Notes from the field, clinical resources & evidence-based updates
COVID19 – CT Findings
While CT is not suggested or required for diagnosis of COVID19, it is certainly a window into the disease process and its impact on the lungs. This fantastic video reviews some of the distinctive patterns of lung injury from COVID19 that appear on CT, and also some of the pearls and pitfalls with CT use…
Is ACE Inhibitor Use a Risk Factor for COVID Mortality?
Separating Fact from Fiction Hypertension is major risk factor for worse outcome with the COVID virus (SARS-CoV-2). That’s a fact. There are many people taking ACE inhibitors and ARBs in the USA and the virus enters the lungs and heart through the ACE2 receptor (see image below). That’s a fact. It was initially thought…
COVID19 Intubation Protocol
Protocol developed for intubation of the COVID19 patient from lessons learned in our NYC institution.
COVID & EMS
Living the Pandemic on the Front Lines & Lessons Learned From a Pre-Hospital Care Perspective. No part of the healthcare system in NYC has been hit harder than the 911 system and the first responders who work in the pre-hospital setting. Chris Root @gueromedico and I talk about the experience, PPE, personal safety, cardiac arrest…
COVID Evidence
Reason can wrestle and overthrow terror – Euripides Collecting data and testing evidence takes time, and in that vacuum of time, fear, frustration and a desire to act animates us to abandon reason. Not a day goes by when more anecdotal evidence, hearsay, or outright falsehoods related to COVID19 don’t scream at us across the…
COVID19 Airway
With over 200 COVID19 intubations, Ralph Slepian MD shares their experience and the lessons learned from a team-based approach to safely managing the airway of COVID19 patients. We understand the important role PPE (or lack of it) plays in caring for COVID19 patients. It’s even more important when we talk about protecting clinicians who are…
COVID Myths
It’s a curious fact that the saying “primum non nocere” (first do no harm) attributed to the hippocratic oath actually comes from his treatise on Epidemics. In times of uncertainty we are desperate to fill the void with something tangible. Unfortunately what usually fills the vacuum in the early stages of, oh let’s say a…
COVID Ethics
Because physicians, nurses, and other clinicians are trained to care for individuals, the shift from patient-centered practice to patient care guided by public health considerations creates great tension, especially for clinicians unaccustomed to working under emergency conditions with scarce resources.The Hastings Center We’re all experiencing the transformation of healthcare delivery during a pandemic. As the…
The Chest X-Ray for COVID19
How do you use the chest x-ray during the evaluation of a suspected COVID19 patient? Our practice has been all over the map as we learn about the clinical course of this disease and how to allocate our resources effectively. Due to the lack of COVID19 testing, we have relied heavily on imaging and the…
Think Cardiac
Don’t just think fever and respiratory symptoms. We are seeing COVID19 patients that have a predominantly cardiac presentation: palpitations, arrhythmias, reduced cardiac function, myocarditis and elevated troponin. #covidresus Cardiac symptoms can be the first sign of COVID19. Patients can have palpitations and chest pain without the typical fever and cough. In a case series study of…
PPE Plus ++
Personal protective equipment (PPE), is only a single part of a diligent and comprehensive plan for personal safety. This post will cover the best evidence on PPE for protection against COVID19, the basics on the types of masks and when to wear them, training on donning & doffing, wellness tips for the frontline provider wearing…
The MedEDge Design Lab 