Resources to support assessment, testing and care for the acutely unwell person. Includes sections for Doctors and ANPs, Midwifery and Obstetrics and those treating unwell children.
Please note: The ARHAI Scotland COVID-19 Addenda Guidance is changing on Monday 29 November 2021.
The guidance will be replaced by the ‘Winter 21/22 Winter Respiratory Infections in Health and Care Settings Infection Prevention and Control Addendum’ and will be found here: https://www.nipcm.scot.nhs.uk/
Our COVID-19 learning materials for staff working in health and social care are currently under review and are being updated in line with the new guidance.
**These resources will be withdrawn for review 23/01/23**
Skills bundles reliably enhance your practice. This multi-professional bundle of skills will support you as a health care or social practitioner working in any setting with patients with suspected COVID-19 and has been designed to support:
The Assessment and Management skills bundle will help to ensure you minimise your exposure and maximise your protection and can be linked to the more detailed resources outlined below. Additional skills bundles on Self-protection and Protecting your workplace can be found in the Protecting yourself and your workplace environment section.
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Resources to assist with testing.
Health Protection Scotland, with support from stakeholders, has produced a short video clip to support colleagues required to obtain an upper respiratory tract diagnostic sample. This resource describes the techniques involved in obtaining an upper respiratory tract COVID-19 diagnostic sample (third video on the page).
HPS video clip: This is a guidance video which outlines the correct way to package samples from suspected COVID-19 patients for Category B transport, in line with UN3373 requirements. It is part of the initial investigation of possible cases collection.
The 2021 Resuscitation Guidelines produced by the Resuscitation Council UK (RCUK) provide detailed information about basic and advanced life support for adults, paediatrics and newborns, including information on the use of Automated External Defibrillators.
These Guidelines were distilled from the 2021 ERC Guidelines and tailored to clinical practice in the UK.
The 2021 Resuscitation Council UK Ethics Guidelines provides an overview of key ethical issues linked to resuscitation.
The RCUK highlights resources to support the resuscitation decision making process.
Guidance: DNACPR and CPR decisions | Resuscitation Council UK
As the evidence base grows, specific guidance on resuscitation in patients with COVID–19 may change. Keep up to date with developments on the RCUK website.
Resuscitation Council (UK) Statements on COVID-19 (Coronavirus), CPR and Resuscitation
Explore the RCUK website for further resources, information and guidance.
European Resuscitation Council (ERC)
The European Resuscitation Council (ERC) Guidelines for Resuscitation 2021 provide specific instructions for how resuscitation should be practiced.
A brief video update from the ERC on their 2021 Guidelines is available
Basic Life Support - ERC Guidelines 2021 - YouTube
NICE
In response to the COVID-19 pandemic, NICE produced multiple, rapid guidelines in support of the health and social care system. These guidelines were reviewed and consolidated into a single guideline and published in January 2023.
The Airway, Breathing, Circulation, Disability, Exposure/Examination (ABCDE) approach is a systematic approach to the immediate assessment and treatment of critically ill or injured patients.
Introducing the ABCDE assessment
This Resuscitation Council UK video demonstrates the initial assessment and management of an acutely unwell patient using the ABCDE approach
ABCDE assessment demonstration
The following resource provides an overview of the ABCDE approach. It refers to the 2015 Guidelines but remains contemporary.
This interactive 360-degree training video demonstrates a cardiac arrest (code blue) as if the doctor is leading an arrest for the first time. The doctor will ask questions during the arrest. Pause the video when you see the information bar appearing and try to answer them.
This slide set details considerations when a deteriorating patient requires intubation outside the critical care environment. Topics include : indications and risks of intubation; equipment review and assisting an intubation.
Best practice guidelines outlining risks associated with ETT and standards of care.
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This short video examines how a practitioner who is new to intensive care can support the intubation of a patient.
Ventilator management essential skills for non-ICU nurses assiting duration intubation : video (8.32)
COVID-19 Ventilator course: learn or review mechanical ventilation
COVID-19 specific online learning resource for healthcare professionals caring for people who require mechanical ventilation. (Free course at MedCram.com - registration is required)
NB. This resource was not produced in the UK and as such the units of measurement will likely vary from those used locally.
