RPPEO is launching the Pediatric Analgesia Feasibility Project, a quality improvement collaboration focused on improving how pain and fever are managed for pediatric patients in the prehospital setting.

This project is being undertaken in partnership with four paramedic services in the RPPEO region:

• Cornwall SDG Paramedic Services
• Hastings–Quinte Paramedic Services
• Lanark County Paramedic Service
• Prescott–Russell Paramedic Service

What is the project about?

Despite how common pain and fever are in pediatric calls, paramedics have had limited options for age‑appropriate oral analgesia in the field. This feasibility project is designed to safely test and evaluate the use of pediatric formulations of acetaminophen and ibuprofen in real‑world prehospital practice.

The project focuses on feasibility rather than clinical outcomes, with goals that include:

• Assessing whether pediatric oral analgesia can be used safely and reliably in the field
• Understanding dosing accuracy, documentation, and workflow considerations
• Evaluating paramedic usability and education supports
• Identifying operational considerations such as stocking and storage
• Recommending pediatric formulations and processes 
• Informing future clinical guidance, education, and medical directive decisions

This is a quality improvement initiative and has received a formal determination that Review Ethics Board oversight is not required.

Clinical oversight and authorization

Participation in the feasibility project is structured and designed for safety and usability:

• Paramedics receive training before being authorized to participate
• Pediatric analgesia is provided only through Base Hospital physician orders, obtained via phone consultation
• Existing Base Hospital oversight and quality review processes remain in place throughout the project

No new standing medical directives are introduced as part of this feasibility work.

Timeline

The feasibility project begins training in April, 2026. Following launch within a service, the project will collect data for approximately six months. Findings will be reviewed collaboratively with participating services and used to determine next steps, including whether broader implementation should be recommended.

What participating paramedics are asked to do

Paramedics participating in the feasibility project are asked to complete a brief online log every time they consider or administer a pediatric formulation of acetaminophen or ibuprofen, for any indication.

The log is a key part of the quality improvement process and helps RPPEO and partner services understand what works well, what does not, and what needs adjustment.