Ottawa Paramedic Service

Pediatric Bypass Criteria

Patient < 18 years of age
Destination unless CTAS 1 with transport > 30 min (then Closest ED). Always confirm with current bypass directives.
Closest ED

Medical or Blunt Trauma VSA

CTASCTAS 1
Closest ED

Complete Airway Obstruction

CTASCTAS 1
CHEO

Stroke Bypass

CTASCTAS 1–2As per Stroke Bypass
CHEO

Sexual Assault / Intimate Partner Violence

CTASCTAS 1–5Call CAS if patient < 16 y/o
Civic

Ventricular Assist Device

CTASCTAS 1–5Patient must be conscious and breathing
CHEO

CTAS 1 — < 30 min transport time

CTASCTAS 1Unless specified elsewhere
Closest ED

CTAS 1 — ≥ 30 min transport time

CTASCTAS 1Unless specified elsewhere
CHEO

CTAS 2–5

CTASCTAS 2–5Unless specified elsewhere
CHEOCivicClosest ED
CPR Refresher

Compression : Ventilation

30:2

Regardless of officer numbers

Rate100–120 /min
Depth≥ 5 cm
Hand placement2 hands — lower sternum
CPR if pulse< 40 BPM
Advanced airway6–10 breaths/min (continuous compressions)

ALS Medications

Epinephrine1 mg IV/IO q3–5 min
Amiodarone300 mg IV/IO (refractory VF/VT)
Lidocaine1–1.5 mg/kg IV/IO (alt)
Magnesium1–2 g IV (torsades)
Sodium Bicarb1 mEq/kg IV (hyperK/TCA)
Peds GuideALS PCS v5.4
kg

Enter patient weight (0.5 – 149 kg)

Enter patient weight to calculate doses