TOTW: Latest Oxygen and Airway Recommendations Summary from May 8th OBHG Memo

Latest Oxygen and Airway Recommendations Summary from May 8th OBHG Memo

 

 

To help highlight the changes in management from the latest OBHG Memo, released May 8th, 2020 Considerations for Paramedics Managing Patients during the COVID-19 Pandemic (here), the following tables for oxygen and airway management have been created by SWORBHP:

*Bold indicates a change May 8, 2020

Oxygen Delivery System Notes
Nasal Prongs MAX 6L/min
High Concentration /Low Flow Use high concentration/low flow masks with a hydrophobic submicron filter

(ex Flow2Max, HiOx. Tavish etc.)

 

Start at 6L/min and increase as necessary to obtain adequate oxygenation

 

Consider using tape at bridge of mask if air leak present

High Concentration/High Flow Avoid oxygen delivery rates of ≥ 16L/min with NRB mask or BVM

 

Use minimal amount of flow required to inflate BVM reservoir bag (~10-12L/min)

CONSIDER donning appropriate PPE for all patients with respiratory symptoms or hypoxemia (Sp02 <92%) in addition to all patients who have a positive screen for COVID-19.

 

Conditions

Bag Valve Mask (BVM) Ventilation Airway Adjunct
Age N/A Age N/A
LOA N/A LOA N/A
HR N/A HR N/A
RR N/A RR N/A
SBP N/A SBP N/A
Other Severe hypoxia (Sp02 <85%) not improving with other therapies

Respiratory arrest

Other Unable to establish an airway through positioning
Supraglottic Airway (1st line advanced airway) Orotracheal Intubation (ACP only) (2nd line advanced airway)
Age N/A Age N/A
LOA GCS = 3 LOA GCS =3
HR N/A HR N/A
RR N/A RR N/A
SBP N/A SBP N/A
Other Patient must be in cardiac arrest. Other Patient must be in cardiac arrest AND

SGA isn’t successful and/or there is airway compromise inhibiting the use of SGA (see contraindications)

CONSIDER donning appropriate PPE for all airway procedures and all cardiac arrests. CONSIDER donning appropriate PPE for all airway procedures and all cardiac arrests.

 

Contraindications

Supraglottic Airway Orotracheal Intubation
Active vomiting N/A
Inability to clear the airway
Airway edema
Stridor
Caustic Ingestion

 

 

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