Congratulations to our Director Penny Price voted by EMS1.com as the 10th most influential woman in EMS internationally.

Congratulations Justin and Sandra for amazing efforts. You have both have touch so many lives and saved numerous! Your efforts will go down in history!!
Great work I am honoured to know both of you.

Dr. Mike Austin, MD

As part of our ongoing work to strengthen medication stewardship and controlled substances oversight, RPPEO has completed a review and revision of several internal policies. While most changes were administrative or formatting in nature, we made one substantive revision that may affect clinical work:

CLI 120 – Ordering and Managing Controlled Substances

The updated policy now includes the following clarifications:

• Expanded Scope: The policy explicitly applies to RPPEO staff, paramedic services, and certified paramedics.
• Authorized Use: Medications prescribed by the RPPEO Medical Director may only be used for their intended clinical purpose and patient, as aligned with Ministry of Health standards for emergency ambulance services, as defined in the Ambulance Act, R.S.O. 1990, c. A.19, such as the Advanced Life Support Patient Care Standards and approved Patient Care Model Standards. Any other use must be authorized through direct consultation with a Base Hospital Physician.

These changes are part of a broader RPPEO Action Plan on Controlled Substances Oversight. The plan reflects our commitment to support safe, appropriate, and transparent medication practices, and will include further improvements to processes, education, and documentation over the coming months.

We encourage all RPPEO-certified paramedics to review the revised CLI 120 policy, which is available on the RPPEO website.

If you have any questions or feedback, please contact us at quality@RPPEO.ca.

Click to download a copy of the RPPEO Memo on CLI 120 Revision. 

An official announcement has been made, the RPPEO has won the Power of a System award in Patient Safety Education from the Canadian Patient Safety Institute

​The Innovations in Patient Safety Education (IPSE) Awards recognize organizations, groups and individuals that demonstrate exemplary practices in patient safety and quality improvement using the Patient Safety Education Program – Canada (PSEP – Canada). Patient safety trainers from healthcare organizations across the country are eligible for awards in three categories: the Power of One, the Power of an Organization and the Power of a System.

RPPEO paramedics are invited to attend a live online discussion about the landmark "DOSE VF" study on October 6, 2023 at 10am. Register now for this event!

The RPPEO has rescinded Medical Advisory 2012-006 "Drug Shortage: Atropine preload."

With the coming into effect of the Advanced Life Support Patient Care Standards version 4.9 on February 1, 2022, the Symptomatic Bradycardia Medical Directive now indicates an IV atropine dose of 1mg. This dose may be repeated twice.

Paramedics should provide treatment consistent with this directive.

The Regional Paramedic Program for Eastern Ontario today rescinded Medical Advisory 2023-02 entitled, "DimenHYDRINATE (Gravol) for Patients 65 and Older."

Paramedics should now follow guidance provided by the Ministry of Health on consideration and use of dimenHYDRINATE when ondansetron is not available.

The Regional Paramedic Program for Eastern Ontario (RPPEO) has released a Clinical Bulletin on Measles Management, developed in response to the 2025 Ontario measles outbreak.

This Clinical Bulletin reflects collaboration with paramedic services across Eastern Ontario, with particular thanks to the Ottawa Paramedic Service for providing valuable feedback on infection control and transport practices.

Measles is a highly infectious disease transmitted in the air. 

The bulletin focuses on core best practices in suspected measles, including:

• Early recognition and patient masking
• Use of appropriate airborne precautions PPE, as outlined by your paramedic service
• Timely and effective hospital notification to minimize system disruption
• Operational reminders about running the ambulance’s internal exhaust system during and after transport, in outdoor areas only

These elements are recommended for any scenario where airborne transmission of infectious disease, such as measles, is suspected. 

Reminder on Infection control

Paramedics should be familiar with your paramedic service's policies and procedures on infection control. These are developed in consultation with provincial guidance including:

• Public Health Ontario – Routine Practices and Additional Precautions

• Ontario Ministry of Health – Patient Care and Transportation Standards (PDF)

Routine Practices

Routine Practices are the standard infection prevention and control measures applied to all patient care, regardless of suspected or confirmed infection status. They include:

• Hand Hygiene: Perform before and after patient contact, after contact with potentially contaminated surfaces, and after removing gloves.

• Personal Protective Equipment (PPE): Based on a point-of-care risk assessment, select appropriate PPE to prevent exposure to blood, body fluids, secretions, excretions, mucous membranes, non-intact skin, or contaminated equipment. This may include gloves, gowns, masks, and eye protection.

• Environmental Controls: Implement measures such as proper cleaning and disinfection of equipment and surfaces, safe handling of sharps and waste, and appropriate patient placement.

• Administrative Controls: Ensure policies and procedures are in place for infection prevention and control, staff education, and monitoring compliance.

Airborne Precautions

Airborne Precautions are additional measures used for patients known or suspected to be infected with pathogens transmitted by the airborne route (e.g., measles, tuberculosis). They include:

• N95 Respirator: Wear a fit-tested, seal-checked N95 respirator when entering the patient care area.

• Patient Placement: Place the patient in an enclosed room with the door closed. Hospitals may place patients in an airborne infection isolation room (AIIR), if available.

• Patient Transport: Limit patient movement outside a defined space. If transport is necessary, have the patient wear a surgical mask to minimize dispersal of infectious droplets. Inform the receiving hospital of the incoming patient suspected to have infectious disease (i.e., measles)

• Additional PPE: Depending on the situation and risk assessment, additional PPE such as gloves, gowns, and eye protection may be required.

It is important to note that PPE requirements may vary based on the specific clinical situation and the results of a point-of-care risk assessment. Healthcare providers should always assess the risk of exposure and select appropriate PPE accordingly.

The Clinical Bulletin on Measles Management is now posted in the RPPEO Clinical Bulletin Library and can also be accessed directly here: RPPEO Clinical Bulletin on Measles Management.

Fall 2023 CME for Advanced Care Paramedics launches online October 11, 2023.

The Regional Paramedic Program for Eastern Ontario (RPPEO) has revised several of our policies.

Paramedics and others for whom RPPEO policies provide guidance should note that there are two important updates to policies CLI 180 and CLI 230. Most of the other policies reviewed received minor revisions that do not substantively impact the guidance.

The revised policies and all RPPEO Policies are available in the online Policy Manual. Read on for more detail on the policy updates.