Version 5.1 of the Advanced Life Support Patient Care Standards (ALS PCS) is now in effect.
The Ministry of Health has amended version 5.0 of the ALS PCS to include 3 new treat and discharge auxiliary medical directives as well as to integrate minor edits. ALS PCS version 5.1 is in force, replacing the previously circulated version 5.0 of the ALS PCS. Support materials related to ALS PCS 5.0 are applicable to 5.1.
The revisions to these Standards include changes to paramedic clinical practice. The Ontario Base Hospital Group (OBHG) Education Subcommittee has prepared a support document that discusses these practice changes.
The Ontario Ministry of Health has not yet announced the release of ALS PCS v.5.4.
While the update was originally expected to take effect in February 2025, the release timeline remains uncertain. Until ALS PCS v.5.4 is formally published, paramedics should continue to follow the current ALS PCS v.5.3 directives.
The Ministry of Health has issued a revised version of the Advanced Life Support Patient Care Standards (ALS PCS). Version 5.2.1 came into force on January 10, 2024.
ALS PCS v5.2.1 corrected the adult doses for atropine and the pediatric doses for pralidoxime in both the PCP and ACP Nerve Agent Exposure Medical Directives.
The Ministry of Health has issued a revised version of the Advanced Life Support Patient Care Standards (ALS PCS). Version 5.3 came into force on February 9, 2024.
ALS PCS v5.3 added intranasal glucagon to the Hypoglycemia Medical Directives for trained and authorized paramedics.
The Ministry of Health has released ALS PCS version 5.4, which will come into force on Monday, June 2, 2025. This update includes meaningful changes to both core and auxiliary medical directives that impact clinical practice across the region.
What’s New
ALS PCS v5.4 includes:
Revised core directives such as analgesia, nausea/vomiting, and cardiac arrest
New core directives for advanced airway and tracheostomy suctioning
Optional auxiliary directives, including:
Tranexamic Acid (TXA)
Lateral patellar dislocation reduction
Valsalva manoeuvre
Ondansetron IV/IM
Double Sequential External Defibrillation (DSED)* (*Paramedics who participated in the Research Study are the only ones currently trained and authorized for DSED. Service implementation may vary.)
The Companion Document provides helpful clinical context and should be reviewed alongside the directives themselves. The Ontario Base Hospital Group Education Subcommittee has also provided this usefulImplementation Memodetailing important changes.
The Education Subcommittee in collaboration with Regional Medical Directors has also produced aVideo Intro to ALS PCS v5.4that provides rationale and details on the updates.
What You Should Do
Paramedics
Paramedics are encouraged to review ALS PCS v5.4 carefully and become familiar with the updates before the in-force date. Training has been provided on the revised core directives, and implementation of auxiliary directives may differ between services. Please speak with your service leadership about which optional directives will apply to your practice.
Paramedic Services
RPPEO has prepared Frequently Asked Questions about the implementation of ALS PCS v.5.4. The guidance helps paramedic services identify impacts of this new standard.
Immediate practice-related changes are limited and include updates to 2 core medical directives (Opioid Toxicity and Withdrawal Medical Directive and Nausea/Vomiting Medical Directive). Paramedics will find changes to auxiliary medical directives within the Chemical Exposure directives and the Special Event directives.
A new clinical app is on its way! Here are the details:
The Ontario Base Hospital Group is pleased to inform you that a new clinical app for Ontario paramedics is coming!
All new app, all new name
In anticipation of creating a new app, we distributed a survey this spring about the naming of a new app. Thank you for completing our survey. We received lots of great suggestions for the new clinical app!
Spring 2022 CME features live events and online content
Spring 2022 CME is a two-part offering again this year, with both virtual workshops for live participation or recorded viewing and online learning modules.
Two optional live virtual workshops are coming to Spring 2022 CME's core learning for RPPEO-certified ACPs! PCPs are also invited to participate in the live or recorded CME events.
The Regional Paramedic Program for Eastern Ontario is pleased to launch Spring 2023 CME's online learning component on Monday, March 27, 2023.
In Spring 2023 CME, RPPEO presents "Discharge from Care," provincially developed training about out of hospital treat and discharge. This is the training that paramedics require to receive authorization to apply the new auxiliary medical directive options in the Advanced Life Support Patient Care Standards (ALS PCS) version 5.1 for patient discharge planning.
The Online Medical Consultation (OMC) service is supporting paramedicine in our region with real-time physician consultation for paramedics during patient care. To further enhance the use of this critical service, we are thrilled to announce the launch of the OMC YouTube Channel.
This dedicated platform features the OMC Video Series, designed to empower paramedics and Base Hospital Physicians with practical insights, actionable tips, and tools for optimizing OMC consultations. Whether you're navigating complex cases, refining communication during consultations, or staying updated on best practices, these videos are tailored to meet your needs.
The Online Medical Consultation (OMC) service is supporting paramedicine in our region with real-time physician consultation for paramedics during patient care. To further enhance the use of this critical service, we are thrilled to announce the launch of the OMC YouTube Channel.