Medical Directives

Review and Acknowledgment of Medical Directives

Physicians are required by legislation to sign off initially and if there is a significant change on Medical Directives for which they are deemed to be responsible. To meet the requirement, Lakeridge Health uses a process that links authorization of Medical Directives relevant to your practice to your annual reapplication. The following statement has been included to the Declaration Section of the Reapplication Form:

I have reviewed and acknowledge the Medical Directives for which I am an authorizing physician.

A comprehensive list of all Medical Directives categorized by practice groups is included below. Legacy RVHS Medical Directives can be found on the WAVE.

New Medical Directive for 2023/24:

• Specimen Collection for Antibiotic Resistant Organisms (AROs) – Medical Directive (all MRPs)

Going forward, we encourage physician participation in the ongoing revision, and development of both existing and new medical directives.  Should you have any recommendations please contact your section chief, program director, or Pharmacy & Therapeutics Committee representative.  We strive for Medical Directives to reflect evidence based best practices.  Your input is welcomed and appreciated.

Thank you in advance for your cooperation and assistance.

Medical Directives By Practice

All Physicians Providing Service at Lakeridge Health Ajax

• Critical Care Outreach Team (CCOT) Adult In-Patient Medical Directive (all LHO Critical Care Intensivists, LHB & LHAP Physicians)

All Physicians Providing Service at Lakeridge Health Bowmanville

• Adult Enteral Tube Feeding Medical Directive
• Critical Care Outreach Team (CCOT) Adult In-Patient Medical Directive (all LHO Critical Care Intensivists, LHB & LHAP Physicians)
• Critical Care Response Team (CCRT) Adult In-patient Medical Directive
• Diet Texture by Speech Language Pathologists (all MRPs)
• Emergency Situations Medical Directives (all MRPs)
• Medic Emergency Situations at Lakeridge Health Medical Directive (all MRPs)
• Parenteral Nutrition (Adult & Paediatric) (all MRPs)
• Rapid Response System - Chest Pain
• Rapid Response System - Respiratory Distress
• Rapid Response System - Abdominal Pain
• Rapid Response System - Changes in Central Nervous System Status
• Rapid Response System - Hypotension/Shock
• Rapid Response System - Suspected Anaphylaxis-Like
• Respiratory Distress - Respiratory Therapy Medical Directive (all MRPs)
• Specimen Collection for Antibiotic Resistant Organisms (AROs) - (All MRPs)

Anesthetists (Lakeridge Health Oshawa Only)

• Emergency Situations Medical Directives (all MRPs)
• Administration of Neuromuscular Blocking Agents and Reversal Agents by the Anesthesia Assistant
• Ambulatory Rehabilitation Centre Referral - Medical Directive (all MRPs)
• Initiation of Peripheral Intravenous in the Operating Room and Endoscopy Suite
• Insertion of Arterial Lines by Anesthesia Assistants
• Management of the Acute Onset of Bradycardia by Anesthesia Assistants
• Management of Hypopnea and/or Apnea in the Sedated Patient by Anesthesia Assistants
• Management of Hypertension by Anesthesia Assistants
• Management of Hypotension by Anesthesia Assistants
• Management of Hypoxemia by Anesthesia Assistants
• Management of Intravenous Fluid Therapy by Anesthesia Assistants
• Medic Emergency Situations at Lakeridge Health Medical Directive (all MRPs)
• Respiratory Distress - Respiratory Therapy Medical Directive (all MRPs)
• Specimen Collection for Antibiotic Resistant Organisms (AROs) - (All MRPs)

Anesthesiologists (Hospital Wide)

• Administration of Pre-Operative Acetaminophen for Paediatric Day Surgery
• Adult Pre-Operative Testing Grid
• Ambulatory Rehabilitation Centre Referral - Medical Directive (all MRPs)
• Initiation of Peripheral Intravenous in the Operating Room and Endoscopy Suite
• Medic Emergency Situations at Lakeridge Health Medical Directive (all MRPs)
• Respiratory Distress - Respiratory Therapy Medical Directive (all MRPs)
• Ultrasound Guidance for Prescribed Procedures

Cardiologists (Ajax)

