It has been 15 years since geriatrician Dr. Camilla Wong spent any significant amount of time working in an intensive care unit.

Back in 2005, when she was still a resident, she did a rotation in critical care, receiving about two months of training.

Despite all the time that has elapsed and her very limited experience in critical care, Wong — and legions of other non-ICU health-care workers across Canada — can expect to soon find themselves on the front lines of the COVID-19 pandemic, caring for the sickest of patients.

“I will do whatever I can to help, but I’m quite nervous obviously. It’s a skill set I don’t necessarily have,” said the specialist from a Toronto hospital.

So she was grateful last week when she discovered on Twitter a website created specifically for health professionals such as herself.

Titled “Quick ICU Training for COVID-19,” the website is essentially a how-to guide for health-care professionals whose regular jobs don’t involve treating patients in life-threatening condition from a highly contagious and potentially deadly infectious disease.

Wong shared it with her followers on Twitter, many of whom are also health-care workers.

“Loving this,” she wrote, describing it as a critical care “101” course.

The website was created in only one week by a group of clinicians and researchers from the University of Toronto and local academic hospitals. Known as the Critical Care Education Pandemic Preparedness team (CCEPP), its members mobilized quickly, recognizing that there was a knowledge gap that urgently needed to be filled.

It’s part of the work being done in the province in the mad scramble to prepare for a surge of COVID-19 patients.

Building up critical care capacity in an already overstretched health system is about more than increasing the number of hospitals beds and ventilators. It’s also about finding health-care professionals to staff those beds.

Under an emergency order issued by the province a week ago hospitals now have the authority to redeploy staff from their regular jobs into such areas as intensive care, which will very soon be stressed by the looming wave of critically sick patients.

Hospitals are currently in the process of making redeployment plans.

The Quick ICU Training guide was created in response to requests for educational resources from physicians, trainee doctors, nurses, respirologists and other health professionals who work in units of hospitals other than intensive care, explained Dr. Jenna Spring, a clinical associate in critical care medicine at U of T and Sunnybrook Health Sciences Centre, and a CCEPP team member.

They are stepping up in this desperate time of need, coming from such areas as oncology, the operating room, internal medicine and geriatrics.

“Colleagues are realizing they are going to be on the front lines taking care of very sick patients and they want to try to prepare,” she said.

The opening of the guide explains that health-care systems around the world “are becoming stretched and sometimes failing” because of the huge increase in critically ill patients.

Ontario’s hospitals are responding like those in other jurisdictions by reinforcing the ranks in critical care.

“Ideally, (reinforcements) will be under the direct supervision of a critical-care physician or nurse, but foreseeing situations where direct supervision may not be available, having guidance for making decisions about management, care, and triage outside of one’s normal professional and entrusted activities is advised,” the guide reads.

Ontario’s health-care regulatory colleges have relaxed their rules during the pandemic so that health-care professionals can work outside of their “scopes of practice” or specialties.

The scopes of practice dictate the kind of work that health-care professionals can do, based largely upon years of specialized education and training. Regulatory colleges are known to take severe action against health professionals who dare practise outside them.

That such regulations have been temporarily suspended speaks to the drastic measures required to combat the rapidly advancing virus.

It also explains why a doctor who has devoted her career to providing health care to older patients could suddenly find herself working in intensive care.

But Wong says she’s up to the challenge, daunting as it is.

“I can’t imagine any front-line worker not being worried,” she said in reference to the many health-care professionals who have become seriously ill or even perished after contracting the virus, mostly due to a shortage of protective equipment such as masks.

“Focus on what you can control,” she continued, sharing her approach to dealing with the fear.

It’s with that attitude that she has embraced the Quick ICU Training guide. She has already familiarized herself with the content.

“Being able to remember everything is a bit unrealistic, but if I need to access the information I know it exists,” she said.

“We have it in our back pockets. We know which pocket it is in and we can reach for it if we need it.”

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In fact, the guide actually does contain “pocket cards,” essentially cheat sheets that clinicians can print out and carry with them, post on a wall or access easily on a cellphone.

Broad topics covered include: airway, breathing, circulation, disability/sedation, environment and PPE (personal protective equipment), and general ICU care.

There are short lectures and narrated slide presentations on subjects such as basic airway management, how to assist during intubation and managing acute respiratory distress syndrome.

There are videos on procedures such as inserting a chest tube or intubating a patient while protecting yourself from infectious respiratory droplets.

And there are links to resources such as clinical guidelines and medical literature.

The guide has been circulating online for less than a week and the response has been “really overwhelmingly positive,” said another of its developers, Stella Ng, director of research and Arrell Family Chair in Health Professions Teaching at U of T’s Centre for Faculty Development, based at St. Michael's Hospital.

While it was created with Ontario’s health-care system in mind, it has been discovered by clinicians around the world, including in Australia, the United Kingdom, South America, Central America and even Tibet.

Ryan Brydges, another core member of the CCEPP team, said some local non-ICU physicians have taken to pulling out old medical school textbooks to refresh their memories and brush up on rusty skills.

“This website has a lot of information for them so they don’t have to worry about going out and finding it,” said Brydges, an associate professor in the Department of Medicine and Institute of Health Policy, Management and Evaluation at U of T. “It’s a confidence and comfort tool.”

The website is a work-in-progress, said CCEPP team member Dr. Brian Cuthbertson.

A critical care physician himself, Cuthbertson said he leaned on peers at hospitals throughout the city to participate in its creation. He asked them to narrate online lectures and share slide presentations and videos.

“There has been such a high degree of altruism. So many people have come forward to help out, even after spending busy days working in intensive care,” he said.

When a reporter remarked that it must feel good to be making such an important contribution, Cuthbertson bristled.

“There is no hero in this. None of us is interested in credit here,” he said. “This is just a lot of people trying to do something that will hopefully help and maybe even save lives in a tragic situation.”

When Wong forwarded the guide to her followers on social media, it landed in the Twitter feed of fellow geriatrician Dr. Eric Wong (no relation).

The last time he cared for critically ill patients in the ICU was four years ago when he was a resident on rotation.

“Although I sometimes consult on patients in the ICU, I haven’t spent a lot of time there for a few years. So this is a very helpful resource to me,” he said.

“This is going to help us be ready for whatever comes our way.”