Date Published

September 29, 2022

Updated For

ALS PCS Version ALS PCS Version 5.2


Have alternative pain control options such as oral morphine and nitrous oxide been (re)considered recently for pre-hospital administration? If not, what's the reasoning?


The Ontario Base Hospital Group Medical Advisory Committee (OBHG MAC) has endorsed the inclusion of morphine and fentanyl in to the scope of PCP practice. In order for this to move forward, there will need to be additional CME time funded by the MoH and a business case has been submitted for this.

This would make a wide variety of analgesic options available to both ACPs and PCPs. There comes a point whereby having an entire array of medications is not logistically feasible for multiple reasons including costs, ongoing CME, storage, logistics etc. With the upcoming incorporation of morphine and fentanyl into PCP scope of practice, all paramedics in Ontario will have the ability to administer the most commonly used analgesic agents that are used in the emergency department.



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