Date Published

September 13, 2023

Updated For

ALS PCS Version ALS PCS Version 5.2


In the latest version of the companion document (v5.1) the following is stated "For a witnessed arrest in the back of the ambulance paramedics should use clinical judgment to decide whether to stay and perform resuscitation or proceed to hospital. Paramedic should perform three full analysis and then proceed/patch or to provide one analysis and go. The paramedic should provide at minimum one analysis. Factors that are part of the decision process include distance to closest hospital, probable cause of arrest, ability to provide adequate CPR/ventilation, shockable vs non-shockable etc..". I was told during my recert in November that this scenario would warrant a 20 minute resuscitation. Can you please clarify.


The simple answer is that the direction you were given at your MCME recert was correct at that time. However, with the dynamic nature of trying to optimize prehospital care via the Medical Directives, direction has now changed.

There has been significant discussion at the provincial Medical Advisory Committee and the following has now been agreed upon province-wide:

For patients who arrest for the first time enroute (not a ROSC who re-arrests), the direction is now to find a safe place to stop the ambulance and perform a minimum of one analysis. Utilize clinical judgement (which will entail multiple factors) to decide whether to stay and perform continued resuscitation, or depart from the scene. For full details please see the communication sent out to SWORBHP paramedics on this topic June 22, 2023 (here). The OBHG Companion Document, as you state, aligns with this direction.



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