COVID-19 Best
practice messages

Saskatchewan Polytechnic and the Saskatoon Institute for Medical Simulation (SIMS), have worked with Luxsonic Technologies Inc. to develop several videos discussing some of the situations EMR and Paramedics may face during the COVID-19 pandemic.

These videos are for information only and are not mandatory viewing for our members.

As this situation is rapidly evolving, EMRs and Paramedics should follow the direction of the either the Saskatchewan Health Authority (SHA) or the Athabasca Health Authority (AHA). All members should follow the direction of their employer if any discrepancy exists between information in these videos and the directions from either the SHA or AHA.

1: Introduction & Disclaimer

• Screening Tool and precautions for COVID-19
• Recommendations for Donning and Doffing PPE for both airborne and droplet precautions
• AGMPs – Aerosol Generating Medical Procedures – what are they, how to be addressed in the Pre-Hospital setting and special considerations
• Airway concerns for COVID-19
• Assessments, Treatment modalities and change of paths for COVID-19
• Pandemic Screening Algorithm – Saskatchewan.ca/coronavirus

Videos can be viewed on this page, or go here to watch in immersive 360 Video​ »

2: Case Study One

• Case Study One focuses on an EMS trauma patient involved in an MVC; 30-40 away from a trauma center. Pt is presenting with Head injury type symptoms with airway compromise. Intubation is being considered. The case study focuses on the communication strategies between EMS and the receiving hospital. The following concepts are discussed:
• If you cannot prove COVID-19 negative, you need to assume the pt is positive when dealing with the airway.
• AGMPs – Arersol Generating Medical Procedures – Anything that requires greater than 6L/min through a nasal canal should be considered an AGMP
• Intubation with minimal assistance and rationale for it
• Postprocedural doffing

Videos can be viewed on this page, or go here to watch in immersive 360 Video »

3: Case Study Two

• Case Study Two focuses on an 82 yr/old patient in a long term care facility or personal residence. The patient presents with COPD exacerbation and a lower respiratory infection. The following concepts are  discussed:
• Considerations with pre-arrival information; patient has screened COVID-19 positive
• Assessments and Equipment distances
• PPE for AGMPs
• Change of views on CPAP and safety for EMS
• MDIs vs Nebs
• CPAP and NEBS – what do we do when they are required in the prehospital setting
• Principals of best practice and care
• BVM with airway adjuncts; PEEP; FIO2
• Intubation and benefits
• Hypotension, Hypoxia, Ventilation Strategies Hypotension-  Maintaining MAP while watching for ARDS; Pressors, Pocket Pressors
• Hypoxia – PEEP and safe conditions
• Ventilation Strategies  – MAP, SPO2, Treatments with ARDS, Tidal Volumes

Videos can be viewed on this page, or go here to watch in immersive 360 Video »

4: Case Study Three

• Case Study Three focuses on a continuation of Case Study 2 where the deterioration of the patient has been noted and the patient has progressed to cardiac arrest. The following concepts are discussed:
• Going against the instinct to “jump in”
• Taking the appropriate time and precautions for PPE
• Summation and Outro
• Access to information on Saskatchewan.ca
• Airborne and droplet precautions
• Mindshift-  assume COVID-19 positive until proven negative
• Significance of AGMPs (Areosal Generating Medical Procedures)
• Keeping yourself and your families safe

Videos can be viewed on this page, or go here to watch in immersive 360 Video »

5: Key resuscitation concepts

• Reviews of three important concepts when resuscitating patients: Hypotension, hypoxemia, and ventilation strategies

6: Vasopressors

• Push pressors and pocket pressors (example on how to draw up)

7: Optimal BVM techniques for COVID pts

• Brief overview of bag mask seal, ventilating, and preoxygenation techniques for the COVID-19 positive patient

8: Evaluating need for PPE

• How EMS can evaluate the need for appropriate personal protective equipment in a simulated scenario

9: Scenario EMS arrival

• Scenario describing first steps taken when arriving at cardiac arrest patient

10: Intubating from an EMS perspective

• A brief overview of when and why we may have to intubate a suspected COVID-19 patient safely in the EMS environment