Date Published
May 11, 2020
Updated For
ALS PCS Version 5.2
#SWORBHPTips
To help highlight the changes in management from the latest OBHG Memo, released May 8th, 2020 Considerations for Paramedics Managing Patients during the COVID-19 Pandemic (here), the following tables for oxygen and airway management have been created by SWORBHP:
*Bold indicates a change May 8, 2020
| Oxygen Delivery System | Notes |
| Nasal Prongs | MAX 6L/min |
| High Concentration /Low Flow | Use high concentration/low flow masks with a hydrophobic submicron filter
(ex Flow2Max, HiOx. Tavish etc.)
Start at 6L/min and increase as necessary to obtain adequate oxygenation
Consider using tape at bridge of mask if air leak present |
| High Concentration/High Flow | Avoid oxygen delivery rates of ≥ 16L/min with NRB mask or BVM
Use minimal amount of flow required to inflate BVM reservoir bag (~10-12L/min) |
| CONSIDER donning appropriate PPE for all patients with respiratory symptoms or hypoxemia (Sp02 <92%) in addition to all patients who have a positive screen for COVID-19. | |
Conditions
| Bag Valve Mask (BVM) Ventilation | Airway Adjunct | |||
| Age | N/A | Age | N/A | |
| LOA | N/A | LOA | N/A | |
| HR | N/A | HR | N/A | |
| RR | N/A | RR | N/A | |
| SBP | N/A | SBP | N/A | |
| Other | Severe hypoxia (Sp02 <85%) not improving with other therapies
Respiratory arrest |
Other | Unable to establish an airway through positioning | |
| Supraglottic Airway (1st line advanced airway) | Orotracheal Intubation (ACP only) (2nd line advanced airway) | |||
| Age | N/A | Age | N/A | |
| LOA | GCS = 3 | LOA | GCS =3 | |
| HR | N/A | HR | N/A | |
| RR | N/A | RR | N/A | |
| SBP | N/A | SBP | N/A | |
| Other | Patient must be in cardiac arrest. | Other | Patient must be in cardiac arrest AND
SGA isn’t successful and/or there is airway compromise inhibiting the use of SGA (see contraindications) |
|
| CONSIDER donning appropriate PPE for all airway procedures and all cardiac arrests. | CONSIDER donning appropriate PPE for all airway procedures and all cardiac arrests. | |||
Contraindications
| Supraglottic Airway | Orotracheal Intubation | |
| Active vomiting | N/A | |
| Inability to clear the airway | ||
| Airway edema | ||
| Stridor | ||
| Caustic Ingestion |
Categories
Additional Resources:
No additional resources available for this #SWORBHPTip.
