This site is intended to provide information for anesthesia providers working in a limited-resource setting caring for patients with COVID-19. If there is any topic you would like to see included or useful information (including pictures) you would like to share please contact Francis Peel.
Keeping you and your patient safe
- Donning and Doffing PPE
- Strategies to conserve PPE
- WHO: Rational use of personal protective equipment for coronavirus disease (COVID-19) and considerations during severe shortages – Options for temporary measures due to the shortage of PPE: extended use, reprocessing or use of alternative PPE
- Recommendations by Partners in Health for optimizing PPE
- Low-cost Solutions to Create or Extend the Use of PPEs – A summary of creative low-cost solutions compiled by Choon L. Bong from KK Hospital, Singapore
- N95 masks – sterilization and reuse efficacy, extended use and reuse – Recommendations from the N95 Decon Scientific Consortium
- Extended use or re-use of single-use surgical masks and filtering facepiece respirators: A rapid evidence review
- Do it yourself PPE
- Centers for Disease Control Guidance Documents for COVID-19 – Information is available through the CDC website on optimizing of PPE and Equipment. Frequently updated guidance.
- Creative low-resource solutions to creating barriers to protect the anaesthesia provider during intubation and extubation:
- Aerosol Block – Link to website with information and videos about the Aerosol Box shield.
- Intubate in a Bag Technique, University of Cape Town, South Africa
- Intubation box and Face Shield, Burundi
- Clear plastic barrier and Perspex box barriers, Harare Children’s Hospital, Zimbabwe
- Do it yourself Hand sanitizer – Recipes to create hand sanitizer.
- Physician well-being – Selected resources relating to wellbeing and psychological support during the COVID-19 pandemic.
- WHO: Ethics and COVID-19 – resource allocation and priority-setting
- Partners in Health – Clinical Management of COVID-19 – Comprehensive guidelines on the clinical management of COVID-19 patients in resource-limited settings. Updated often.
Perioperative Care
- COVID-19 preparedness within the surgical, obstetric and anesthetic ecosystem in Sub Saharan Africa – An Article in the Annals of Surgery on preparing the surgical, obstetric, and anesthesia ecosystem of Sub Saharan Africa for COVID-19.
- Lifebox COVID-19 – Includes selection of resources relevant to resource-constrained environments.
- COVID-19 Anaesthesia specific tools:
- COVID-19 Intraoperative Checklist – To be used in conjunction with the WHO SSCL to minimize healthcare provider exposure when operating on a COVID-19(+) or suspected patient:
- List of aerosol-generating procedures (AGPs) – From the CDC website.
- Extended use or re-use of single-use surgical masks and filtering facepiece respirators: A rapid evidence review – Research paper from the Centre for Evidence-Based Medicine (CEBM).
- COVID-19 Guidance for Regional Anaesthesia – ASRA and ESRA guidelines regarding the safety of regional anesthesia on a COVID-19(+) patient.
- Neuraxial anaesthesia and peripheral nerve blocks during the COVID-19 pandemic: a literature review and practice recommendations
- Tables
- Regional anaesthesia is preferred over general anaesthesia for patients with suspected or confirmed COVID-19 infection as it reduces the need for aerosol-generating procedures
- Recommendations for personal protective equipment for regional anaesthesia in a patient with suspected or confirmed COVID-19 infection
- Tables
Critical/Intensive Care
- Managing COVID-19 in resource-limited settings: critical care considerations – An article with recommendations for creative use of existing resources and repurposing others for human medical care during COVID-19 pandemic. Click here to access summary table of recommendations.
- WFSA’s ATOTW #426 – Practical guide for the intensive care management of patients with COVID-19
- Oxygen therapy with Limited Resources – Recommendations for practical oxygen use with COVID-19 Severe Acute Respiratory infection and pneumonia.
- Using Pulse Oximetry for Decision Support for COVID-19 – Lifebox/Alima/WHO Algorithm for using pulse oximetry for triaging suspected COVID-19(+) patients.
- Guidance for the use of Proning with the conscious COVID-19 patient – Intensive Care Society decision tool for the use of proning in the conscious patient.
- Basics of Mechanical Ventilation for Non-Critical Care MDs (SAGES) – Published by Society of American Gastrointestinal and Endoscopic Surgeons.
- Partners in Health Clinical Management of COVID-19 – Comprehensive guidelines on the clinical management of COVID-19 patients in resource-limited settings. Updated often.
- Management of Severe COVID-19 Disease – Guidelines developed by Kenya Society of Anaesthesiologists, Critical Care Society of Kenya, and the Respiratory Society of Kenya on the management of the patient with COVID-19.
- UCSF Ventilator pocket reference – Respiratory therapy reference card for managing critically ill patients.
- APSF/ASA Guidance on Purposing Anaesthesia Machines as ICU Ventilators – This live document is updated frequently as more information becomes available.
- Oxygen Concentrators: How they work and how to maintain them – Video demonstration and tutorial by Medical Aid International.
- CPR Modifications for suspected or confirmed COVID-19 Patients:
- Resuscitation Council UK – Paediatric Advanced Life Support
- Resuscitation Council UK-Adult Advanced Life Support
- AHA BLS Healthcare Provider – Pediatric Cardiac Arrest for 2 or more rescuers
- AHA BLS Healthcare Provider – Pediatric Cardiac Arrest for single rescuer
- AHA Pediatric Cardiac Arrest Algorithm
- AHA BLS Healthcare Provider – Adult Cardiac Arrest
- AHA ACLS Cardiac Arrest Algorithm
Simulation
- Vital Anaesthesia Simulation Training (VAST) – COVID-19 Simulation Resources
- Ventilator simulator (OPEN Pediatrics) – Open source basic ventilator simulator on OPEN Pediatrics.
Webinars and apps
- WHO-AFRO & WFSA – Critical and Surgical Anaesthetic Care in the Context of COVID 19
- WHO-AFRO & WFSA – Soins Critiques Et Chirugicaux Et Anesthesiques
- WHO-AFRO & WFSA – O cuidado anestésico-cirúrgico e terapia intesiva no contexto da pandemia da COVID-19
- WHO Academy: Covid-19 Learning centre – A mobile learning app targeted specifically to health workers. It is available in the Apple App Store and the Google Play Store.