• Ambulatory Rehabilitation Centre Referral - Medical Directive (all MRPs)
• Computed Tomography (CT) Coding
• Medic Emergency Situations at Lakeridge Health Medical Directive (all MRPs)
• Respiratory Distress - Respiratory Therapy Medical Directive (all MRPs)

Code Blue First Responders

• Adult Advanced Life Support (ALS) - Code Blue, Emergency & Critical Care Physicians)
• Advanced Life Support Automated External Defibrillation
• Advanced Life Support Intraosseous Cannulation and Infusion
• Ambulatory Rehabilitation Centre Referral - Medical Directive (all MRPs)
• Automated External Defibrillation (AED) Medical Directive
• Medic Emergency Situations at Lakeridge Health Medical Directive (all MRPs)
• Emergency Situations Medical Directives (all MRPs)
• Respiratory Distress - Respiratory Therapy Medical Directive (all MRPs)

COVID-19 Associated Clinic Physicians

• Management of Anaphylaxis for Paediatric Patients from 12-16 years of Age for Pfizer-BioNTech COVID-19 mRNA Vaccine 
• Management of Anaphylaxis for Pfizer-BioNTech and/or Moderna COVID-19 mRNA Vaccine for COVID-19 following immunization
• Medic Emergency Situations at Lakeridge Health Medical Directive (all MRPs)
• Moderna Spikevax COVID-19 mRNA Vaccine for COVID-19 immunization
• Paramedic Pfizer-BioNTech and Moderna Covid-19 mRNA Vaccine

• Pfizer-BioNTech/ Bivalent Pfizer-BioNTech COVID -19 mRNA Vaccine for Adult (12 years of age and older) COVID-19
  Immunization - Medical Directive

• Unregulated Care Providers Pfizer-BioNTech COVID-19 mRNA Vaccine for COVID Immunization Clinic

Diagnostic Imaging Physicians

• Ambulatory Rehabilitation Centre Referral - Medical Directive (all MRPs)

• Computed Tomography (CT) Coding

• CT Chest, Ontario Lung Screening Program OLSP
• Emergency Situations Medical Directives (all MRPs)
• Hyoscine Butylbromide (Buscopan) Injection for Diagnostic Imaging Procedures
• Interventional Radiology (IR) Protocoling by Medical Radiation Technologists (MRT) - Medical Directive
• Medic Emergency Situations at Lakeridge Health Medical Directive (all MRPs)
• Pre-MRI X-ray - Medical Directive
• Respiratory Distress - Respiratory Therapy Medical Directive (all MRPs)
• Specimen Collection for Antibiotic Resistant Organisms (AROs) - (All MRPs)

Endocrinologists

• Adult Enteral Tube Feeding Medical Directive
• Ambulatory Rehabilitation Centre Referral - Medical Directive (all MRPs)
• Diet Texture by Speech Language Pathologists (all MRPs)
• Emergency Situations Medical Directives (all MRPs)
• Medic Emergency Situations at Lakeridge Health Medical Directive (all MRPs)
• Parenteral Nutrition (Adult & Paediatric) (all MRPs)
• Point of Care Glucose Meter Testing and Treatment for Out-Patients with Suspected Hypoglycemia
• Respiratory Distress - Respiratory Therapy Medical Directive (all MRPs)
• Specimen Collection for Antibiotic Resistant Organisms (AROs) - (All MRPs)

ER Physicians (Hospital Wide)

• Adult Intubation by Registered Respiratory Therapist
• Adult Enteral Tube Feeding Medical Directive
• Adult Advanced Life Support (ALS) - Code Blue, Emergency & Critical Care Physicians)
• Advanced Life Support Automated External Defibrillation
• Advanced Life Support Intraosseous Cannulation and Infusion
• Ambulatory Rehabilitation Centre Referral - Medical Directive (all MRPs)
• Automated External Defibrillation (AED) Medical Directive
• COPD
• Diet Texture by Speech Language Pathologists (all MRPs)
• Emergency Department - Medical Directives
• Emergency Department Naloxone Distribution Kit
• Emergency Situations Medical Directives (all MRPs)
• Medic Emergency Situations at Lakeridge Health Medical Directive (all MRPs)
• Nicotine Replacement Therapy
• Obstetric Patient in the Emergency Department
• Off Site Naloxone Administration (Emergency Department physicians)
• Oral Nutrition Therapy
• Parenteral Nutrition (Adult & Paediatric) (all MRPs)
• Pediatric Asthma
• Respiratory Distress - Respiratory Therapy Medical Directive (all MRPs)
• Specimen Collection for Antibiotic Resistant Organisms (AROs) - (All MRPs)
• Ultrasound Guidance for Prescribed Procedures

