Coronavirus in Italy - Report From the Front Lines

Coronavirus in Italy - Report From the Front Lines



Educational Objective


Review how Italian health care leaders adapted ICU utilization protocols to centralize processes


Physicians in Lombardy, Italy, have been overwhelmed by COVID-19 patients requiring critical care. Based on an existing ECMO center network they developed an ICU network to rapidly identify, triage, and manage patients infected with SARS-2-CoV. Maurizio Cecconi, MD, of Humanitas University in Milan discusses the region’s approach to the surge, including clinical and supply management, health care worker training and protection, and ventilation strategies, with JAMA Editor Howard Bauchner.


Read the report of Dr Cecconi's experience at: https://jamanetwork.com/journals/jama...


Topics covered in this video:


00:00 Introduction

02:22 Where is Lombardy in Italy and why is it unique?

03:45 COVID-19 cases and case-fatality rates in Italy to date

04:45 What happened after the first patient tested positive?

06:52 How did you reorganize your intensive care services as cases increased?

08:54 How many critical care beds were available the first week?

10:10 How many ICU beds were you able to add as cases surged?

10:57 How does your experience match China's?

12:50 Have there been infected children?

14:51 Are the younger patients (30-40 yo) doing well after receiving treatment?

15:47 Have you created separate ICUs for COVID-19 patients?

17:20 How are you protecting health care personnel?

20:36 Are health care workers allowed to go home?

21:30 Are you making painful triage decisions?

22:52 Are you seeing non-respiratory manifestations of disease?

24:50 Are you using therapies besides traditional approaches to respiratory failure?

26:58 Have you seen any cases of reinfection?

28:10 What are your recommendations for the United States?

29:49 How do the case numbers in Lombardy compare to cases in the rest of Italy?

31:07 Are you attempting noninvasive ventilation in less severe cases?

33:30 When you go home, how are you protecting your family?


출처: https://edhub.ama-assn.org/jn-learning/video-player/18315311