Covid-19 Podcast from Italy with Roberto Cosentini. St Emlyn’s

Dr Roberto Cosentini is an old friend of St Emlyn’s who works in Bergamo, in Northern Italy. He is right at the heart of the recent Covid-19 outbreak. He kindly found an hour to record a podcast with us on his experiences. Click on the link below to listen

There are so many essential lessons in this podcast. Please share with clinical and non-clinical colleagues, as we need to plan NOW. Roberto is quite clear that if we don’t train and get plans into place before the wave of cases hit us, then both ourselves and our patients will suffer.

In the interest of speed I’m not going to summarise the whole podcast. You have to listen to it all yourself to see what’s relevant to you. These are some of my takeaway messages.

  • Divide your department into resp patients and non-resp patients.
  • Wear PPE and know how to use it.
  • You will need clinicians who do not usually work in ED. Train and orientate them now (before you need them).
  • Most patients are hypoxic and this responds to O2 and CPAP. You’re going to need a lot of CPAP and how that happens could be tricky. They found hoods the best (Ed – but how many of those do we have?).
  • Although hypoxic, patients have good lung compliance.
  • They regularly saw diurnal variation with many patients presenting in the early afternoon.
  • It’s emotionally exhausting. Prepare yourself and your team psychologically and support them during the pandemic. Roberto’s department has an embedded psychologist.
  • Health care worker infections were quite low (because they wore PPE for all resp cases).
  • Flow through the department and onto wards is absolutely vital.
  • Flow out the the main hospitals to other units that can rehabilitate is vital.
  • Decisions for ICU level care were similar to normal (in his hospital).

We rarely declare one of our podcasts a ‘must listen’ but this is an exception. Please listen and share widely. Please think hard about the issues Roberto raises and PLEASE ACT NOW.

Also please note our call for papers at the EMJ on the link below. Also have a look at Salim’s link to a similar vodcast on ICU management from Italy. You can also use this link to the RCEM page on Covid-19.

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Posted by Simon Carley

Professor Simon Carley MB ChB, PGDip, DipIMC (RCS Ed), FRCS (Ed)(1998), FHEA, FAcadMed, FRCEM, MPhil, MD, PhD is Creator, Webmaster, owner and Editor in Chief of the St Emlyn’s blog and podcast. He is Professor of Emergency Medicine at Manchester Metropolitan University and a Consultant in adult and paediatric Emergency Medicine at Manchester Foundation Trust. He is co-founder of BestBets, St.Emlyns and the MSc in emergency medicine at Manchester Metropolitan University. He is an Education Associate with the General Medical Council and is an Associate Editor for the Emergency Medicine Journal. His research interests include diagnostics, MedEd, Major incidents & Evidence based Emergency Medicine. He is verified on twitter as @EMManchester

  1. Thanks Simon, very helpful- as always.

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  2. Can you ask him what type of PPE they were using to keep the staff safe. I am highly suspicious of our current move away from aerosol precautions down to droplet precautions here in the states.

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  3. […] St. Emlyn’s: COVID-19 Podcast form Italy with Roberto Consentini […]

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  4. I am intrigued by their experience with NIV particularly helmet CPAP from an infection control point of view. Have they published their results e.g. inclusion/exclusion criteria, procedure, steps to prevent transmission, duration of therapy etc. There is little experience of this where I work and I couldn’t imagine our respiratory ward wanting to manage this.

    From a pragmatic point of view, I would put it down near the list of heroic interventions such as split ventilators.

    Reply

  5. Philipp Gotthardt March 17, 2020 at 10:28 am

    do you have any documents to share including recommendations for doctors usually not in contact with respiratory distress/covid?
    Thanks your Great work!

    Reply

  6. […] The St Emlyn’s podcast with Dr Cosentini is here […]

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  7. […] St. Emlyn’s: Podcast from Italy with Roberto Cosentini, MD […]

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  8. […] St. Emlyn’s: Podcast from Italy with Roberto Cosentini, MD […]

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  10. […] a different creature. This virus is very contagious and spreads even before someone is symptomatic. Personal accounts of its impact from Italian medical colleagues are chilling and hint to the chaos that will likely […]

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  11. I am also very interested in what PPE they were wearing to keep healthcare transmission so low. I feel the PPE being offered here in Australia is inadequate.

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  19. […] same time," Dr. Roberto Cosentini, a doctor in the northern city of Bergamo near Milan, said in a podcast for emergency room physicians. "It's like a regular daily […]

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  23. […] a health care provider within the northern town of Bergamo close to Milan, mentioned in a podcast for emergency room physicians. “It’s like a standard day-to-day […]

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  24. […] same time,” Dr. Roberto Cosentini, a doctor in the northern city of Bergamo near Milan, said in a podcast for emergency room physicians. “It’s like a regular daily […]

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  25. […] Cosentini, a physician within the northern metropolis of Bergamo close to Milan, mentioned in a podcast for emergency room physicians. “It’s like an everyday day by day […]

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  26. […] same time,” Dr. Roberto Cosentini, a doctor in the northern city of Bergamo near Milan, said in a podcast for emergency room physicians. “It’s like a regular daily […]

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  27. […] same time,” Dr. Roberto Cosentini, a doctor in the northern city of Bergamo near Milan, said in a podcast for emergency room physicians. “It’s like a regular daily […]

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  29. […] has been an awful lot to catch up on, admittedly a lot of it COVID-19 related. Simon recorded a fascinating podcast with Roberto Cosentini, an Emergency Physician in Northern Italy, discussing his experience of Coronavirus and how his […]

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  30. Thank you Simon and huge thank you to Roberto Cosentini, encouraging to hear and that we are following very much in their steps as they went forward.

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  31. […] St Emlyns interview with ED physician Dr Roberto Cosentini podcast (Italy)  […]

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  32. same time,” Dr. Roberto Cosentini, a doctor in the northern city of Bergamo near Milan, said in a podcast for emergency room physicians. “It’s like a regular daily

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  33. […] We suggest you first listen to this LITFL podcast with Roberto Cosentini (Emergency medicine consultant in Italy) to start to get an idea of how COVID-19 has affected how we work in ED departments and the new challenges we face: https://www.stemlynsblog.org/covid-19-podcast-from-italy-with-roberto-cosentini-st-emlyns/  […]

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Thanks so much for following. Viva la #FOAMed


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