Clinical Practice Guidelines on the Management of Hypoxic COVID-19 Patients (SCCM, 2020)

Society of Critical Care Medicine and the European Society of Intensive Care Medicine

This is a quick summary of the guidelines without analysis or commentary. For more information, go directly to the guidelines by clicking the link in the reference.

April 24, 2020

Clinical practice guidelines on the management of hypoxic COVID-19 patients have been released by the Society of Critical Care Medicine and the European Society of Intensive Care Medicine.[1]

Hypoxic Patients With COVID-19

If there is an indication for endotracheal intubation, do the following:

  • Perform the intubation.

  • Ensure an airway expert performs the intubation.

  • Use N-95/FFP-2 or equivalent respirator masks and other personal protective equipment and infection control precautions.

  • Minimize staff presence in the room.

  • Consider using videolaryngoscopy if available.

If endotracheal intubation is not indicated and the patient is tolerating supplemental oxygen, do the following:

  • Closely monitor the patient for worsening.

  • Target peripheral capillary oxygen saturation (SpO2) at 92-96%.

  • Ensure appropriate infection control precautions are in place.

  • Do not delay endotracheal intubation should the patient’s condition worsen.

If endotracheal intubation is not indicated and the patient is not tolerating supplemental oxygen, consider using high-flow nasal cannula. If this is tolerated, do the following:

  • Closely monitor the patient for worsening.

  • Target SpO2 at 92-96%.

  • Ensure appropriate infection control precautions are in place.

  • Do not delay endotracheal intubation should the patient’s condition worsen.

If endotracheal intubation is not indicated, the patient is not tolerating supplemental oxygen, and the patient is not tolerating high-flow nasal cannula (or it is not available), do the following:

  • Consider noninvasive positive-pressure ventilation.

  • Closely monitor the patient at short intervals.

  • Do not delay endotracheal intubation should the patient’s condition worsen.

For more, information see the Novel Coronavirus Resource Center, Coronavirus Disease 2019 (COVID-19), and Treatment of Coronavirus Disease 2019 (COVID-19) Investigational Drugs and Other Therapies.

For more Clinical Practice Guidelines, go to Guidelines.

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