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TOC to PCP after narcotics

Question# 797

I am writing to request clarification regarding the protocol or best practice for ACP/PRU/Supts administering narcotics for pain management and leaving the patient under the care of a primary care paramedic on the scene for autonomous transport?


Primary Care Paramedics have the capacity to assume care of patients after narcotics have been administered. They have the tools to mitigate adverse effects (i.e. Airway Management/Naloxone/IV fluids if IV autonomous).

We also appreciate the complexity of deployment and additional responsibilities that First Reasponse/Superintendents may have that can limit attaching themselves to the PCP configuration after providing treatment for a patient.

When narcotics are being considered, please engage the crew in a discussion regarding the most appropriate interventions, including multimodal analgesia, and determine if the PCP crew is comfortable assuming care of the patient after an ALS intervention is provided.

Variables such as ongoing need for advanced care, any adverse events observed by the ACP as a result of advanced care, ACP/transport crew comfort level and proximity to receiving facility can all be considered when making the safest, patient-centred decisions.



28 March 2024

ALSPCS Version




Please reference the MOST RECENT ALS PCS for updates and changes to these directives.