Hamilton

Hamilton and Toronto researchers help develop COVID-19 care guidelines for critical patients

A panel of international experts developed intensive care unit guidelines for frontline healthcare workers managing COVID-19 surge.

Ontario had more than 430 confirmed and suspected COVID-19 patients in ICU Monday

A medical worker wearing a protective mask and suit treats patients suffering from COVID-19 in an intensive care unit at the Oglio Po hospital in Cremona, Italy on March 19, 2020. (Flavio Lo Scalzo/Reuters)

A team of international experts, including medical specialists from Hamilton and Toronto universities and research institutes has produced guidelines on how to care for COVID-19 patients in intensive care.

The team managed to put the guidelines together in less than three weeks, instead of following the typical process that takes as long as a year.

The process was rushed as the number of COVID-19 cases, critically ill patients and deaths continue to climb around the world.

In Ontario alone, CBC discovered that the number of patients in critical care beds exceeded 430 as of Monday. Of these, 125 are confirmed to have the virus while the remaining 353 are "suspected" cases. 

The team includes six experts from McMaster University in Hamilton, and has members from University of Toronto,  Sunnybrook Health Sciences Centre, St Joseph's Healthcare's GUIDE research methods group in Hamilton and the Population Health Research Institute, also in Hamilton.

The recommendations released by the Surviving Sepsis Campaign COVID-19 panel hopes to better guide frontline workers as they tackle the increasing demand within the intensive care unit (ICU). 

The 54 guidelines suggest the best infection control, care measures and therapy practices. 

Of the recommendations, four are best practice statements, nine are strong and 35 are weak. The top four include the wearing of personal protective equipment during invasive procedures, the use of negative pressure rooms, intubation by airway management experts and closely monitoring adults in critical condition. 

"Previously there was limited guidance on acute management of critically ill patients with COVID-19, although the World Health Organization and the United States Centers for Disease Control and Prevention have issued preliminary guidance on infection control, screening and diagnosis in the general population," said sepsis panel member Waleed Alhazzani in a press release.

Alhazzani is also an intensive care physician at St. Joseph's Healthcare Hamilton. 

To compile this list, the experts started out by proposing 53 questions they felt were relevant to managing COVID-19 in the ICU. 

Individually they searched academic literature and took note of information that answered their questions. This evidence was then assessed using reliable clinical practice standards, with robust practices making it to the final cut. 

The full set of guidelines were co-published online Friday in the Critical Care Medicine and Intensive Care Medicine journals. 

With files from Mike Crawley

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