
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These online guidelines systematically review the evidence related to seven potential COVID-19 treatment options and grade recommendations as strong, conditional, or a knowledge gap. Complementary recommendations are available on diagnostics and infection prevention.
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This health advisory provides background information and a case definition for multisystem inflammatory syndrome in children.
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This webpage provides a high-level quick reference for clinicians caring for patients with COVID-19. Links to more in depth information are included throughout the page.
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This updated page recommends infection prevention and control (IPC) practices during the COVID-19 pandemic, and particular IPC practices when caring for a patient with suspected or confirmed SARS-CoV-2 infection.
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This algorithm depicts the clinical pathway for assessing children for Multisystem Inflammatory Syndrome.
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This algorithm depicts the clinical pathway for assessing children with COVID-19.
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The summary highlights recommendations for payment, better evidence, and state allocation. The full text of the report is linked from the top of the page.
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This Consensus Report from the Emergency Cardiovascular Care Committee and Get With the Guidelines - Resuscitation Adult and Pediatric Task Forces of the American Heart Association in collaboration with the American Academy of Pediatrics, American Association for Respiratory Care, American College of Emergency Physicians, The Society of Critical Care Anesthesiologists, American Society of Anesthesiologists, American Association of Critical Care Nurses, and National EMS Physicians provides guidelines for treatment of cardiac arrest in patients with suspected or confirmed COVID-19.
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This page includes guidance on the administration and study of investigational COVID-19 convalescent plasma. It includes pathways for use, information on collection of convalescent plasma, labeling, and recordkeeping.
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The authors reviewed data from 1,099 laboratory-confirmed COVID-19 patients in 552 mainland China hospitals through January 29, 2020. The cumulative risk of the composite end point of admission to an intensive care unit, use of mechanical ventilation, or death was 3.6% for all patients and 20.6% for patients with severe disease. The authors noted that 15.7% developed severe illness after hospital admission; 1.4% died; 43.8% of patients presented with fever, but 88.7% developed a fever while hospitalized; and 2.9% of those with severe and 17.9% of those with non-severe disease had no radiologic abnormalities on initial presentation.
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These guidelines highlight recent updates and general considerations followed by a table showing treatment considerations and special considerations for various clinical situations. Extensive references are listed for each of the therapeutic options.
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Infectious Diseases Education and Assessment Program. (2020).
COVID-19 Treatment.
University of Washington .
This resource page includes summaries, slide decks, and links to additional information on potential COVID-19 treatments based on ongoing clinical trials and published literature.
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These online guidelines systematically review the evidence related to eight COVID-19 infection prevention practices and grade recommendations as strong, conditional, or a knowledge gap. Related guidelines are available for treatment and management and diagnostics.
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These guidelines reflect the best information available to guide decision making in the management of COVID-19 patients. Included is information on screening and triage, infection prevention, specimen collection, clinical management, treatment options, telemedicine, emergency medical services, and ethical considerations. It also includes appendices with checklists, supply lists, algorithms, and other tools.
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This report summarizes case reports and case series about multisystem inflammatory syndrome in adults associated with SARS-CoV-2.
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This illustrated article provides a comprehensive literature review of long haul COVID. The authors review its pathophysiology, organ-specific sequelae, and considerations for multidisciplinary patient care.
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This webpage includes resources for providers, prescribers, and patients to help support the safe and appropriate use of COVID-19 infusion therapies. Resources include a searchable COVID-19 antibody treatment locator, antibody therapy guidebooks and playbooks, order sets, checklists, flowsheets, coding guide, frequently asked questions, patient education resources, and other tools.
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This frequently updated page from the United Kingdom includes rapid guidelines, evidence summaries, and other information based on national and international guidance and policies and the experience of clinicians treating patients during the COVID-19 pandemic. The guidelines are supported by tools and resources, including implementation support, decision aids, algorithms, and practice guides. Topics include critical care in adults, acute myocardial injury, dialysis service delivery, severe asthma, cystic fibrosis, delivery of radiotherapy, managing suspected or confirmed pneumonia in the community, delivery of systemic anticancer treatment, rheumatological disorders, gastrointestinal and liver conditions, stem cell transplantation, and managing symptoms.
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This rapid, dynamic review discusses the long-term effects of COVID-19, based on the experiences of patients who have experienced them, expert consensus, and published evidence. It also addresses how care services should respond and articulates questions for future research.
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A COVID-19 Treatment Guidelines Panel developed these guidelines to assist clinicians caring for patients with COVID-19. Each of the recommendations in the frequently updated guidelines includes ratings of the strength of the recommendation and the quality of evidence supporting the recommendation.
