Category Archives: BLS Patient Care Standards

What exactly are the oxygen flow rates per mask? I was given a different answer (specifically for a NRB) as a working medic than my friend who is in school

So, just to be perfectly clear, as I have heard this in a round-about way from a few sources... We are not to use high concentration/High Flow oxygen via a BVM with a VSA patient without inserting an SGA - so when treating a VSA pt, we go directly to the SGA without ever using an OPA or NGA, correct? And what are our options if the SGA fails after 2 attempts and we do not have any extra hands to ensure a tight seal on the BVM mask - do we ventilate at all, or just administer compressions and carry on?

Questions regarding intubation. Should we be opting for aggressive airway management with intubation or SGA on VSA patients as well as severely obtunded non-asthmatic patients where patient presentation would allow? Should this take precedence over ACLS drugs during cardiac arrest? When intubated with inline filter in place are we permitted to BVM an normal rate?

*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?

Question: With the new recommendations for oxygen during the pandemic, I’m a bit confused as to what to do if my patient needs >5L NP?

Question: hello, in regards to COVID 19, are paramedics using surgical masks or N-95 when applying Flo2max? will it depend if our patient is screened negative or positive or pending? I understand in AGMP's we are to use N-95. it is my understanding that Flo2max is a high concentration/ low flow mask system. a second question, would you advise to proceed with applying flo2max rather than NRB masks on all patients who are FREI positive and/or Covid 19 screened positive?

In light of the COVID 19 crisis occurring and recent posting from the service about the use of the NRB in patients that are experiencing FREI symptoms and potential exposure to COVID 19 with low O2 sats and difficulty breathing, would the paramedics be supported by the Base Hospital if the patient only received a nasal cannula application at max flow rate of 6 lpm or if they were to use high concentration-low flow masks (Hi-OX, FloO2 system).

The ALS PCS 4.5 STEMI directive follows the BLS V3.0.1 criteria and no longer has a pulse rate of <50 as a contraindication for bypass. Does this mean a bradycardic patient with a pulse in the 40’s can now be transported on a STEMI bypass? In the past medics where taught differing regions would have slightly different STEMI receiving acceptance criteria. Are there any considerations we as medics should consider for STEMI receiving hospitals in our governing region?

Are there any tools that we can use to differentiate Bell’s palsy from a CVA to prevent us from an unnecessary stroke bypass?

Question: In regards to the new BLS 3.0.1 under the paramedic prompt card for acute stroke protocol contraindications, it clearly states CTAS 2 and/or uncorrected airway, breathing or circulatory problem. My question in regards to this contraindication is does this automatically make a patient a CTAS level 1 when they are presenting with all signs and symptoms of a stroke and meet stroke protocol or does this mean that any other issues (i.e. chest pain making them a CTAS 2) puts them out of stroke protocol?

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