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.

Major revision of CLI 230

RPPEO has revised Policy CLI 230 “Management of Death in the Prehospital Setting.” In cases of cardiac arrest where a patient’s wishes are for do not resuscitate (DNR) but no Ministry of Health DNR Confirmation Form is available, paramedics should consider patching to a Base Hospital Physician (BHP) to consult on the appropriateness of withholding further resuscitation.

The update to RPPEO Policy CLI 230 aligns it with Medical Advisory 2023-03 “Acceptance of Verbal or Written Do Not Resuscitate Requests,” which RPPEO issued on April 19, 2023.

Retirement of CLI 180

RPPEO has retired Policy CLI 180 “Paramedic Responsibilities when Working with Midwives,” and it is no longer in force. CLI 180 restated information found in other guidance documents, which may cause confusion.  The Basic Life Support Patient Care Standards (BLS PCS version 3.4, Regulated Health Professional Standard, page 21) speak to paramedic interaction with midwives and other health care professionals. RPPEO’s Policy CLI 110 “Interaction with and Transfer of Care from Health Care Providers on Scene” also addresses clinical interaction with a health care professional and names midwives as one of the included groups.

Paramedics should refer to the BLS PCS’ Regulated Health Professional Standard and RPPEO Policy CLI 110 for guidance on interaction with midwives and other health care professionals. A courtesy version of CLI 180 remains available in the Policy Manual for temporary reference, although the policy is no longer in force as of December 27, 2023.

Policy users will find more information about any minor changes to a policy in the revision records available at the end of each one.

RPPEO reviews our policies annually and revises them as needed during review.

All official RPPEO Policies are available online in the Policy Manual.