COVID-19 Information for Low Resource Settings
This site is intended to provide information for anaesthesia 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.
The information on this page is organised into five thematic groups. Click on the following links to jump to the information relevant to you:
- Keeping you and your patient safe
- Perioperative care
- Critical/ intensive care
- Webinars and apps
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
- Ideas to create your own face mask and shield – Early research has indicated that these masks may offer a useful alternative in the case of N95/FFP3 masks not being available or for situations where a fluid-resistant facemask is required instead. These do not protect to the same degree as N95 masks, and are dependant on mask fitting and the filtration properties of the surgical material used. For further information, please contact firstname.lastname@example.org.
- 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.
- The basics of face masks and respirators – WFSA’s ATOTW #434
- **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
- **Studies have highlighted potential problems with the use of some barrier adjuncts. Users should perform individual risk-benefit analysis prior to their use.
- 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 management of suspected/ confirmed cases of COVID19 – WFSA’s ATOTW #421
- Anaesthetic management of pregnant patients with COVID-19 – WFSA’s ATOTW #432
- 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.
- The COVID-19 Pandemic: Effects on Low- and Middle-Income Countries – An article from Anesthesia & Analgesia.
- 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
- 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
- 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.
- Practical guide for the intensive care management of patients with COVID-19 – WFSA’s ATOTW #426
- 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
- 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.
- Lifebox – Virtual Grand Rounds:COVID-19