CEPCP v5.4 (2025) — tap any directive to view full details
Medical Cardiac Arrest
Non-traumatic cardiac arrest.
Trauma Cardiac Arrest
Cardiac arrest secondary to severe blunt or penetrating trauma.
Return of Spontaneous Circulation (ROSC)
ROSC after resuscitation was initiated.
Cardiac Ischemia
Suspected cardiac ischemia.
Acute Cardiogenic Pulmonary Edema (ACPE)
Moderate to severe respiratory distress AND suspected acute cardiogenic pulmonary edema.
Cardiogenic Shock
STEMI positive 12-lead AND cardiogenic shock.
Tachydysrhythmia
Symptomatic tachydysrhythmia.
Tachydysrhythmia Treat-and-Discharge (if authorized)
PCP may treat and discharge if authorized.
CPAP – Auxiliary
Severe respiratory distress AND signs/symptoms of acute pulmonary edema (any origin) OR COPD exacerbation.
Supraglottic Airway (iGel / King LT)
Need for ventilatory assistance OR airway control AND other airway management is ineffective.
Advanced Airway & Tracheostomy Suctioning
Patient with ETT, SGA (with gastric suction port), or tracheostomy tube AND airway obstructed or increased secretions present.
Bronchoconstriction
Respiratory distress AND suspected bronchoconstriction.
Moderate to Severe Allergic Reaction
Exposure to probable allergen AND signs/symptoms of moderate to severe allergic reaction (including anaphylaxis).
Croup
Current history of upper respiratory tract infection AND barking cough or recent history of barking cough.
Suspected Adrenal Crisis
Patient with primary adrenal failure who has signs of an adrenal crisis.
Analgesia
Pain.
Hypoglycemia
Suspected hypoglycemia.
Hypoglycemia Treat-and-Discharge (if authorized)
Patient treated under Hypoglycemia directive AND PCP authorized for treat-and-discharge.
Opioid Toxicity
Altered LOC AND respiratory depression AND inability to adequately ventilate OR persistent need to ventilate AND suspected opioid overdose.
Nausea and Vomiting
Nausea and/or vomiting.
Intravenous and Fluid Therapy
Actual or potential need for IV medication OR fluid therapy.
Emergency Childbirth
Pregnant patient experiencing labour OR immediately following delivery.
Home Dialysis Emergency Disconnect
Patient connected to home dialysis AND requires transport to a receiving facility.
Traumatic Hemorrhage (TXA) – Auxiliary
Suspected hemorrhage (external or internal) due to trauma AND hemodynamic instability.
Lateral Patellar Dislocation – Auxiliary
Patient with suspected lateral patellar dislocation.
Palliative Care – Hallucinations or Agitation
Patient registered in palliative care program AND increasing agitation or suspected new/increased hallucinations.
Palliative Care – Nausea or Vomiting
Patient registered in palliative care program AND nausea and/or vomiting.
Palliative Care – Terminal Congested Breathing
Patient registered in palliative care program AND congested/loud/rattling breathing near end of life.
Palliative Care – Treat and Refer
Patient registered in palliative care program AND symptoms improved to patient/SDM satisfaction AND preference to remain home.
Special Events Medical Directives
Mass gathering straining host community resources AND Medical Director pre-authorization for the specific event.
Nerve Agent – CBRNE (Auxiliary)
Exposure to known or suspected nerve agent AND signs and symptoms of a cholinergic crisis.
Cyanide Exposure – CBRNE (Auxiliary)
Suspected exposure to cyanide with signs and symptoms of poisoning AND cardiac arrest, OR altered level of awareness, OR hypotension.
Hydrofluoric (HF) Acid Exposure – CBRNE (Auxiliary)
Exposure to vapour and/or liquid HF acid AND signs/symptoms of HF poisoning.
Symptomatic Riot Agent Exposure – Auxiliary
Known or suspected exposure to a riot agent with signs and symptoms.
Newborn Resuscitation (<24 hours)
Newborn patient (<24 hours old).