Category Archives: Covid-19

When working as a first response while covid vaccines are being administered in LTC facilities, are all severe reactions to be considered under the anaphylaxis protocol and be given epi and benadryl as per our current protocol?

I have two questions with regards to the Bronchoconstriction Medical Directive, under the current (February 22nd, 2021) Considerations for Paramedics Managing Patients during the COVID-19 Pandemic. 1) Are we still only administering IM epinephrine to patients who require BVM ventilations? 2) Are we only administering IM epinephrine under this medical directive to patients presenting with a cough? It was previously stated in the January 4th, 2021 update that: "Paramedics should consider administering IM epinephrine for severe respiratory distress with cough in known asthma patients..." I understand that the top of the new memo states: " This memo replaces both the May 6th, 2020 and the January 4th, 2021 considerations documents and memos." Just looking for some clarification on the current practice please. Thank you.

Since COVID supraglottic airways are highly recommended to be placed in a VSA patient prior to CPR. Is this for medical VSAs or does this apply to traumatic as well?

During the pandemic, we have been advised to tape over the suction port on King LTs, and now we are switching to iGels, which also have suction capabilities. Are we to tape over the suction port of iGels as well? Furthermore, if the patient is in need of suction, what are the next steps recommended to safely maintain the airway, as only oral suctioning is recommended? Thank you

Why was an age restriction of 50 years of age placed on utilizing IM epinephrine for the Bronchoconstrictive Medical Directive in the latest update to the COVID-19 Management considerations?

When do I use a BVM and an oral airway? If my patient is unconscious then can I use these airway tools?

In keeping with the Covid-19 Cardiac Arrest algorithms can Midaz procedural sedation be applied to SGA similar to how it is used for ETT maintenance post ROSC should the pt increase gcs during the ROSC?

Hello! Question about using CPAP during this time. I've had a two instances where my patients could've potentially benefitted from the use of CPAP, however they had went into cardiac arrest during transport and ended up pronounced at the hospital. I was wondering what you're thoughts are now, in terms of applying CPAP to a patient who fits all the criteria as long as we wear the right PPE. In our service Level 1(Tyvek Suit, P100, safety goggles, and gloves) is indicated whenever we are to perform an AGMP. Cardiac arrests are one of these scenarios where we utilize the BVM with a HEPA Filter. I was just wondering, since CPAP is withheld do to it being an AGMP why can't we use it to our discretion with a HEPA filter and wearing Level 1 PPE. The concern is obviously depending on where the patient is located and having CPAP on a patient and then transporting across public space to get to the ambulance is a risk for transmission to others. How do you feel during that instance if we just get on High Flow o2 @15L/min and then once in the back of the ambulance with the exhaust on and having Level 1 PPE on to be okay to use CPAP? Also giving the hospital a pre-alert to have a negative pressure room ready. Sometimes 5cm of H2O(which is 8L/min or can be helpful to a patients breathing. Also just to confirm anything greater than 15L/min of oxygen is considered an AGMP, according to the new research?

In current pandemic situation, nebulized epinephrine is being withheld for those with croup. What management is recommended, should the patient (without hx of asthma) deteriorate (apnea/silent chest) ? Is epinephrine IM an acceptable route? If not, what is the rationale?

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.

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