Internet Book of Critical Care (IBCC)

Basics
  • COVID-19 is a non-segmented, positive sense RNA virus.
  • COVID-19 is part of the family of coronaviruses.  This contains:
    • (i) Four coronaviruses which are widely distributed and usually cause the common cold (but can cause viral pneumonia in patients with comorbidities).
    • (ii) SARS and MERS – these caused epidemics with high mortality which are somewhat similar to COVID-19.  COVID-19 is most closely related to SARS.
  • COVID-19 binds via the angiotensin-converting enzyme 2 (ACE2) receptor located on type II alveolar cells,  intestinal epithelia, and the vascular endothelium (Hamming 2004).
    • This is the same receptor as used by SARS (hence the technical name for the COVID-19, “SARS-CoV-2”).
    • When considering possible therapies, SARS (a.k.a. “SARS-CoV-1”) is the most closely related virus to COVID-19.
  • COVID-19 is mutating, which may complicate matters even further.  Virulence and transmission will shift over times, in ways which we cannot predict.  Ongoing phylogenetic mapping of new strains can be found here.

For complete book Access:

CMS Updates PDPM Grouper

CMS has posted an update to the PDPM Grouper DLL, as v1.0009, to add support for new ICD-10 codes that may be used for assessments with target dates on or after 1/1/2021.

The posting notice lists those as: Z11.52, Z20.822, Z86.16, M35.81, M35.89 and J12.82.

It notes that codes M35.81 and M35.89 replace code M35.8, which should no longer be used on assessments with target date on or after 1/1/2021.

They’ve also released new lookup files for allowable ICD-10 codes for item I0020B, as of 1/1/2021.

New Group will be included in the upcoming ADL Update.

Congress Approves IoT Cybersecurity Bill

Passed by the U.S. Congress on November 17, 2020 and heading to the White House for the President’s signature, the Internet of Things Cybersecurity Improvement Act “requires the National Institute of Standards and Technology (NIST) and the Office of Management and Budget (OMB) to take specified steps to increase cybersecurity for Internet of Things (IoT) devices.”

Given the many recent security issues with “smart” devices and their rapid proliferation in the marketplace, we’re glad to see the U.S. Congress taking a step in the right direction to establish IoT security standards and best practices for the federal government.

Nonopioid Treatments for Chronic Pain

Principles of Chronic Pain Treatment

Patients with pain should receive treatment that provides the greatest benefit. Opioids are not the first-line therapy for chronic pain outside of active cancer treatment, palliative care, and end-of-life care. Evidence suggests that nonopioid treatments, including nonopioid medications and nonpharmacological therapies can provide relief to those suffering from chronic pain, and are safer.

Effective approaches to chronic pain – Download:

//www.cdc.gov/drugoverdose/pdf/nonopioid_treatments-a.pdf

Coronavirus Disease 2019 (COVID-19): Supporting Your Loved One in a Long-Term Care Facility

We recognize the hardship that our residents and families are experiencing right now due to COVID-19. As part of our facility’s commitment to protecting residents, families, and staff from serious illness and complications, we are continuing to follow guidance from the Centers for Medicare & Medicaid Services (CMS) and the Centers for Disease Control and Prevention (CDC), and will provide families with regular updates regarding our facility’s COVID-19 status and visitation policies via phone and email.

We remain committed to helping residents stay connected with their families and loved ones. We would like to work together with you to make this possible. Below are some ideas on how to keep in touch if you are unable to visit in-person, and ways we are supporting communication between our residents and their families:

//www.cdc.gov/coronavirus/2019-ncov/downloads/supporting-loved-one-in-long-term-care-facility.pdf