The most current version of the Paramedic Clinical Protocols have been released today for use by licensed EMRs and Paramedics of the Saskatchewan College of Paramedics. It is posted on the Protocol Manuals page of the SCoP website >
This new manual has been titled version 9.0 and has significant changes to the EMR scope of practice which have been approved by the Paramedic Practice Committee (PPC) and the College of Physicians and Surgeons of Saskatchewan (CPSS). This is to align to the newly adopted Canadian Paramedic Competency Framework equivalency assessment completed in the summer of 2025.
These changes will reflect the prehospital care provided by EMRs in Saskatchewan and enhance these members scope of practice to better the patient experience in our province. Many of these changes had impacted revisions and wording changes throughout the previous protocol manual (version 8.0). Users will note these changes throughout the document along with a change in previous algorithmic flows in the Patient Care Plan sections.
Another addition found in this document will be the addition of Hydroxocobalamin for ACP use in cyanide exposure. It has been found that current cyano-kits no longer provide Amyl Nitrate as an antidote for individuals suffering from cyanide toxicity. For this reason the PPC along other key interested parties have reviewed and approved the use of Hydroxocobalamin for licensed ACP providers. For specific dosing of this medication, we encourage registrants to refer to the SHA drug monograph created for this antidote.
As a brief overview of the changes found in the Paramedic Clinical Protocols 9.0, a list is provided below indicating key changes registrants will find useful prior document review.
1. EMR Scope of Practice Changes
EMRs have seen an increase in the approved procedures and medications that they may provide their patients. These include insertion of nasopharyngeal airways, monitoring of peripheral crystalloid infusion with no additives/medications, attaching and acquiring 3-lead ECG, fracture reduction, hemostatic agent application for uncontrolled external bleeding, ostomy monitoring, IM naloxone administration, and Salbutamol MDI assistance for patients already prescribed this medication. These changes have been reflected in the patient care plans, procedures, and approved medication by licence policy.
For currently licensed EMRs, this training can be accessed by contacting education organizations or employers who have developed approved training compliant to the core training requirements established. A link to this document is attached below for individuals interested in providing this training.
https://collegeofparamedics.sk.ca/colleges/emr-scope-of-practice-approved-additional-skills/
These courses do not require review by SCoP, however they must adhere to the core training requirements. If this training is to be used as a Continuing Education component for members, please submit the course outline and objectives for CE review using the pathway found on the SCoP website or by clicking the link below.
https://collegeofparamedics.sk.ca/professional-practice/cme-approvals/
2. Hydroxocobalamin approval for ACP scope of practice
Advanced Care Paramedics are now permitted to administer Hydroxocobalamin as an antidote for cyanide toxicity. Members must be aware that not all employers may provide this medication for use in their service/industry. Although Hydroxocobalamin is the preferred medication administered as an antidote for cyanide toxicity, amyl nitrate may still be considered in available for this patient demographic by all licensed members of SCoP.
3. ICP Benzodiazepine administration for Alcohol Withdrawal
ICPs may administer benzodiazepines for acute alcohol withdrawal consistent to the current alcohol withdrawal scoring system identified by the SHA. This is to allow for increased appropriate management of these patients in the prehospital setting.
4. Changes to Interfacility Transfer of Patients with Medical Devices in Place
Numerous devices have been approved for EMRs and Paramedics to monitor during interfacility transports. These include for licensed PCP/ICP/ACPs-aspirate drainage devices (Jackson Pratt devices or similar), continuous bladder irrigation, and ostomy devices (urostomy, ileostomy, colostomy). For licensed EMRs who have completed required training, monitoring ostomy devices and peripheral crystalloid with no additives or medications will now be permitted.
5. Extensive language changes
With the increase to the EMR scope of practice, many patient care plans and procedures have been adjusted to reflect this scope. Although these are new procedures and therapies for EMRs, they are deemed as additions or revisions to the existing protocols. An example of this is the transition of the previously used “Cardiac Monitor” used to signify 3/12/15 lead ECG placement and monitoring. This has been replaced with “Attach cardiac monitor and acquire 3 lead ECG” for EMR scope of practice. Users will note that for PCP it is now deemed “Continuous cardiac monitoring” to signify 3/12/15 lead ECG acquisition and monitoring.
For further information on the additions and revisions made in the 9.0 version of the Paramedic Clinical Practice Protocols, please refer to the version control portion of the document. The College encourages all members to be familiar with the content of the protocol manual; we also encourage users to report any errors or omissions made in the 9.0 version of the manual.
If you have any questions or concerns regarding the Paramedic Clinical Practice Protocols, please contact Destin Ash or Jennifer Williams at the emails provided below.
o Destin Ash; destin.ash@collegeofparamedics.sk.ca
o Jennifer Williams; jen.williams@collegeofparamedics.sk.ca
Core Training Requirements for new scope of practice skills for EMR
The Clinical Practice Protocol Manual version 9.0 includes recent changes to the EMR scope of practice.
These significant changes will require the completion of formal education before an EMR can perform these skills. The training can be provided by an employer or an educational provider.
The Education Committee has approved educational requirements that must be met by anyone who is developing the training for these skills. Approved training for EMRs in the new changes to the scope of practice must, at a minimum, meet these objectives and requirements.
Members are responsible for ensuring they have taken the initial training and are competent before they are permitted to perform any new skill. This document will also outline assessment and instructor qualifications. EMRs can receive Continuing Education credits for the training if the training is approved by SCoP.
Core Training Requirements for new scope of practice skills for EMR >