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This blog post by the director of the National Institutes of Health (NIH) summarizes current knowledge about Long COVID. It includes links to additional research information and a video of the December 2020 NIH-hosted Virtual Workshop on Post-Acute Sequelae of COVID-19.
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Office of the Assistant Secretary for Preparedness and Response. (2021).
Veklury (Remdesivir).
(Added 1/11/2021.) U.S. Department of Health and Human Services.
This page offers a timeline of the approval of Veklury (remdesivir) for treatment of patients with COVID-19 requiring hospitalization and describes how it has been allocated under U.S. government oversight.
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This alert summarizes complications and sequelae of COVID-19 identified during the first seven months of the pandemic.
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This living systematic review assesses the safety and effectiveness of convalescent plasma or hyperimmune immunoglobulin transfusions for the treatment of COVID-19. The authors conclude that convalescent plasma is not a beneficial treatment among patients with moderate to severe COVID-19.
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ASPR, Project ECHO, NETEC, and other public-private partners host a national series of weekly clinical rounds. This peer-to-peer learning network focuses on critical care, emergency department, and emergency medical services patient care and operations. Videos and slides are available following each session.
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These guidelines from a hospital in the United Kingdom offer a one-page summary listing necessary equipment and supplies, staffing roles, patient preparation steps, and an airway assessment and intubation plan. Also included are an admission and daily care checklist, critical care escalation plan, extubation procedure, nutrition quick guide, and information on personal protective equipment.
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This resource page - updated as needed - summarizes treatment candidates in development for COVID-19. Therapeutics are categorized as frontline candidates, novel candidates, and therapeutics approved for other indications.
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This guidance document includes a case definition and clinical management information related to a rare syndrome first identified in pediatric COVID-19 patients by clinicians in Great Britain.
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This resource page includes several editable airway management infographics, a training video on tracheal intubation, and a consensus statement on airway management and tracheal intubation of adult COVID-19 patients.
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This resource summarizes information about COVID-19 in the clinical setting, regimens, and other comments.
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This blog post highlights key themes from two webcasts on preparing adult clinicians to treat pediatric patients during the COVID-19 pandemic. Themes included delineation between children and adults, multisystem inflammatory syndrome in children, similarities and differences of care methods, and opportunities for parent support. The blog includes links to recordings of both webcasts as well as SCCM's Pediatric Fundamental Critical Care Support course.
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This frequently updated web page supports clinicians in making informed decisions on COVID-19 patient care. It synthesizes evidence on various topics including presentation, testing, treatment, populations at greater risk, personal protective equipment, social distancing, and mortality.
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This guide is based on the experience of clinicians treating patients at The First Affiliated Hospital. It includes sections on prevention and control management, diagnosis and treatment, and nursing. It includes tables, step-by-step lists, infographics, algorithms, and images supporting the descriptive text.
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This document summarizes lessons learned from clinicians with experience caring for COVID-19 patients. Topics covered include: presentation, mechanical ventilation, fluid balance, antibiotics, workforce and infection control, renal support, and oxygen.
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This resource page - updated as needed - is a collaborative statewide effort to collect best practices on managing COVID-19 patients.
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This report looks at the symptoms of long COVID, who is affected, what help can be offered to those affected, how big of a problem it is, and conclusions and recommendations.
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This document from the Emergency Cardiovascular Care Committee and Get With the Guidelines - Resuscitation Adult and Pediatric Task Forces of the American Heart Association in collaboration with the American Academy of Pediatrics, American Association for Respiratory Care, American College of Emergency Physicians, the Society of Critical Care Anesthesiologists, American Society of Anesthesiologists, and American Association of Critical Care Nurses provides guidelines for treatment of cardiac arrest in pediatric and neonatal patients with suspected or confirmed COVID-19.
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This article summarizes 20 COVID-19 articles from among the more than 80,000 published that the authors deemed most relevant to critical care clinicians. Articles are categorized as: manifestations of severe disease, pharmacological therapy, ventilatory support, and healthcare system and worker stress.
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This interactive map displays locations across the U.S. that recently received shipments of Bamlanivimab or Casirivimab/Imdevimab to assist clinicians and patients in determining availability of monoclonal antibody treatments.
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This frequently updated document provides guidance to clinicians caring for COVID-19 patients in Belgium.
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This article describes the epidemiological and clinical characteristics of 138 hospitalized patients with 2019 novel coronavirus-infected pneumonia in a single hospital. While the article is the largest case series to date, it was published before outcomes were known for most patients.
