Strong second COVID-19 wave calls for a second look at ICU triage guidelines

The revised Swiss guidelines bring not only a useful framework for delicate discussions and decisions at the bedside, but hopefully also progress in public awareness of some limits of the best health systems in the world, appearing much faster in a time of scarcity of resources. Based on what we learned from the crisis of this year, several aspects of our and other health systems could benefit from a revision or an update, in line with a recognised truism.

Ventilatory weaning and early rehabilitation in COVID-19-related acute respiratory distress syndrome: the experience at Locarno hospital, canton of Ticino, Switzerland

The experience presented here, although limited, allows us to draw some important conclusions which may become useful in the current context of increasing numbers of COVID-19 patients needing hospitalisation.

Multisystem inflammatory syndrome with refractory cardiogenic shock due to acute myocarditis and mononeuritis multiplex after SARS-CoV-2 infection in an adult

Multisystem inflammatory syndrome associated with SARS-CoV-2 can occur in adults. The clinical presentation can include severe organ damage with features of incomplete or complete Kawasaki disease, including coronary aneurysm, as well as myocarditis-associated cardiogenic shock and also mononeuritis multiplex.

Impact of first medical contact to revascularisation time on long-term clinical outcomes in ST-segment elevation myocardial infarction patients

COVID-19 pandemic: triage for intensive-care treatment under resource scarcity (3rd, updated version)

Given the development of the pandemic in October, the guidelines issued by the Swiss Academy of Medical Sciences (SAMS) and the Swiss Society of Intensive Care Medicine (SSICM) needed to be revised and updated in the light of the experience accumulated since March. There has been no change in the guiding principle that uniform criteria for intensive-care unit (ICU) admission and continued occupancy should be applied throughout Switzerland. The present guidelines provide the necessary basis.