ER Physicians (Lakeridge Health Oshawa Only)

• Adult Enteral Tube Feeding Medical Directive
• Ambulatory Rehabilitation Centre Referral - Medical Directive (all MRPs)
• Automated External Defibrillation (AED) Medical Directive
• Diet Texture by Speech Language Pathologists (all MRPs)
• Domestic Violence-Sexual Assault Medical Directive
• Emergency Department - Medical Directives
• Emergency Department Naloxone Kit Distribution
• Emergency Situations Medical Directives (all MRPs)
• Erythromycin for Chlamydia Drug Prophylaxis When a Client is Pregnant or Breastfeeding
• Medic Emergency Situations at Lakeridge Health Medical Directive (all MRPs)
• Nicotine Replacement Therapy
• Parenteral Nutrition (Adult & Paediatric) (all MRPs)
• Respiratory Distress - Respiratory Therapy Medical Directive (all MRPs)
• Specimen Collection for Antibiotic Resistant Organisms (AROs) - (All MRPs)

Family Medicine Obstetrics

• Ambulatory Rehabilitation Centre Referral - Medical Directive (all MRPs)
• Initial Screening and Management of Hypoglycemia in Neonates Greater than 35 weeks Gestation
• Medic Emergency Situations at Lakeridge Health Medical Directive (all MRPs)
• Respiratory Distress - Respiratory Therapy Medical Directive (all MRPs)
• Well Newborn - Family Medicine Obstetrics

General Surgeons

• Adult Pre-Operative Testing Grid
• Adult Enteral Tube Feeding Medical Directive
• Ambulatory Rehabilitation Centre Referral - Medical Directive (all MRPs)
• Diet Texture by Speech Language Pathologists (all MRPs)
• Emergency Situations Medical Directives (all MRPs)
• Initiation of Peripheral Intravenous in the Operating Room and Endoscopy Suite
• Medic Emergency Situations at Lakeridge Health Medical Directive (all MRPs)
• Parenteral Nutrition (Adult & Paediatric) (all MRPs)
• Respiratory Distress - Respiratory Therapy Medical Directive (all MRPs)
• Staging Investigations for Colorectal Patients Within the Colorectal Diagnostic Assessment Program
• Specimen Collection for Antibiotic Resistant Organisms (AROs) - (All MRPs)
• Orthopedic and General Surgery Preoperative Blood Conservation - (Orthopedic  And General Surgeons)

Gastroenterologists

• Initiation of Peripheral Intravenous in the Operating Room and Endoscopy Suite

Hospitalists

• Adult Enteral Tube Feeding Medical Directive
• Ambulatory Rehabilitation Centre Referral - Medical Directive (all MRPs)
• Diet Texture by Speech Language Pathologists (all MRPs)
• Emergency Situations Medical Directives (all MRPs)
• Medic Emergency Situations at Lakeridge Health Medical Directive (all MRPs)
• Parenteral Nutrition (Adult & Paediatric) (all MRPs)
• Adult Intubation by Registered Respiratory Therapist
• Oral Nutrition Therapy
• Respiratory Distress - Respiratory Therapy Medical Directive (all MRPs)
• Specimen Collection for Antibiotic Resistant Organisms (AROs) - (All MRPs)

