Date Published

March 23, 2020

Updated For

ALS PCS Version 5.2


The OBHG MAC recently released a memo to provide considerations for paramedics regarding the application of medical directives when managing patients who “screens positive” for possible COVID-19 exposure. . Update:

As of Oct, 2021, the latest OBHG recommendation allows for Paramedics to utilize clinical judgement when rendering treatments that were previously restricted. The intent of this wording is to allow you to use your clinical judgement as to whether or not to provide standard BLS/ALS PCS treatment or continue to utilize treatment as outlined within this Considerations Document. If you choose to utilize IM Epinephrine for severe respiratory distress, under the Considerations:

IM Epi is ONLY considered for patients with severe respiratory distress with cough when ALL 3 of the following are met:

1. Patient meets the Indications of the Bronchoconstriction Medical Directive (Respiratory distress; AND Suspected bronchoconstriction).

2. Has a history of asthma

3. Age: patient is < 50 years-old


In these cases, the patient may or may not meet the need for BVM as outlined in the memo (RR ≥ 40 OR ≤ 6 with SpO2 < 85% despite oxygen administration)

The reason for the changes to certain treatment considerations in this distinct population is to reduce the risk of transmission via aerosolization of the virus with nebulization of salbutamol, BVM, CPAP and/or intubation.

Link to OBHG Paramedic 2019-nCoV Treatment Considerations Memo

Link to ALS-PCS v4.6.1


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