Prolonged Field Care has posted a podcast on Oxygenation, Ventilation and COVID19. This is austere medical management information, so you will hopefully not need it for our current pandemic, but better prepared than scared as we say.
Doug and Dennis talk austere management of COVID19 patients with an emphasis on strategies for oxygenation and ventilatory support. The remainder of the post is an massive amalgamation of resources I have been collecting for over a year for my own respiratory refresher. It’s a lot to take in but if you are looking for something related to airway, oxygenation or ventilation, scroll down and you should have some great rabbit holes to dive down.
We have been trying to get more vent training with the Advanced Special Operations Medical Sergeant Course, Regional Support Medic program and prolonged field care training for a while recognizing that this is a universal weakness for the majority of us SOF Medics. We just don’t do it enough. I had the 6 students go through over 7 hours of vent training in 4 blocks over the course of 9 weeks and we were just getting comfortable with the basics. Most go back to their day jobs and won’t likely touch it again for a long time.
While getting ready for an upcoming class I was invited to take, I wanted to review everything I had found useful for airway and ventilation. There is a lot here but contains all the resources I found most useful…
COVID19 Airway and Vent
Disclaimer: I am not currently taking caring for any COVID19 patients,or any others for that matter, but these resources seem to be helpful to those who are. Recommendations are evolving daily so be sure to check the date on everything in this section…
Use an exhalation filter no matter what airway or vent you are using!
10th SFG(A) SOCRATES Training:
EMCrit always has some great resources like this 4 Apr webinar…
This deals with other, non-invasive positive pressure solutions such as COVID19 CPAP: https://emcrit.org/pulmcrit/cpap-covid/
This is the comprehensive PulmCrit/EMCrit Internet Book of Critical Care post if you have the time: https://emcrit.org/ibcc/COVID19/
Bill Cantrell also has some great resources on ResusMed: http://www.resusmed.com/2020/03/30/protected-airway-management/
You could try awake proning
CPAP machines (and some kind of viral exhaust filter) could buy time or prevent getting them on a vent. Most of the stuff I have read says that COVID19 Patients on vents have anywhere from a 50% to 90% mortality even with properly trained and equipped ICU teams. A SOF medic probably shouldn’t intentionally be trying to do any of this without very close oversight or in extremis. Like I said, it would be a bad day for the best of us…(continues)