The American Association for Respiratory Care (AARC) wants all respiratory therapists to be fully prepared and equipped with the up-to-date information regarding COVID-19. As we know this is an ever-changing situation and one that can easily be miscommunicated to others. Below are links to Centers for Disease Control (CDC), which is providing the best comprehensive information. It is updated on a daily basis.
• How many people have been affected by COVID-19?
• How many people have been diagnosed/hospitalized/died in the United States?
• What are the symptoms of COVID-19?
• How do people get tested for COVID-19?
• What do I do if I’ve been exposed to COVID-19 at work?
• How do I protect myself in the community?
• How do I protect myself in the workplace? What PPE are required?
• What infection control measures should we use in the workplace?
• How do we care for COVID-19 positive persons in the home?
• Healthcare FAQ from the CDC for further reading.
National Stockpile Ventilators
In addition, we encourage respiratory therapists to view the video presentations about the Strategic National Stockpile Ventilators. In the event that there is a shortage of ventilators, these ventilators can be put into service, and it is critical that respiratory therapists know how to operate the stockpile ventilators, should the need arise. There have been several live presentations about the stockpile ventilators throughout the country hosted by the AARC in the last several years and we expect to do more in 2020.
Joint Statement on Multiple Patients on One Ventilator
The AARC issued a joint statement with various professional medical organizations from across the U.S. this week, addressing the question of placing multiple patients on one ventilator. The statement advises clinicians that sharing mechanical ventilators should not be attempted because it cannot be done safely with current equipment. The AARC also prepared a Guidance Document to accompany the statement.
FDA’s Recommendations for Ventilator Supply Mitigation Strategies
Recognizing that the need for ventilators and ventilator-related accessories may outpace the available supply, the FDA issued recommendations based on their recent “Enforcement Policy” guidance. The FDA reminds health care professionals that your patient’s condition, the available technology, and the respiratory care expertise and experience present in your institution should be considered when choosing the appropriate ventilation for your patient. According to the FDA, their “recommendations are intended to augment, not replace, specific controls and procedures developed by health care organizations” and the CDC.
BOMA Letter Urges U.S. Surgeon General to Recognize RTs
Peter Papadakos, MD, FCCM, FCCP, FAARC, chair of the AARC Board of Medical Advisors (BOMA), sent a letter to the U.S. Surgeon General, asking for assistance in recognizing respiratory therapists. The letter brings to light the need to recognize the valuable contributions respiratory therapists make each day as they work to fight the COVID-19 virus.
“Respiratory therapists have played a key role in my career in critical care,” Dr. Papadakos said. “A number of my therapists have joined me in research projects that have lead to multiple publications in Mechanical Ventilation, ARDS and NIV. I owe you all a debt of gratitude for all you do from the neonatal ICU to the point of end of life.”
Surviving Sepsis Campaign COVID-19 Guidelines
SCCM has released its Surviving Sepsis Campaign COVID-19 guidelines to manage critically ill adults with COVID-19 in the intensive care unit (ICU). This guideline is expected to be updated as new evidence becomes available.
AARC Letters to Leaders
The AARC sent letters to U.S. Vice President Mike Pence, U.S. Congress, the Department of Health and Human Services, and the Centers for Medicare and Medicaid Services. These letters advocate for the role of the respiratory therapist during this crisis and beyond.
State Licensure Waivers During the Pandemic
As states continue to implement emergency declarations, the Federation of State Medical Boards keeps track of details on what states are doing to lift licensing laws to permit health care professionals to work across state lines. The list is updated regularly. Idaho and South Carolina specifically mention respiratory therapists. You may also want to check with the licensing board in your state that governs respiratory therapists.
Interview with Dr. Michael Anderson
As an authority on children’s health policy, pediatric disaster preparedness, system quality and physician workforce, Michael R. Anderson, MD, MBA, FAAP, FAARC, took a moment to speak with the AARC. He is a supporter of respiratory therapists, and a proud fellow of the AARC. In this conversation, Dr. Michael Anderson discusses COVID-19 and important aspects relevant to the respiratory therapist’s ability to provide safe and effective care.
Discussion From Washington State
On Mar 18, 2020, AARC Adult Acute Care Section Chair Carl Hinkson MSRC, RRT, RRT-ACCS, RRT-NPS FAARC dedicated time to a discussion of COVID-19. Hinkson and colleague Darryl Keffer RRT shared their experiences caring for patients diagnosed with COVID-19.
Join the COVID-19 Conversation
The AARC opened an AARConnect community dedicated to sharing COVID-19 resources and dialoguing about challenges and solutions during this outbreak. The AARConnect community is free and open to all members. Just go to the community page and join the discussion.
Trending Questions from the Community:
Should I use noninvasive ventilation or high-flow nasal cannula for my patient with COVID-19?
Some studies have indicated that HFNC and NIV have not been useful in treating patients with COVID-19. Studies have shown that there is a potential for secondary inhalation of emissions released from the patient on HFNC. Some recommend placing these patients in negative-pressure rooms if HFNC is used. There are some recommendations from clinicians about proper ways to manage these patients in the ICU.
Should I aerosolize medications for my patient?
CDC’s guidance on aerosol generating procedures (AGPs):
- Some procedures performed on a patient with known or suspected COVID-19 could generate infectious aerosols. In particular, procedures that are likely to induce coughing (e.g., sputum induction, open suctioning of airways) should be performed cautiously and avoided if possible.
- If performed, the following should occur:
- HCP in the room should wear an N95 or higher-level respirator, eye protection, gloves, and a gown.
- The number of HCP present during the procedure should be limited to only those essential for patient care and procedure support. Visitors should not be present for the procedure.
- AGPs should ideally take place in an AIIR (airborne infection isolation room).
- Clean and disinfect procedure room surfaces promptly as described in the section on environmental infection control below.
For RT tips for safety and links to members in the news on this topic go to our RTs, Thank You for Fighting COVID-19 page.