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Clarification on oxygen delivery for COVID-19 Patient

Question# 19

I just have a question in regards to oxygen treatment. With the recent memorandum it states that in all cases high flow oxygen delivery should be avoided unless via ETT/SGA. Does this mean we are no longer able to use a BVM for a patient who is severely short of breath when a high concentration/low flow masks with a submicron filter is no longer able to maintain an appropriate 02 saturation level?

Answer:

According to the memorandum released on April 3rd 2020 regarding considerations for Paramedics Managing Patients during the COVID-19 Pandemic, it states to CONSIDER witholding manual ventilation in any spontaneously breathing patient; instead IN ALL CASES where adult patients require high concentration oxygen, use high concentration/low flow masks with a hydrophobic submicron filter. Therefore, you are correct, you should not utilize a BVM despite the 02 saturation levels as this increases the risk of aerosolization of the virus to the Paramedics. Additionally, patients with COVID-19 may not respond to oxygen therapy, and therefore their 02 saturation levels may not increase.

Medical Directive Category

Oxygen Therapy

ALSPCS Version

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623

Please reference the MOST RECENT ALS PCS for updates and changes to these directives.