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Raport elaborat de Centrul pentru Politici și Analize în Sănătate.
The spread of COVID-19 poses a challenge for emerging markets such as those in Africa and Latin America. While governments around the world are suffering from a shortage of ventilators, hospital beds, and personal protective equipment, availability of these items is already extremely limited in some... countries. In Africa, countries including Mali, Liberia, and Burkina Faso have only a few ventilators available to aid their populations, and there is also a lack of reliable oxygen supplies, ICUs, and healthcare workers to treat the sick. Additionally, many countries in Africa are already suffering from food insecurity and weak economies, which will worsen the long-term effects of coronavirus.
Keeping these factors in mind, GeoPoll conducted a remote study in 12 countries in sub-Saharan Africa on the effects coronavirus is already having on people throughout the region.more
v.1 (3 de abril de 2020)
Este guia de prática clínica fornece recomendações baseadas em evidências para o controle de infecção, coleta de amostras, cuidados de suporte, tratamento medicamentoso e prevenção de complicações. As recomendações são dirigidas a todos os profissionais de sa...de que atendem os pacientes no serviço de urgência/emergência e na unidade de terapia intensiva (UTI) (médicos com especialidade em medicina de urgência, pneumologia, medicina intensiva, clínica médica, anestesiologia, infectologia, fisioterapeutas respiratórios, enfermeiros e farmacêuticos). O guia deve ser usado por tomadores de decisão e membros de entidades governamentais relacionados com o tratamento de pacientes com COVID-19 em UTI na região das Américas. Este guia não incluirá aspectos relacionados com a nutrição, fisioterapia (exceto fisioterapia respiratória) e tratamento de complicações.more
Esta tercera versión resumida de la Guía para el cuidado de pacientes adultos críticos con COVID-19 en las Américas se elaboró con el objetivo de facilitar la consulta de las recomendaciones para el manejo de pacientes adultos críticos con COVID-19 atendidos en las unidades de cuidados intensi...vos. Ofrece recomendaciones basadas en evidencia para la identificación de marcadores y factores de riesgo de mortalidad de los pacientes críticos, el control de la infección, la recogida de muestras, la asistencia a los pacientes (ventilatoria y hemodinámica), el tratamiento farmacológico, la rehabilitación temprana, el uso de imágenes diagnósticas, la prevención de complicaciones y los criterios de egreso. Las recomendaciones están dirigidas a todo el personal de salud que atiende a pacientes en los servicios de urgencias y de emergencias y las unidades de cuidados intensivos. Asimismo, tienen por objetivo brindar apoyo a los responsables de la toma de decisiones y miembros de entidades gubernamentales relacionados con el manejo de pacientes con COVID-19 en las unidades de cuidados intensivos de la Región de las Américasmore
Many African countries were amongst the most rapid to respond to the emerging threat of COVID-19, implementing large-scale interventions at very early stages of their epidemic. As demonstrated in this document using very simple models, this rapid mobilization and timeliness of implementing control m...easures is likely to be an important determinant of their success. Indeed, as these measures were relaxed, subsequent waves of disease have been observed in many countries including South Africa, Kenya, Tunisia, Morocco, Sudan and the Democratic Republic of Congo (DRC) where such waves have severely impacted the health system by straining the supply of oxygen and ICU beds and inflicting a heavy toll on healthcare workers, often necessitating the re-imposition of control measures.more
tep 1 Competencies have been designed to provide staff with the core skills required to care for a critically ill patient safely, whilst under supervision. It is expected that Step 1 competencies will be completed prior to commencing an academic critical care programme.
Steps 2 & 3 Competencies hav...e been designed to further develop your essential critical care skills and will require enhanced theoretical knowledge to underpin your practice. It is anticipated that Steps 2 & 3 competencies will be undertaken whilst undertaking an academic critical care programme.
Step 4 Competencies have been designed to provide staff with the core skills required to take charge in a critical care unit; building management and leadership capability into your professional development, to demonstrate safe and effective coordination and prioritisation of unit workload, workforce and resources.
You can downlaod any of the Steps Competency Documents from this linkmore
List of essential medicines for the management of patients admitted in intensive care units with a suspected or confirmed diagnosis of COVID 19. Third version, 1 February 2022
For patients on HFNO with persistent hypoxaemia or respiratory distress:
• Check the equipment: inspect the exterior of the machine, the tubing (circuit), the prong for any sign of mechanical damage, confirm it fits and the filters are in place. Ensure the settings are appropriate and flow is max...imized.
• Check the oxygen source: there is sufficient oxygen available and flowing through the device. If FiO2 > 50% of oxygen is needed, the device must have a blender.
• Check there is no obstruction with secretions: patients with COVID-19 may have very thick secretions which may block small and large airways and cause sudden respiratory deterioration.more
WHO recommends prompt recognition of progressive acute hypoxaemic respiratory failure when a patient with respiratory distress is failing to respond to standard oxygen therapy and adequate preparation to provide advanced oxygen/ventilatory support.
Hypoxaemic respiratory failure in ARDS commonly re...sults from intrapulmonary ventilation-perfusion mismatch or shunt and usually requires mechanical ventilation.
At any time, if there are urgent or emergent indications for intubation, do not delay.
WHO suggests that hospitalized patients with severe or critical COVID-19 with acute hypoxaemic respiratory failure that do not require emergent intubation be treated with HFNO, or CPAP or NIV (BiPAP) rather than standard oxygen therapy.more
WHO recommends prompt recognition of progressive acute hypoxaemic respiratory failure when a patient with respiratory distress is failing to respond to standard oxygen therapy and adequate preparation to provide advanced oxygen/ventilatory support.
Hypoxaemic respiratory failure in ARDS commonly ...results from intrapulmonary ventilation-perfusion mismatch or shunt and usually requires mechanical ventilation.
At any time, if there are urgent or emergent indications for intubation, do not delay.
We recommend prompt recognition of progressive acute hypoxaemic respiratory failure when a patient with respiratory distress is failing to respond to standard oxygen therapy and adequate preparation to provide advanced oxygen/ventilatory support.
WHO suggests that patients with severe or critical COVID-19 with acute hypoxaemic respiratory failure that do not require emergent intubation be treated with HFNO, or CPAP or NIV (BiPAP) over standard oxygen therapy.more
For patients on NIPPV or HFNO with persistent hypoxaemia or respiratory distress:
• Check the equipment: inspect the exterior of the machine, the tubing (circuit), the mask for any sign of mechanical damage, confirm it fits securely without leak (if CPAP/BiPAP) and the filters are in place. Ensur...e the settings are appropriate and flow is maximized.
• Check the oxygen source: there is sufficient oxygen available and flowing through the device. If FiO2 > 50% of oxygen is needed, the ventilator must have a blender.
• Check there is no obstruction with secretions: patients with COVID-19 may have very thick secretions which may block small and large airways and cause sudden respiratory deterioration.more