Date Published

March 17, 2020

Updated For

ALS PCS Version ALS PCS Version 5.2


I am seeing information from sources I trust discouraging the use of BVMs (even with filters) and BIPAP for suspected COVID-19 patients with respiratory distress (due to the danger of aerosolizing the virus). NRB use (also not ideal) with early (Safe) intubation (no pre oxygenation with BVM) is encouraged. the last update from SWORBP stated that CPAP should be avoided with suspected Corona virus patients (Im assuming for the same reason), but continuing to advocate for assisted ventilations. Any update on BVM use?


 You are correct that all of these updates are to help prevent spread of the virus and to protect those on the frontlines.

With regards to Assisted Ventilation and suspected patients with COVID-19, the Feb 5, 2020 OBHG Memo Considerations for Paramedics Managing Patients with Possible Novel Coronavirus, outlines when BVM should be utilized.

Specifically for BVM the Indications are:,

RR‰¥40 OR <6 breaths per minute AND (a) Sp02 <85% (with oxygen administration) OR (b) EtC02 ‰¥50mmHg (if available) AND EtC02 increases by a further 5mmHg (if available)

With Conditions for BVM Ventilation including: RR ‰¥40 OR <6

These changes restrict the use of BVM to those with impending respiratory failure. Please don and doff all PPE as per your Service training and policy to keep yourselves as safe as possible.

As you are witnessing, this is an ever-evolving situation. We will be sure to distribute any updates to care as any further changes are made.



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