Date Published

March 27, 2020

Updated For

ALS PCS Version ALS PCS Version 5.2

Question:

1)In regards to the bronchoconstriction medical directive with the indication to give epinephrine (severe respiratory distress and cough, with or without BVM, and hx of asthma), does this only apply to patients who screen COVID- POSITIVE? or all patients. 2) Does the new indications for BVM (RR <6 or <40 and SPO2 less than 85% on oxygen) only apply to COVID POSITIVE patients? 3) All other "IN ALL CASES" for medications sent out by SWORBHP (ex. no CPAP, no neb Ventolin, no suctioning) does this only apply to patients screen POSITIVE? OR ALL patients (even if they don't screen positive).

Answer:

1) Since the updated March 20th 2020 release of the OBHG Considerations for Paramedics Managing Patients with Possible COVID-19 (here), the considerations for these directives now apply to all patients with signs of respiratory distress instead of those who screen COVID-POSITIVE (as was the case after the release of the Feb 5, 2020 OBHG memo release).

2) Similar to above, the new considerations for these directives, including the indications for BVM, now apply to all patients with signs of respiratory distress.

3) Since CPAP, Salbutamol nebs and suctioning of an endotracheal or tracheostomy tube (that is not a closed system unit) are used in patients who are in respiratory distress and the considerations now apply to all patients with signs of respiratory distress, they should not be utilized.

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