Category: Other

COVID considerations - Aerosol Generating Medical Procedures (AGMPs)

Question#: 535


With regards to COVID 19. Most Paramedics have received both dosages of the vaccine. Case numbers are decreasing. When are we going to be allowed to administer nebulized salbutamol and CPAP? Especially since most CPAP systems used by EMS are closed and we are wearing PPE as a policy.


The considerations document is targeting minimization of risk to the paramedics of COVID-19 transmission through an AGMP such as CPAP and nebulization. There are two factors present: 1) withholding nebulized medications/CPAP are considered to minimize the exposure of COVID-19 on paramedics, 2) the COVID considerations document allows for paramedics to use judgment in assessing if the patient need outweighs the risk to the paramedics.

Based on the risk (COVID-19 transmission risk), and risk mitigation strategy (PPE, vaccination status, treatment in ventilated area, etc.) the paramedics can use judgment in determining if their risk is outweighed by the patient need (or risk of withholding treatment).

In addition, the MAC has been reviewing the COVID considerations document and provincial direction. A new document came out on Oct 19, 2021 with updated information and recommendations on AGMPs that you can find here:

RPPEO encourages the paramedics to assess and document their risk assessment on exposure vs patient need. Note that you can also consult with a Base Hospital Physician and decide together what the best course of action would be for your patient.

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