Date Published
April 16, 2020
Updated For
ALS PCS Version ALS PCS Version 5.2
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?
Answer:
Happy to confirm that the recommendations have changed. The one thing that is consistent in this pandemic is constant change as we learn more about the virus, in order to best protect you and the community.
The most recent OBHG recommendations can be found here, on the SWORBHP website. All recommended practice changes are made available on our website for you.
The current recommendations from the April 6th memo regarding oxygen administration are summarized here. Keep an eye out for a TOTW coming out soon with a summary of the latest recommendations for oxygen administration and airway procedures.
| Oxygen Delivery System | Notes |
| Nasal Prongs | Maximum 5L/min |
| High concentration /Low Flow | Use high concentration/low flow masks with a hydrophobic submicron filter
(ex Flow2Max, HiOx) Do not exceed 6L/min Consider using tape at bridge of mask if air leak present |
| High concentration/High Flow | Do not use NRB Masks
Only use if SGA or ETT inserted for patients in cardiac arrest Use minimal amount of flow to inflate BVM reservoir bag (~10-12L/min) |
| CONSIDER donning appropriate PPE for all patients with respiratory symptoms or hypoxemia (Sp02 <92%) | |
Addendum:
As of May 8, 2020, the latest release of the OBHG Treatment Considerations memo (here) have made updated recommendations to oxygen administration and airway procedures. For a summary of these recommendations, please see our TOTW (here).
Categories
Keywords
BVM, Coronavirus, COVID-19
Additional Resources
No additional resources are available for this SWORBHP Tip.
