Non-traumatic cardiac arrest.

Cardiac arrest secondary to severe blunt or penetrating trauma.

ROSC after resuscitation was initiated.

Suspected cardiac ischemia.

Moderate to severe respiratory distress AND suspected acute cardiogenic pulmonary edema.

STEMI positive 12-lead AND cardiogenic shock.

Bradycardia AND hemodynamic instability.

Symptomatic tachydysrhythmia.

ACP may treat and discharge a patient experiencing tachydysrhythmia, if authorized to use this Medical Directive.

Severe respiratory distress AND signs/symptoms of acute pulmonary edema (any origin) OR COPD exacerbation.

Need for ventilatory assistance or control AND other airway management is ineffective.

Need for ventilatory assistance OR airway control AND other airway management is ineffective.

Need for advanced airway AND intubation AND SGA insertion unsuccessful or contraindicated AND unable to ventilate.

Patient with ETT, SGA (with gastric suction port), or tracheostomy tube AND airway obstructed or increased secretions present.

Respiratory distress AND suspected bronchoconstriction.

Exposure to probable allergen AND signs/symptoms of moderate to severe allergic reaction (including anaphylaxis).

Current history of upper respiratory tract infection AND barking cough or recent history of barking cough.

Patient with primary adrenal failure who has signs of an adrenal crisis.

Pain.

Altered LOC AND respiratory depression AND inability to adequately ventilate OR persistent need to ventilate AND suspected opioid overdose.

Active generalized motor seizure.

Post-seizure patient AND ACP authorized for treat-and-discharge.

Combative, violent, or agitated behaviour requiring sedation for patient safety.

Post-intubation OR transcutaneous pacing.

Pre-arrest or VSA AND absent or severely diminished breath sounds on affected side(s).

Suspected hemorrhage (external or internal) due to trauma AND hemodynamic instability.

Patient with suspected lateral patellar dislocation.

Suspected hypoglycemia.

Patient treated appropriately under Hypoglycemia Medical Directive AND ACP authorized for treat-and-discharge.

Suspected hyperkalemia in high-risk patient (dialysis, ESRD, crush injury) AND cardiac arrest OR pre-arrest with 12-lead ECG changes suggestive of hyperkalemia.

Nausea and/or vomiting.

Pregnant patient experiencing labour OR immediately following delivery.

Actual or potential need for IV medication OR fluid therapy.

Actual or potential need for IV medication OR fluid therapy AND IV access unobtainable AND patient in cardiac arrest or near-arrest.

Actual or potential need for IV medication OR fluid therapy AND IV access unobtainable AND patient in cardiac arrest or pre-arrest state.

Patient connected to home dialysis AND requires transport to a receiving facility.

Known or suspected exposure to a riot agent with signs and symptoms of riot agent exposure.

Mass gathering straining host community resources AND Medical Director pre-authorization for the specific event.

Patient registered in palliative care program AND uncontrolled pain or dyspnea, OR uncontrolled dyspnea with suspected bronchoconstriction.

Patient registered in palliative care program AND increasing agitation or suspected new/increased hallucinations.

Patient registered in palliative care program AND nausea and/or vomiting.

Patient registered in palliative care program AND congested/loud/rattling breathing near end of life.

Patient registered in palliative care program AND symptoms improved to patient/SDM satisfaction AND after informed discussion patient/SDM preference to remain home.

Exposure to known or suspected nerve agent AND signs and symptoms of a cholinergic crisis.

Suspected exposure to cyanide AND cardiac arrest, altered LOA, or hypotension.

Exposure to vapour and/or liquid HF acid AND signs/symptoms of HF poisoning.