New COVID-19 clinical guidance website launched for anaesthetists and intensivists

Anaesthetists working closely with intensive care doctors to tackle COVID-19

Updating of core skills can reduce pressures on critical care resources and enhances patient care for those who need it most

New multidisciplinary website launched today containing information, guidance & resources to tackle COVID-19

The expected surge in the number of COVID-19 patients requiring critical care will mean that intensive care resources in many NHS hospitals and Trusts will undoubtedly be put under severe pressure. The Government’s ‘Delay’ phase in its COVID-19 Action Plan provides a small window of opportunity for intensivists and anaesthetists to work even more closely together to prepare for this surge by laying down plans to:

• increase critical care capacity
• review clinical guidance
• allow time for staff to refresh skills with some protected time for training
• identify requirements such as the need for more ventilators, more critical care rooms and, importantly, the redeployment of nurses and doctors to provide additional patient care.

Working in collaboration, Royal College of Anaesthetists, the Faculty of Intensive Care Medicine, the Intensive Care Society and the Association of Anaesthetists and the are urgently reviewing and revising clinical guidance to provide the UK intensive care and anaesthetic community with up-to-date clinical information, guidance and resources needed to better understand and manage COVID-19.

While intensive care medicine and anaesthesia are two separate medical specialties, there is much crossover in the skills and knowledge of these two groups of highly skilled and experienced doctors. When there is severe pressure on critical care resources, anaesthetists have the skills and training to support the vital work of intensivists. Intensive care medicine is a key component of the training of all anaesthetists in the UK and Ireland, and those who have recently completed training in anaesthesia will have much of the skillset necessary to help intensivists to care for sick patients.

Many anaesthetists are already also intensivists and many of those who may not have allocated sessions in intensive care medicine, but are involved in subspecialties such as cardiothoracic or neuro-anaesthesia are more than familiar with current best practice in some aspects of intensive care.

As a collaborative of medical organisations, we are therefore strongly recommending that departments of intensive care medicine and anaesthesia work closely together and develop plans that may include updating the skills of anaesthetists in intensive care medicine – we call this “cross-skilling”.

To support this proposal, a new website (www.icmanaesthesiacovid-19.org) has been launched today for intensivists and anaesthetists. This will become the central hub for all new multidisciplinary guidance, information and resources to support the understanding and management of patients with COVID-19. In addition to patient information, clinical guidance being devised and redeveloped includes that for airway management, obstetric anaesthesia, ICU/anaesthesia liaison and simulation/training. As more guidance is developed, this will be added to the website.

Professor Ravi Mahajan, President of the Royal College of Anaesthetists said: “We support the Government’s decision to move its COVID-19 (Coronavirus) Action Plan to the ‘Delay’ phase. Cross-skilling between ICU and anaesthetic departments is a crucially important activity. I strongly urge all our hospital and Trust departments to participate. In recent weeks I have seen anaesthetists joining intensivist colleagues on ward rounds and taking advantage of CPD material provided by the Faculty of Intensive Care Medicine and the Intensive Care Society. This must be encouraged.”

Dr Alison Pittard, Dean of the Faculty of Intensive Care Medicine said: “I am extremely grateful to the Royal College of Anaesthetists and the Association of Anaesthetists for their support in what is likely to be a testing time for us all. We will jointly update the new website to ensure it is the hub for the most up-to-date information and, for this reason, FICM will cease to use our own website for COVID-19 advice but signpost only to the joint site. By working together, we are stronger and will be able to do the best for our patients. Keep it simple, keep it safe.”

Dr Ganesh Suntharalingam, President of The Intensive Care Society said: “The Society is delighted to work with partner organisations to provide a common hub for key information. It is essential that we show consistency and simplicity under the current circumstances. Like our partners I am very grateful for the work put into this joint website. The ICS will maintain some resources on our own site in order to allow greater detail or background, but key output will be shared on this joint hub”

Dr Kathleen Ferguson, President of the Association of Anaesthetists said: “ ‘A healthy well-resourced workforce delivers the best quality care’ has been a mantra of the Association for some time now. In the coming days and weeks having an informed, prepared and practised anaesthesia workforce will prove vital in the clinical response to the COVID-19 challenge. Working together in a collaborative way with our critical care colleagues across the acute sector is essential to providing the best for our patients and to keeping us all well at the same time. This joint initiative provides the most up to date information, guidance and support our organisations can offer and I commend this resource to inform our practice and performance.”

More information can be found at www.icmanaesthesiacovid-19.org.