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Patient Management Standard

The paramedic shall:

  1. if the patient is vital signs absent (VSA) and meets “obvious death” criteria as per the Deceased Patient Standard, follow the procedures outlined within the Deceased Patient Standard;
  2. if the patient has an MOHLTC Do Not Resuscitate (DNR) Confirmation Form, refer to the Do Not Resuscitate (DNR) Standard;
  3. perform appropriate critical interventions to establish/improve and maintain airway patency, ventilation and circulation, which include:
    1. protecting C-spine if C-spine precautions are indicated by the Spinal Motion Restriction (SMR) Standard,
    2. initiating cardiopulmonary resuscitation (CPR) as per current Heart and Stroke Foundation of Canada Guidelines and as per the Cardiac Arrest Standards, if the patient is VSA (perform appropriate cardiac arrest medical directives as outlined in the ALS PCS),
    3. clearing airway obstructions as per the Airway Obstruction Standard, with attention to suctioning of saliva, blood and vomit where necessary,
    4. ventilating or assisting ventilations as per the Respiratory Failure Standard or Shortness of Breath Standard, and
    5. controlling trauma-related external hemorrhage as per the Soft Tissue Injuries Standard, or as specified in other standards for both trauma and non-trauma related conditions.
  4. administer oxygen therapy as per the Oxygen Therapy Standard;
  5. initiate management of other life-, limb- and/or function-threatening conditions as outlined in other sections of the Standards and the ALS PCS;
  6. position or re-position the patient in order to support, protect, improve and/or promote,
    1. C-spine alignment,
    2. airway patency,
    3. breathing,
    4. venous return and perfusion,
    5. extremity injury, and
    6. patient comfort;
  7. if the patient is stable, initiate management on-scene for non-critical conditions as outlined in other sections of the Standards;
  8. continually monitor the patient and provide assessment and management as required by the Standards;
  9. give the patient nothing by mouth unless indicated by the Standards or ALS PCS; and
  10. ensure the patient maintains a comfortable temperature, or as required by the Standards.


Ministry of Health and Long-Term Care
5700 Yonge Street, 6th Floor
Toronto, ON M2M 4K5