Australian ambulance service puts restrictions on intubation, nebulizers

New South Wales Ambulance has reportedly instructed its crews to avoid procedures that put them at risk of COVID-19 exposure


By Laura French

AUSTRALIA — An Australian ambulance service has reportedly placed restrictions on the use of nebulizers and intubation in an effort to reduce crews' exposure to COVID-19. 

New protocols implemented this month at New South Wales (NSW) Ambulance instruct medics to only use nebulizers when there is no alternative to administering medication and to only nebulize outdoors or in a well-ventilated area instead of an ambulance or other confined space, according to Daily Mail Australia. Medics are instructed to give patients hand-held inhalers during transport.

New South Wales Ambulance has reportedly restricted the use of nebulizers and intubation during the COVID-19 pandemic. (Photo/Helitak430 via Wikimedia Commons, CC BY-SA 4.0)
New South Wales Ambulance has reportedly restricted the use of nebulizers and intubation during the COVID-19 pandemic. (Photo/Helitak430 via Wikimedia Commons, CC BY-SA 4.0)

The Daily Mail also reports that endotracheal intubation has been temporarily banned. 

An NSW paramedic told the Daily Mail that needing to nebulize outside of an ambulance is impractical when a patient, such as someone having an asthma attack, needs urgent care. 

A spokeswoman for NSW Ambulance told the Daily Mail that there have been no deaths reported as a result of the new restrictions. 

NSW Ambulance provides ambulance services to the entire state of New South Wales, Australia's most populous state. 

The Australian Department of Health has also released guidelines saying the use of nebulizers should be avoided, and that "care should be taken" during other aerosol-generating procedures such as intubation and CPR.

Read next: Airway management adjustments in the era of COVID-19

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