RPPEO has issued a new Medical Advisory (MA-2025-02) providing clinical guidance on STEMI Hospital Bypass by Primary Care Paramedics (PCPs) with Autonomous IV (AIV) certification. The Medical Advisory comes into effect on July 22, 2025. 

This advisory recognizes that PCPs with AIV certification are equipped to effectively manage hypotension, enabling them to safely apply STEMI bypass criteria under circumstances previously limited to Advanced Care Paramedics. Specifically, it outlines when bypass to the University of Ottawa Heart Institute (UOHI) is appropriate for stable STEMI patients treated by PCP-AIVs.

This clarification does not change existing BLS PCS guidance for standard PCPs, for whom hypotension remains a contraindication to STEMI bypass.

 Development Through Regional Collaboration

The advisory was developed through the RPPEO Quality of Care Committee, which includes representation from all nine regional paramedic services. We extend our sincere thanks to these partners for their active participation and input, which was instrumental in developing this clear, safety-focused guidance.

You can access the full advisory and all current Medical Advisories on the RPPEO website.

For questions or clarification, please contact us at quality@RPPEO.ca or reach MedicLINE at 1-877-587-7736.