Infectious Diseases Physicians - Positive Care Clinic

• Abbott ID Now COVID Swab and Processing 
• Ambulatory Rehabilitation Centre Referral - Medical Directive (all MRPs)
• Collection of Acute Respiratory Infection (ARI) for Infection, Prevention, and Control Surveillance and Outbreak Management
• Emergency Situations Medical Directives (all MRPs)
• Medic Emergency Situations at Lakeridge Health Medical Directive (all MRPs)
• Nurse-Drawn Standardized Investigations for Positive Care Clinic Patients
• Parenteral Nutrition (Adult & Paediatric) (all MRPs)
• Respiratory Distress - Respiratory Therapy Medical Directive (all MRPs)
• Specimen Collection for Antibiotic Resistant Organisms (AROs) - (All MRPs)
• Take Home Naloxone Kit (Positive Care Clinic Physicians & RAAM physicians)

Intensivists

• Adult Enteral Tube Feeding Medical Directive 

• Adult Advanced Life Support (ALS) - Code Blue, Emergency & Critical Care Physicians)

• Advanced Life Support Automated External Defibrillation

• Advanced Life Support Intraosseous Cannulation and Infusion
• Ambulatory Rehabilitation Centre Referral - Medical Directive (all MRPs)
• Automated External Defibrillation (AED) Medical Directive
• CCOT - Abdominal Pain
• CCOT - Changes in Central Nervous System Status
• CCOT - Chest Pain
• CCOT - Hypotension-Shock
• CCOT - Respiratory Distress
• CCOT - Suspected Anaphlyaxis
• Critical Care Response Team (CCRT) Adult In-patient Medical Directive
• Critical Care Outreach Team (CCOT) Adult In-Patient Medical Directive (all LHO Critical Care Intensivists, LHB & LHAP Physicians)
• Diet Texture by Speech Language Pathologists (all MRPs)
• Emergency Situations Medical Directives (all MRPs)
• Medic Emergency Situations at Lakeridge Health Medical Directive (all MRPs)
• Parenteral Nutrition (Adult & Paediatric) (all MRPs)
• Point of Care Arterial Blood Gas Test in Emergency and Critical Care
• Adult Intubation by Registered Respiratory Therapist

• Oral Nutrition Therapy

• Respiratory Distress - Respiratory Therapy Medical Directive (all MRPs)

• Specimen Collection for Antibiotic Resistant Organisms (AROs) - (All MRPs)

• Ultrasound Guidance for Prescribed Procedures

Midwives

• Ambulatory Rehabilitation Centre Referral - Medical Directive (all MRPs)
• Initial Screening and Management of Hypoglycemia in Neonates Greater than 35 weeks Gestation
• Medic Emergency Situations at Lakeridge Health Medical Directive (all MRPs)
• Respiratory Distress - Respiratory Therapy Medical Directive (all MRPs)
• Well Newborn - Midwives

Nephrologists

• Administration of Influenza Vaccination to Out-Patients of the Regional Nephrology Program
• Adult Enteral Tube Feeding Medical Directive
• Ambulatory Rehabilitation Centre Referral - Medical Directive (all MRPs)
• Diet Texture by Speech Language Pathologists (all MRPs)
• Emergency Situations Medical Directives (all MRPs)
• Medic Emergency Situations at Lakeridge Health Medical Directive (all MRPs)
• Parenteral Nutrition (Adult & Paediatric) (all MRPs)
• Respiratory Distress - Respiratory Therapy Medical Directive (all MRPs)
• Treatment of Anaphylaxis within the Regional Nephrology Program
• Adult Intubation by Registered Respiratory Therapist
• Oral Nutrition Therapy
• Specimen Collection for Antibiotic Resistant Organisms (AROs) - (All MRPs)

Obstetricians

• Adult Enteral Tube Feeding Medical Directive
• Ambulatory Rehabilitation Centre Referral - Medical Directive (all MRPs)
• Diet Texture by Speech Language Pathologists (all MRPs)
• Emergency Situations Medical Directives (all MRPs)
• Hypertension Screening With Routine Non-Stress Test
• Medic Emergency Situations at Lakeridge Health Medical Directive (all MRPs)
• Obstetric Patient in the Emergency Department
• Parenteral Nutrition (Adult & Paediatric) (all MRPs)
• Respiratory Distress - Respiratory Therapy Medical Directive (all MRPs)
• Adult Intubation by Registered Respiratory Therapist
• Oral Nutrition Therapy
• Specimen Collection for Antibiotic Resistant Organisms (AROs) - (All MRPs)