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This report describes the joint World Health Organization-China 25-member mission to understand the evolving COVID-19 outbreak in China. The report details epidemiologic and clinical data through February 20, 2020 and describes measures taken by China to prevent transmission, slow the outbreak, and reduce cases. The report offers recommendations for China, for countries with imported cases or outbreaks, for countries with no known cases, for the public, and for the international community.
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This document provides clinicians with information on managing suspected adult, pregnant, and pediatric COVID-19 patients. It provides information on screening and triage, infection control, collection of laboratory specimens, management of various symptoms and levels of illness, therapies, care of at-risk population groups, and clinical research on potential treatments.
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This resource offers a clinical case definition for long COVID and describes the process used to achieve consensus.
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The authors describe their findings from a retrospective cohort study of 201 hospitalized COVID-19 patients in a single Chinese hospital between December 25, 2019 and January 26, 2020 with final follow-up on February 13, 2020. They found that 41.8% of patients developed acute respiratory distress syndrome (ARDS) and 52.4% of those who developed ARDS died. The authors concluded that a less rigorous immune response in older adults was associated with a greater risk of developing and death and that while fever was associated with developing ARDS, those with ARDS and fever had better outcomes. The also cautiously noted that methylprednisolone may be a beneficial treatment for ARDS, but additional research is needed.
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Triage/Testing
The chart compares molecular and antigen tests (RT-PCR, LAMP, CRISPR) currently in use to diagnose COVID-19, using a Q and A format. Diagnostic test specimen collection methods are also described (Nasopharyngeal swab, Oropharyngeal swab, Nasal mid-turbinate swab, Anterior nasal swab and Saliva sample), listing method steps, who may collect the specimen and the PPE required for the parties involved in the test .
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Jill Taylor, Ph.D., Senior Advisor for Scientific Affairs, Association of Public Health Laboratories shares essential information regarding the use of point-of-care tests (including molecular and antigen) for COVID-19 diagnosis in this short video.
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This toolkit includes resources describing the different types of testing, information on available tests and testing services, factors to consider when developing a testing strategy, and answers to frequently asked testing questions.
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These updated guidelines detail processing and handling of clinical specimens for COVID-19 by specimen type and priority, and address storage and shipping.
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This updated page offers guidance about the regulatory requirements for Point-of-Care (POC) testing, specimen collection & handling, help with performing POC tests, reporting requirements and frequently asked questions about POC Testing.
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This algorithm depicts the clinical pathway for emergency department screening for COVID-19.
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This algorithm depicts the clinical pathway for assessing children with COVID-19.
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This page includes calculators to assist providers in estimating patients risks associated with various conditions. COVID-19 calculators predict the probability of a positive test result, hospitalization, and intensive care unit admission or death.
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This one-pager developed jointly by the College of Urgent Care Medicine and the American College of Emergency Physicians assists clinicians in determining whether suspected or confirmed COVID-19 patients should be discharged to their homes or transferred to an emergency department.
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Position statement Interim-20-ID-01 – approved in April 2020 - created a standardized case definition for COVID-19 and added it to the list of nationally notifiable conditions. Position statement, Interim-20-ID-02, superseded Interim-20-ID-01 by clarifying criteria for case ascertainment and classification, updating probable case classifications, and adding suspect case classifications. Position statement 21-ID-01, again updated the standardized surveillance case definition.
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This protocol defines the process for managing emergency department surge capacity and preventing patients from leaving without a screening exam.
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These online guidelines systematically review the evidence related to 15 COVID-19 diagnostic testing options and grade recommendations as strong or conditional. Related guidelines focus on infection prevention and treatment and management.
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This video demonstrates the process of collecting oropharyngeal and nasopharyngeal swabs for novel coronavirus testing.
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This page aggregates tools useful for professionals working in healthcare settings responding to the COVID-19 pandemic. The tools are organized into categories: overall hospital management, ICU tools related to respiratory issues, ARDS and ECMO, and inflammation and thrombosis; and scarce resource allocation.
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This video demonstrates how to collect a nasopharyngeal specimen for COVID-19 laboratory testing.
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ASPR, Project ECHO, NETEC, and other public-private partners host a national series of weekly clinical rounds. This peer-to-peer learning network focuses on critical care, emergency department, and emergency medical services patient care and operations. Videos and slides are available following each session.
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This fact sheet summarizes information about SARS-CoV-2 viral composition, COVID-19 clinical factors, immune responses and outcomes, nucleic acid and protein tests, performance comparison of different test types, and other related details. It also includes a list of tests cleared by the Food and Drug Administrations.
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Agencies and Organizations
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American College of Emergency Physicians.
COVID-19.
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The American College of Obstetricians and Gynecologists.
COVID-19.
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