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The Regional Paramedic Program for Eastern Ontario is proud to support the advancement of professionalization in paramedicine. We recognize that innovations in governance, oversight, and stewardship are essential to advancing the growing maturity and recognition of the paramedic profession. RPPEO is committed to supporting initiatives that strengthen the capacity, responsibility, and excellence of paramedic care in Ontario, and we are proud to collaborate with system partners in building a strong, accountable future for paramedics.

Recent News and Updates

17 July 2025
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…
18 June 2025
We are seeking exceptional Primary and Advanced Care Paramedics to join our team as Education Facilitators. Help Shape the Future of Paramedicine As an Education Facilitator, you’ll take a lead role in strengthening paramedic practice across Eastern Ontario. Whether it’s through delivering Continuing Medical Education (CME) sessions or assessing…
03 June 2025
A new RPPEO Medical Advisory is in effect. Medical Advisory on Bougie Use Through Suction Catheter 2025-01 provides clinical practice guidance for RPPEO-certified paramedics. In accordance with our preoccupation for patient safety, the Medical Advisory on Bougie Use Through Suction Catheter 2025-01 presents gui…
26 May 2025
The Ministry of Health has released ALS PCS version 5.4, which will come into force on Monday, June 2, 2025. This update includes meaningful changes to both core and auxiliary medical directives that impact clinical practice across the region. What’s New ALS PCS v5.4 includes: Revised core directives such as analgesia, nausea/vomiting, and…
21 May 2025
As paramedics, staying informed means staying ready. In this edition of MedicNEWS, we spotlight several developments shaping your practice this spring. In this issue: 🆕 ALS PCS v5.4 Comes Into Force – June 2, 2025 One of the most significant updates in recent years, ALS PCS v5.4 introduces new directives, revised protocols, and clarifies sta…
21 May 2025
We are pleased to announce that Dr. Sara-Pier Piscopo has joined the Regional Paramedic Program for Eastern Ontario as a new Associate Medical Director. Dr. Piscopo is a pediatric emergency physician with a strong background in prehospital and transport medicine. She completed her fellowship in Prehospital and Transport Medicine (P…
14 May 2025
The Regional Paramedic Program for Eastern Ontario (RPPEO) has released a Clinical Bulletin on Measles Management, developed in response to the 2025 Ontario measles outbreak. This Clinical Bulletin reflects collaboration with paramedic services across Eastern Ontario, with particular thanks to the Ottawa Paramedic Service for providing valuable f…
24 April 2025
The Regional Paramedic Program for Eastern Ontario (RPPEO) is excited to announce the return of Trauma Days for 2025! Following another year of success, Eric Gagnon is back to deliver his popular and informative Trauma Day Continuing Medical Education (CME) sessions.
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Upcoming Education Events

Latest MedicASK Questions

Adenosine Preload vs Vial: Tips for Admin
Question: Due to recent challenges with stocking the 6mg and 12mg Adenosine preloads, our pharmacy supplier has provided Adenosine 6mg/2ml (mg/ml) vials for rapid IV bolus use. We're reaching out to seek your…
Gravol for patients ≥65
Question: Are we now authorized to administer Gravol to patients 65 and older without a patch? The ALS PCS states “If Zofran is NOT available…” and the Companion Document doesn’t address this.
ASA for SVT
Question: I was advised a year ago now from a medic that works with the RPPEO that we should be giving all patients in an SVT ASA. Recently, I was told by a second medic with the RPPEO that we should in fact b…
Treatment based on transport decision
Question: Is there communication regarding whether treatment should be held or proceeded with prior to transport decision making? I understand some medications are non-negotiable, however with some of the oral…
Acetaminophen for Fever
Question: When it comes to acetaminophen administration, our medical directives state it is only to be used in the setting of pain as an analgesic. Why isn't there an inclusion for it to be used as an antipyre…

RPPEO Medical Team

RPPEO MedicASK provides paramedics the opportunity to ask questions to our Medical Directors regarding ALS PCS medical directives or other related patient care opportunities.

All questions will be reviewed and answered by staff within the RPPEO. Please browse through our questions and answers, as well as the latest ALS or BLS Patient Care Standards or Companion Document for the Advanced Life Support Patient Care Standards.

Upcoming Education Events

11 September 2025

ISMP Incident Analysis and Proactive Risk Assessment for Paramedicine