Occupational Health Physician(s)

• Adult Enteral Tube Feeding Medical Directive
• Ambulatory Rehabilitation Centre Referral - Medical Directive (all MRPs)
• Antiviral Medication
• BloodTest, Chest X-Ray and Tuberculin Skin Test
• Emergency Situations Medical Directives (all MRPs)
• Influenza Vaccination
• Management of Anaphylaxis
• Management of Anaphylaxis for Pfizer-BioNTech and/or Moderna COVID-19 mRNA Vaccine for COVID-19 following immunization
• Medic Emergency Situations at Lakeridge Health Medical Directive (all MRPs)
• Moderna Spikevax COVID-19 mRNA Vaccine for COVID-19 immunization
• Occupational Health Vaccination for Vaccine-Preventable Diseases
• Parenteral Nutrition (Adult & Paediatric) (all MRPs)

• Pfizer-BioNTech/ Bivalent Pfizer-BioNTech COVID -19 mRNA Vaccine for Adult (12 years of age and older) COVID-19
  Immunization - Medical Directive

• Respiratory Distress - Respiratory Therapy Medical Directive (all MRPs)

Oncologists

• Adult Enteral Tube Feeding Medical Directive
• Ambulatory Rehabilitation Centre Referral - Medical Directive (all MRPs)
• Clinical Trials Laboratory Investigations
• Diet Texture by Speech Language Pathologists (all MRPs)
• Emergency Situations Medical Directives (all MRPs)
• EMLA Cream Application for Oncology & Hematology Patients
• Gynecological Diagnostic Assessment Program Investigations
• Alteplase (Cathflo) Instillation for Complete or Partially Occluded Central Venous Access Devices
• Adult Intubation by Registered Respiratory Therapist
• Medic Emergency Situations at Lakeridge Health Medical Directive (all MRPs)
• Oral Nutrition Therapy
• Ordering Specific Diagnostic Tests, Images, Scans and Procedures by Nurse Practitioners
• Parenteral Nutrition (Adult & Paediatric) (all MRPs)
• Respiratory Distress - Respiratory Therapy Medical Directive (all MRPs)
• Specimen Collection for Antibiotic Resistant Organisms (AROs) - (All MRPs)

Orthopedic Surgeons

• Adult Pre-Operative Testing Grid
• Adult Enteral Tube Feeding Medical Directive
• Ambulatory Rehabilitation Centre Referral - Medical Directive (all MRPs)
• Diet Texture by Speech Language Pathologists (all MRPs)
• Emergency Situations Medical Directives (all MRPs)
• Medic Emergency Situations at Lakeridge Health Medical Directive (all MRPs)
• Outpatient Surgical Preoperative Blood Conservation
• Rapid Access Clinic Physiotherapists Ordering of Diagnostic Imaging - Medical Directive
• Specimen Collection for Antibiotic Resistant Organisms (AROs) - (All MRPs)
• Orthopedic and General Surgery Preoperative Blood Conservation - (Orthopedic  And General Surgeons)
• Parenteral Nutrition (Adult & Paediatric) (all MRPs)
• Physician Assistant Lakeridge Health Ajax Pickering Shoulder Centre
• Medical Directives for Physician Assistant - Surgical Program Orthopedic Division
• Respiratory Distress - Respiratory Therapy Medical Directive (all MRPs)

Pediatricians and Neonatologists

• Acetaminophen Administration for Treatment of Fever In Pediatric Patients Admitted to the Pediatric Unit
• Adult Enteral Tube Feeding Medical Directive
• Ambulatory Rehabilitation Centre Referral - Medical Directive (all MRPs)
• Emergency Situations Medical Directives (all MRPs)
• Initial Screening and Management of Hypoglycemia in Neonates Greater than 35 weeks Gestation
• Medic Emergency Situations at Lakeridge Health Medical Directive (all MRPs)
• Naloxone (Narcan) Administration in Respiratory Depressed Pediatric Patients Receiving Opioids
• Neonatal/Infant/Pediatric Intubation
• Parenteral Nutrition (Adult & Paediatric) (all MRPs)
• Sucrose 24% Oral Solution for Pain Management in Neonates and Infants
• Well Newborn - Pediatricians and Neonatologists
• Adult Intubation by Registered Respiratory Therapist
• Oral Nutrition Therapy
• Respiratory Distress - Respiratory Therapy Medical Directive (all MRPs)
• Specimen Collection for Antibiotic Resistant Organisms (AROs) - (All MRPs)

