Skip to main content

PCP AIV - Pain management alternatives

Question# 563

Good afternoon,

Does the RPPEO have any long term plans for the PCP scope of practice now that we will soon all be AIV? Is there any plans to add additional pain management alternatives to our scope of practice other then Ibuprofen, Tylenol, Toradol, with less contraindications. Often times as a PCP crew patient's are contraindicated for the current pain drugs and we end up transporting them without any pain medication and it seems to result in added suffering until the TOC at hospital. I understand calling for ACP's is a possibility in select circumstances but often times there are no ACP units available. Thanks for taking the time to answer my question.


Thank you you for the thoughtful question.

The RPPEO supports developing and progressing prehospital care and the paramedic profession. The PCP AIV program is driven by the patient care needs of the paramedic service and local municipality. The Paramedic Services volunteer and opt-in to have paramedics trained with the additional autonomous treatment options. RPPEO supports training as many paramedics in PCP-AIV as needed.

We are constantly looking for ways to improve care in our region. The RPPEO just finished a research study to add Methoxyflurane to the list of PCP approved analgesia medications. This medication has fewer contraindications than Ibuprofen and Acetaminophen and is used in other paramedic jurisdictions. RPPEO intends to conduct a larger study to prove the use in Ontario as well as evaluate other medications for PCP use. We are a proponent of paramedic-led research, if you have ideas regarding alternate medications we are interested to hear your perspective to drive the future of the profession.



Medical Directive Category



23 February 2022



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