Question: Good afternoon. I just have a question regarding a VSA patient scenario. If the patient has a pulse with an SGA inserted (patient tolerates SGA) to give ventilations, how many ventilations would I give? 1 every 10 seconds or 1 every 5-6 seconds? And do I also wear an N95 mask?

For your first question, per the AHA guidelines, If an advanced airway is in place, it may be reasonable for the provider to deliver 1 breath every 6 s (10 breaths/min) while continuous chest compressions are being performed. From an evidence standpoint, there has been 1 observational human study and 10 animal studies comparing different ventilation rates after advanced airway placement.  No clear benefit from a rate of 10 was identified, but no other rate was found to be superior.

For your second question, per the latest OBHG MAC Considerations for Paramedics Managing Patients during the COVID-19 Pandemic (here): Airborne precautions are indicated for AGMPs.  SGA insertion is considered an AGMP.  Therefore, in the scenario that you describe, an N95 should be worn.  For all other PPE queries, per the Considerations, Paramedics should follow the guidance of their service for infection prevention and control policies and procedures for personal protective equipment and post-intervention cleaning or decontamination.

Panchal AR et al. Part 3: Adult basic and advanced life support: 2020 American Heart Association guidelines for cardiopulmonary resuscitation and emergency cardiovascular care.  2020. Circulation: 142(16):S366-S468.

Airway/Breathing,Cardiac/Circulation,Medical Cardiac Arrest,Supraglottic Airway

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