Tonight I had a chance to chat with Dr. Blair Schwartz, intensivist at the Jewish General Hospital in Montreal, Canada, one of the ministry-designated COVID centers, in part due to their ICU which was designed with pandemics in mind and able to physically be divided in sealed-off halves. Impressive stuff.

Here is our chat:

So thus far, the small Montreal experience parallels what we have heard from the Chinese and Italian experiences: they crash fast, so intubate them early, then deal with a high compliance ARDS that is difficult to oxygenate, and prone them. Oh yeah and the critically ill are not the very elderly at least so far…

Oh yes and I also questioned Blair on whether they were re-using N95s or staying completely protected for the day – seems to have been a practice in some of the dedicated areas in China, but so far, given “only” 3 patients they are keeping the general unit “clean” and disposing of all PPE between patients.

We’ll keep tabs on the evolution of the critically ill cases and try to share anything useful.

Here are my other COVID links: POCUS & COVID and Clinical Discussions.

Scott has a great video on COVID preox here:

And if you are running out of vents be sure to check out Josh Farkas’s post here on increasing your patient to ventilator ratio!

Jonny Wilkinson’s fantastic COVID page.

wash your hands & stay safe

Philippe