Cardiopulmonary resuscitation (CPR) in patients with severe acute respiratory syndrome coronavirus-2Àassociated disease (coronavirus disease 2019) poses a unique challenge to health-care providers due to the risk of viral aerosolization and disease transmission. This has caused some centers to modify existing CPR procedures, limit the duration of CPR, or consider avoiding CPR altogether. In this review, the authors propose a procedure for CPR in the intensive care unit that minimizes the number of personnel in the immediate vicinity of the patient and conserves the use of scarce personal protective equipment. Highlighting the low likelihood of successful resuscitation in high-risk patients may prompt patients to decline CPR. The authors recommend the preemptive placement of central venous lines in high-risk patients with intravenous tubing extensions that allow for medication delivery from outside the patients' rooms. During CPR, this practice can be used to deliver critical medications without delay. The use of a mechanical compression system for CPR further reduces the risk of infectious exposure to health-care providers. Extracorporeal membrane oxygenation should be reserved for patients with few comorbidities and a single failing organ system. Reliable teleconferencing tools are essential to facilitate communication between providers inside and outside the patients' rooms. General principles regarding the ethics and peri-resuscitative management of coronavirus 2019 patients also are discussed.

Burnout syndrome results from unmanaged chronic workplace stress. It is characterized by emotional exhaustion, lack of a sense of personal accomplishment, and depersonalization. Burnout is associated with the development of poor work-related outcomes, mental health disorders, substance abuse, and cardiovascular disease. Burnout in physicians and other health care providers can negatively affect patient care. The prevalence of burnout in anesthesiology is among the highest of all medical specialties, with rates approaching 40%. Unique risk factors for the development of burnout in anesthesiologists may include environmental social isolation, long work hours, lack of control over one’s career, and the presence of certain personality traits that select for a career in anesthesia. System-based interventions targeting workplace contributions to burnout and individual resilience and mindfulness training can be helpful in reducing burnout symptoms. Future research efforts examining both the health care environmental structure and the specific burnout risk factors for anesthesiologists will help produce targeted treatment strategies for members of the anesthesiology community.

Rare exceptions to consider initiation of BiPAP in PUIs or COVID-19 patients include  Patients with a DNI order who have an acute indication for NIPPV  Patients who use NIPPV chronically (e.g. OHS / OSA),  Patients who present with a COPD or CHF exacerbations that are expected to be rapidly reversible (e.g. 2 hours trial)  Rarely extubation to NIPPV in patients at high-risk for reintubation (requires attending approval please see separate policy ****),

A novel coronavirus has had global impact on individual health and health care delivery. In this C4 article, contributors discuss various aspects of transplantation including donor and recipient screening, management of infected patients, and prevention of coronavirus disease (COVID). Donor screening with SARS‐CoV‐2 nucleic acid testing (NAT) close to the time of procurement is recommended. Many programs are also screening all potential recipients at the time of admission. The management of COVID has evolved with remdesivir emerging as a new potential option for transplant recipients. Dexamethasone has also shown promise and convalescent plasma is under study. Prevention strategies for transplant candidates and recipients are paramount. Pediatric‐specific issues are also discussed. Strategies for the psychological well‐being of patients and providers are also imperative, in addition to future research priorities for transplantation.

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