Are we still withholding EPI in bronchoconstriction for greater than 50 year old patients? It’s not in the protocols to but I remember the memo from Feb 2021 saying to withhold it.

Why do the pandemic guidelines allow for the administration of 2 doses of epinephrine (<50y) in bronchoconstriction (asthma exacerbation) vs the ALS PCS allowing only a single dose (without age guideline)?

Can we just wear a surgical mask and goggles for all AGMPS and optional gown if we want to? Shouldn’t there be an update for our PPE as well and not just our screening tool, now that we know a little bit more about COVID? Thank you!

When working as a first response while covid vaccines are being administered in LTC facilities, are all severe reactions to be considered under the anaphylaxis protocol and be given epi and benadryl as per our current protocol?

Since COVID supraglottic airways are highly recommended to be placed in a VSA patient prior to CPR. Is this for medical VSAs or does this apply to traumatic as well?

During the pandemic, we have been advised to tape over the suction port on King LTs, and now we are switching to iGels, which also have suction capabilities. Are we to tape over the suction port of iGels as well? Furthermore, if the patient is in need of suction, what are the next steps recommended to safely maintain the airway, as only oral suctioning is recommended? Thank you

If you arrive to a patient who is circling the drain very low heart rate respirations are almost none due to opioid overdose and you take a bgl and it comes back no hypoglycemia would you be wrong to administer naloxone before obtaining a full set of vitals and hooking up the cardiac monitor due to the condition of the patient. (covid times so it meets an inability to adequately ventilate).

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.

Questions regarding intubation. Should we be opting for aggressive airway management with intubation or SGA on VSA patients as well as severely obtunded non-asthmatic patients where patient presentation would allow? Should this take precedence over ACLS drugs during cardiac arrest? When intubated with inline filter in place are we permitted to BVM an normal rate?

*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

Question: The latest Memo regarding oxygen delivery states “IN ALL CASES where adult patients require high concentration oxygen, use high-concentration/low flow masks with a hydrophobic submicron filter” and then later reads that high concentration oxygen be avoided unless SGA. The instructions for the FLO2MAX mask our service carries instructs you to set the oxygen flow-meter to 15lpm, or to level prescribed by a physician. What do you recommend we set the flow meter at if we use these masks?

Question: What is the best method to cover the King LT suction port? You mentioned this practice during your 2nd podcast.

*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?

Question: With the new recommendations for oxygen during the pandemic, Im a bit confused as to what to do if my patient needs >5L NP?

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?

Two questions First: Piggbacking on the question regarding nasal cannula vs NRM. Should the service be equipped with a filtered NRM is there a BETTER option between the filtered NRM or low flow nasal cannula. Keeping in mind that the filtered NRM fits large on many pt’s faces and isn’t like CPAP where a good seal is provided. Second: Is high flow oxygen considered aerosol generating where we should be wearing an N95 when providing or no? Thanks!