Hello, two questions. 1. If I am bagging for a patient in respiratory distress but they do not have a supraglottic airway in, how would I measure their end tidal? Will just attaching my end tidal to the bvm without that same seal provide an accurate reading? 2. If I am assisting ventilations via BVM for a COPD patient who is in respiratory failure should I be concerned about their SpO2 going up to 100? Our current BVM’s don’t have a way to adjust how oxygen they are getting. I don’t want to make my COPD patients hypercapnic by delivering too much O2.

So, just to be perfectly clear, as I have heard this in a round-about way from a few sources… We are not to use high concentration/High Flow oxygen via a BVM with a VSA patient without inserting an SGA – so when treating a VSA pt, we go directly to the SGA without ever using an OPA or NGA, correct? And what are our options if the SGA fails after 2 attempts and we do not have any extra hands to ensure a tight seal on the BVM mask – do we ventilate at all, or just administer compressions and carry on?

When dealing with a patient who is VSA due to a complete foreign body airway obstruction, what is recommended in regards to ventilations and OPA use (during this COIVD-19 pandemic) since inability to clear the airway is a contraindication of SGA use.

*UPDATED* Question: Regarding the removal of “inability to ventilate” consideration for narcan. In a pt who fails the covid screening, and who has overdosed on opiates, spontaneous resp rate <8, low says. Are we to withhold BVM and apply hi-flo mask at 8L and give narcan? Or use BVM as usual to assist ventilations prior to narcan administration. Its the use of the BVM in this pt that is the question

*UPDATED* Question: A work email came out on April 8 2020 that lists OBHG recommendations. On the list it states to withhold BVM ventilation in all spontaneously breathing patients that do not improve with BLS airway maneuvers and high conc/low flow mask with filter at 10L/min. A site from OBHG on March 20 2020 states to use BVM in patients with a resp rate < 6 or >40 and sats below 85% with oxygen or ETCO2 >50 and increasing by 5 %. I have also read to limit flow rates no higher than 5 L/M on April 8th it mentions 10 L/M. Can you please confirm a change has been made?