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Acute management of COVID-19 in the emergency department: An evidence-based review
Kundavaram P P Abhilash1, Sandeep David1, Emma V St Joseph2
1Department of Emergency Medicine, Christian Medical College, Vellore, Tamil Nadu, India.
Insights
This review outlines emergency department guidelines for critically ill COVID-19 patients, focusing on essential resuscitation components like airway, breathing, and circulation. It emphasizes supportive care and avoiding unnecessary interventions while practicing antibiotic stewardship.
Area of Science:
- Emergency Medicine
- Infectious Diseases
- Critical Care
Background:
- The COVID-19 pandemic has presented continuous challenges to emergency departments worldwide.
- Rapidly evolving information and recommendations necessitate updated clinical guidelines.
Purpose of the Study:
- To review and synthesize current evidence on the triage, evaluation, and management of critically ill COVID-19 patients requiring emergency resuscitation.
- To provide evidence-based recommendations for emergency department care during the pandemic.
Main Methods:
- Systematic review of available literature and guidelines.
- Compilation of evidence related to resuscitation and supportive care for severe COVID-19 cases.
Main Results:
- Key resuscitation priorities include airway, breathing, and circulation (ABC) management.
- Supportive care is fundamental for critically ill COVID-19 patients.
- Avoidance of irrational investigations and therapeutics is crucial.
Conclusions:
- Effective management hinges on core resuscitation principles and robust supportive care.
- Adherence to antibiotic stewardship is vital during medical uncertainty.
- Guidelines are essential for consistent and optimal emergency care of COVID-19 patients.
Abstract:
Coronavirus disease (COVID-19) has been relentlessly battering the world wave after wave in different countries at different rates and times. Emergency departments (EDs) around the globe have had to constantly adapt to this ever-changing influx of information and recommendations by various national and international health agencies. This review compiles the available evidence on the guidelines for triaging, evaluation, and management of critically ill patients with COVID-19 presenting to the ED and in need of emergency resuscitation. The quintessential components of resuscitation focus on airway, breathing, and circulation with good supportive care as the cornerstone of acute management of critically ill COVID-19 patients. Irrational investigations and therapeutics must be avoided during these times of medical uncertainty and antibiotic stewardship should be diligently followed.
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