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Medical Directives


In effect: Jul 10, 2023

The purpose of the Advanced Life Support Patient Care Standards (ALS PCS) is to guide the specifics of patient care that are to be undertaken consistent with the scope of practice of the three occupational levels of paramedics.

Update to: Document preamble, Opioid Toxicity Medical Directive, and migration and update of chemical exposure directive to Auxiliary sections. The order of directives has been updated to align with the OBHG books and app.

Patient Care and Transportation Standard Version 2.3 - DOWNLOAD 

ALS PCS 5.2 — Memo: Impact on Clinical Practice and Educational Summary

In effect: Jul 14, 2023


On July 10, 2023, version 5.2 of the ALS PCS was put into effect by the Ministry of Health (MOH). This communication memo will focus on the impact of clinical practice on patient care within the ALS PCS v.5.2 utilized by Ontario paramedics. It is the responsibility of the paramedic to ensure they have reviewed all aspects of the ALS PCS and medical directives in their entirety.

Patient Care Model Standards

In effect: Feb 1, 2023
The Ministry of Health (ministry) has proceeded with the implementation of patient care models for eligible 9-1-1 patients, as enabled since the regulatory and legislative changes proclaimed on November 1, 2019. These patient care models will provide eligible patients with appropriate community-based care options to improve patients’ timely access to care needed, and to reduce pressures on hospital emergency departments and ambulance services.


In effect: Mar 10, 2023

The BLS Patient Care Standards are the Ministry of Health and Long-Term Care expectations with respect to how paramedics will interact with their patients.

Palliative Care Medical Directives

The Palliative Care Medical Directives provide the standards of paramedic care for patients receiving palliative care who are attended by emergency paramedics participating in the Ministy of Health's special project, Paramedics Providing Palliative Care.

ACP Palliative Care Treat & Refer

Version 2.1

PCP Palliative Care Treat & Refer

Version 2.1

ALC PCS Handbooks

Due to the frequency of updates to the ALS PLS Medical Directives the pocket books are no longer available and have been replaced by the web app available on this page.

Ontario Paramedic Clinical Guide

Web app available

Available for Apple and Android devices.

Due to the frequency of updates to the ALS PLS Medical Directives the pocket books are no longer available.