An overview of mechanical ventilation in the intensive care unit
BMJ Learning have produced several useful short videos on a range of subjects relevant to managing patients in the Intensive care unit. These include mechanical ventilation key settings and ventilator alarms. Explore the full range of videos below
Videos
Educational Video designed for medical practitioners, describing the patient centred approach to acute NIV.
Introductory material for Acid Base Balance and ABG analysis. Suitable for staff new to ICU environment.
Slightly more advanced material. Parts 1 & 2 of an 8-part course (free playlist on MedCram YouTube channel or at MedCram.com. Recommend parts 1 and 2 as introduction or refresher).
NB. The ABG course 2 resource were not produced in the UK and as such the units of measurement will likely vary from those used locally
Review of ARDS and specific considerations in the context of COVID-19.
How to prone and position safely.
Resources
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Introduction to the basic physiology of haemodynamics.
Introduction to vasopressors and their use in critical care.
Resources
These resources provide support for those caring for deteriorating patients. They are closely aligned with the ABCDE assessment.
This short filmed resource provides a general overview and introduction the SEPSIS pathway.
SIGN consensus recommendations on care of deteriorating patients.
This is a scenario depicting a severe hypoglycaemic episode in a hospital setting.
Comprehensive examination of the patient will require them to be exposed, with clothing, bedding adjusted or removed as necessary.
Examine the patient for signs of trauma, bleeding, skin reactions, needle marks, or other potential causes for the deterioration in their condition. Care should be taken to minimise heat loss and preserve the patient’s dignity.
Additional information will also be required as detailed by the Resuscitation Council UK - The ABCDE Approach | Resuscitation Council UK
National Early Warning Score (NEWS)2:
The NEWS is based on a simple aggregate scoring system in which a score is allocated to physiological measurements, already recorded in routine practice, when patients present to, or are being monitored in hospital. Six simple physiological parameters form the basis of the scoring system:
See guidance from the Royal College of Physicians.
National Early Warning Score (NEWS) 2 : charts in PDF format from Royal College of Physicians.
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Situation, Background, Assessment, Recommendation (SBAR) and Acute Assessment of the Critically Unwell Adult Treatment and Escalation (AACUTE):
SBAR is an easy to use, structured communication format that enables information to be transferred accurately between individuals. SBAR stands for Situation, Background, Assessment, Recommendation. This introduction shows how to use the tool, including examples of use.
SBAR bedside report demonstration for nursing students.
Introduction to the use of NEWS2.
This slide set outlines the AACUTE COURSE- Acute Assessment of the Critically Unwell Adult Treatment and Escalation.
This Edinburgh Napier University learning resource can support the development of skills and confidence in recognising the severely ill person, initiate immediate treatment and escalate care appropriately. There are 2 learning resources available:
Create an account on the Edinburgh Napier site. Once you have logged in, click the “COVID-19 Open Access Course” link. Click “Enrol me” at the self-enrolment prompt.
Please note that the interactive simulation game must run on Windows 10 computers. It is important to read the installation guide; you will need to download the installer and then download the game to your computer. It is recommended to tick the “Create a desktop shortcut” when installing as it will put an icon on your Desktop, making the game easily accessible.
The game should not be copied or forwarded onto any users without permission from Edinburgh Napier University.
This resource supports application of the Adults with Incapacity (Scotland) Act (2000) in acute general hospitals.
Prepared on behalf of the British Dietetic Association (BDA) Critical Care Specialist Group (CCSG), this document provides best practice guidance on enteral feeding in prone position.
Some aspects of COVID-19 presentation and treatment present special challenges for safely confirming nasogastric tube placement. This aide memoire gives reminders of established safety steps.
This document introduces critical care to practitioners new to the acute environment and patient care needs. It functions as a guide and may inform education for those introducing new staff or organising group education for the deteriorating person.
Delirium is a common complication in Intensive Care Units. The following provides resources to support the assessment and management of delirium in this setting.
The Medicines and Healthcare products Regulatory Agency has created a Coronavirus Yellow Card reporting site which aims to collect reports of suspected medicine side-effects or incidents with equipment used to treat Coronavirus, to help understand how medicines and medical equipment work for COVID-19.