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RIT (Rapid ICU Training) - OSU Department of Anesthesiology
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Ohio State University - RIT (Rapid ICU Training)

Overview: This is an overview designed to identify resources and support practicing clinicians  at The Ohio State University to care for critically ill patients with COVID-19. Much of the content is geared toward practicing Anesthesiologists, but more detailed training and handout documents will be added. Additionally, these are distilled guidelines, they are not intended to impart clinical nuance nor dogma. Please email david.stahl@osumc.edu with suggested edits or additions.

The links below are all short tip sheets, graphics, or audio designed to be used in the moment. If you are looking for something longer to read, The SOCCA ICU Guide is detailed but not hard to read.

Jump to: Neuro, CV, Pulm, Renal, GI, ID, Endo, Heme, Best Practices, Checklists, Ethics,

Or Jump to: OSU-Specific Handouts

Neuro: 

One page reference on sedation/delirium

Brief overview of neurologic management in the ICU or Listen

ABCDEF is one mnemonic to think about the neurologic management in the ICU

Cardiovascular: 

If you are worried consider a STAT TTE (order) or bedside ultrasound to narrow ddx

Check ECG, Troponins q6h

If ↓BP → epinephrine (start 0.04mcg/kg/min)

If nl BP → dobutamine (start 5mcg/kg/min)

If you want more detail, read about myocardial injury from SARS-CoV-2.

COVID Code Blue

Pulmonary: 

Brief overview of mechanical ventilation in the ICU

Brief overview of other pulmonary management in the ICU

If the patient continues to be hypoxemic, follow the OSU Guideline (recently updated)

ECMO may be considered, listen about it here

Renal: 

Gastrointestinal: 

Brief overview of GI management in the ICU or listen here

Infectious Disease: 

Brief refresher on infectious disease in the ICU

You will see the surviving sepsis guidelines for COVID-19 posted, use extreme caution with these recommendations as they are based on limited evidence and early data from centers experienced in COVID conflicts many recommendations

Endocrine: 

Brief overview of endocrine management in the ICU or listen

Hematologic: 

Best Practices: 

Checklists: Rounds in the ICU end with a checklist to ensure completeness and prophylaxis (ppx) are met.

Ethics in the setting of limited resources:

Reminder: Goals of Care should be assessed early to inform code status

DNR-CCA (do not resuscitate from cardiac arrest) vs. DNR-CC (comfort care)

Read or Listen

David Stahl MD, Amar Bhatt MD, Rafal Kopancyk DO

Jesse Lester MD, Michael Lyaker MD

Veena Satyapriya MD, Ravi Tripathi MD

Updated: 4/16/2020