Category Archives: Covid-19

According to the new SWORBHP protocol release May 8th, 2020, IntraNasal Administration is still prohibited (for pain control in the pediatric population & seizure Control) even though it has been deemed as a “NON AGMP” in said document. 1) Can SWORBHP please re-institute these options since it is no longer an AGMP? 2) Could SWORBHP now consider the addition Midazolam I/N to the combative patient protocol (especially in dealing with the violent post-ictal patient) which would greatly facilitate dealing with these extremely strenuous scenarios while in full Level 1PPE to assists in avoiding PPE breach by venapuncture.

Question: Can SWORBHP or the Ambulance service purchase and own the cell phone used for BHP patches? The could have the same stewardship and sign out process as the controlled drugs. The devices given to us by CACC are an outdated technology from the early 1990's flip phone. We can barely hear to begin with and now with covid PPE its virtually impossible to now. All patches are going to be Patch Failures so what is the point? Can the recording not be done at the hospital end or via the cellphone itself. Relying on CACC to record these conversations and then provide antiquated technology seems counterintuative.

Question: With the lockdown in place and time on our hands can we contract out an application programmer to develop a more user friendly protocol app. We have updated to the current version and it still takes almost 10 minutes each time to no matter the device to load. Not very functional on a time sensitive ACP call. I'm sure there are plenty of software engineer students out there bored not 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?

When dealing with a patient who is VSA due to a complete foreign body airway obstruction, what is recommended in regards to ventilations and OPA use (during this COIVD-19 pandemic) since “inability to clear the airway” is a contraindication of SGA use.

Clarification: all of the info regarding the protocols say "consider", but all of your response say "should not". Why can't BH come out and say do not, at least where other routes of treatment exist? Or maybe a should not with a patch point if you think you have to? There is so much up in the air right now, a little black and white would be nice.

Question: The latest Base Hospital Memorandum from April 6th says we are to withhold suction via an endotracheal or tracheostomy tube unless using a closed system suction unit. Does this mean we are to withhold suction ONLY via endotracheal or tracheostomy tube? Can we suction an airway full of vomit or blood?

In a previous response to a question, it was mentioned that the SGA is an effective way to create a closed system and reduce risk of aerosolization when ventilating. Would it then be reasonable to go directly to the SGA in the setting of VSAs, to further protect all those involved in the resuscitation from possible aerosolization with an OPA/BVM?

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: Regarding the removal of "inability to ventilate" consideration for narcan. In a pt who fails the covid screening, and who has overdosed on opiates, spontaneous resp rate <8, low says. Are we to withhold BVM and apply hi-flo mask at 8L and give narcan? Or use BVM as usual to assist ventilations prior to narcan administration. Its the use of the BVM in this pt that is the question

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