Question: hello, in regards to COVID 19, are paramedics using surgical masks or N-95 when applying Flo2max? will it depend if our patient is screened negative or positive or pending? I understand in AGMP's we are to use N-95. it is my understanding that Flo2max is a high concentration/ low flow mask system. a second question, would you advise to proceed with applying flo2max rather than NRB masks on all patients who are FREI positive and/or Covid 19 screened positive?

1^st question:

Given the first part of your question is a BLS issue, we would suggest you review the latest Emergency Health Regulatory and Accountability Branch MOH Training Bulletin Novel Coronavirus (COVID-19) to find your answer.  The latest version at the time of this question can be found here: 03/31/2020: UPDATED Training Bulletin - Novel Coronavirus v1.4. We also suggest reviewing your Paramedic Service policy.

You are correct; the Flo2Max is a high concentration low flow mask that has a hydrophobic submicron filter, thereby reducing the risk of exposure.  You are correct that AGMPs require N-95 mask.  If the oxygen flow is <6L/min, it is not considered an AGMP and a surgical mask with protective eyewear or shield (along with other appropriate PPE) is all that is required.  Flow of 6L/min or higher, is considered high flow and therefore is considered an AGMP.  This is why per the latest OBHG Memo, approved by the MOHLTC Apr 6th (here) states that IN ALL CASES high flow oxygen delivery should be avoided (unless via ETT/SGA) and note the memo also states, that these advanced airways are for those patients in cardiac arrest.

2^nd question:

Per the latest OBHG Memo April 6th, oxygen can be delivered by nasal prongs up to 5L/minute.  If the patient requires higher concentration oxygen, use a high concentration/low flow mask with a hydrophobic submicron filter.  The same goes for pediatric patients (if the high concentration/low flow mask is carried by your service).

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AGMP, COVID-19

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