The RPPEO's Base Hospital Physicians play a vital role in the delivery of prehospital care in the form of online medical direction.  Though paramedics are able to practice with relative independence, there are occasions where they need to consult a Base Hospital Physician before they can proceed with an intervention.  This usually occurs when a paramedic exhausts his or her offline medical directives (standing orders).  However, there are a small number of "supercontrolled" acts such as trasncutaneous pacing, synchronized cardioversion, and needle thoractostomy that require Base Hospital Physician authorization.

The RPPEO has over 60 Base Hospital Physcians working at two hospitals in eastern Ontario: The Ottawa Hospital (Ottawa) and Hotel Dieu Hospital (Kingston).  These licensed emergency room physicians are available to paramedics by phone 24 hours per day, 365 days per year.  They receive approximately 2,300 patches (medical consultations) from paramedics each year.

In order to ensure that Base Hospital Physcians provide appropriate medical direction, the RPPEO provides each physician with in-person and online training that outlines paramedic scopes of practices and the skillset specific to each of them.  We provide the Base Hospital Physicians with the opportunity to complete "clinical vignettes" (scenarios) based on real-life calls to ensure the direction they provide is appropriate to the situation at hand.