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A health care worker makes his way into the Emergency department of Vancouver General Hospital, on March 30, 2020.

JONATHAN HAYWARD/The Canadian Press

Emergency doctors have been warned to try to avoid using the limited supply of medications needed for patients on ventilators, as they could be critical in the fight against COVID-19.

Putting a patient on an artificial breathing machine, as happens with people severely sick with COVID-19, usually requires a sedative such as propofol, and painkillers such as fentanyl and morphine.

The Canadian Association of Emergency Physicians wrote a statement to members, warning them of potential shortages of those drugs and their responsibility for conserving them.

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“These medications are increasingly used in the emergency department, in addition to their traditional use in the OR and ICU,” the association wrote. “As such, emergency physicians have some agency with respect to their use and increasing responsibility for their stewardship.”

Propofol and morphine shortages have already been reported to Health Canada by some manufacturers in the last week.

The association warned Canada’s shortage could become critical in weeks.

“This would have significant clinical impact and therefore requires immediate investigation and action,” the association wrote in a statement.

There are fears a shortage of the drugs could aggravate a dreaded scenario in which ICUs are flooded with critical COVID-19 patients.Emergency doctors have been warned to try to safeguard the limited supply by looking for alternative medications and reducing waste.

The group has called on federal and provincial governments to review the existing stock and keep doctors informed.

They also suggest the government needs to manage the national supply of those vital drugs, and create incentives for domestic production to avoid shortages.

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Countries around the world have grappled with drug shortages, as the virus has wrought havoc on manufacturing plants and distribution.

The Public Health Agency of Canada and Procurement Canada are working to secure a steady supply of essential medications, needed for daily use as well as the treatment of COVID-19, the prime minister said Wednesday.

“We have very strong relationships around the world on getting medication and necessary supplies,” Justin Trudeau said.

He said the government is doing everything it can to make sure hospitals and patients have what they need.

The COVID-19 pandemic has transformed emergency rooms and changed the way hospital staff work. Nurses from one hospital in Vancouver reflect on how it's affecting them, their colleagues and the quiet tone of anticipation as they await a possible surge in cases. The Canadian Press

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