PASS Program Physicians

• Adult Enteral Tube Feeding Medical Directive
• Ambulatory Rehabilitation Centre Referral - Medical Directive (all MRPs)
• Diet Texture by Speech Language Pathologists (all MRPs)
• Emergency Situations Medical Directives (all MRPs)
• Medic Emergency Situations at Lakeridge Health Medical Directive (all MRPs)
• Parenteral Nutrition (Adult & Paediatric) (all MRPs)
• PASS Implementation of Specific Diagnostic Tests, Images & Scans by NPs
• Adult Intubation by Registered Respiratory Therapist
• Oral Nutrition Therapy
• Respiratory Distress - Respiratory Therapy Medical Directive (all MRPs)
• Specimen Collection for Antibiotic Resistant Organisms (AROs) - (All MRPs)
• Stroke Prevention Clinic Diagnostic – Medical Directive

Pinewood Centre Practitioners

• Ambulatory Rehabilitation Centre Referral - Medical Directive (all MRPs)
• Emergency Situations Medical Directives (all MRPs)
• Medic Emergency Situations at Lakeridge Health Medical Directive (all MRPs)
• Parenteral Nutrition (Adult & Paediatric) (all MRPs)
• Respiratory Distress - Respiratory Therapy Medical Directive (all MRPs)
• Residential Withdrawal Management Service (RWMS) Admission COVID-19 Point of Care (POC) Testing for Clients

Psychiatrists

• Adult Enteral Tube Feeding Medical Directive
• Ambulatory Rehabilitation Centre Referral - Medical Directive (all MRPs)
• Diet Texture by Speech Language Pathologists (all MRPs)
• Emergency Situations Medical Directives (all MRPs)
• Urine Drug Screens/Blood Alcohol Levels
• Adult Intubation by Registered Respiratory Therapist
• Medic Emergency Situations at Lakeridge Health Medical Directive (all MRPs)
• Parenteral Nutrition (Adult & Paediatric) (all MRPs)
• Oral Nutrition Therapy
• Nicotine Replacement Therapy
• Residential Withdrawal Management Service (RWMS) Admission COVID-19 Point of Care (POC) Testing for Clients
• Respiratory Distress - Respiratory Therapy Medical Directive (all MRPs)
• Specimen Collection for Antibiotic Resistant Organisms (AROs) - (All MRPs)

Rapid Access Addiction Medicine Clinic Physicians

• Ambulatory Rehabilitation Centre Referral - Medical Directive (all MRPs)
• Medic Emergency Situations at Lakeridge Health Medical Directive (all MRPs)
• Respiratory Distress - Respiratory Therapy Medical Directive (all MRPs)
• Take Home Naloxone Kit (Postivie Care Clinic Physicians & RAAM physicians)

Respirologists

• Ambulatory Rehabilitation Centre Referral - Medical Directive (all MRPs)
• Initiation of Peripheral Intravenous in the Operating Room and Endoscopy Suite
• Malignant Pleural Effusion Clinic Investigations 
• Medic Emergency Situations at Lakeridge Health Medical Directive (all MRPs)
• Parenteral Nutrition (Adult & Paediatric) (all MRPs)
• Respiratory Distress - Respiratory Therapy Medical Directive (all MRPs)

SACC Physicians

• Ambulatory Rehabilitation Centre Referral - Medical Directive (all MRPs)
• Domestic Violence-Sexual Assault Medical Directive
• Emergency Situations Medical Directives (all MRPs)
• Erythromycin for Chlamydia Drug Prophylaxis When a Client is Pregnant or Breastfeeding
• Medic Emergency Situations at Lakeridge Health Medical Directive (all MRPs)
• Parenteral Nutrition (Adult & Paediatric) (all MRPs)
• Respiratory Distress - Respiratory Therapy Medical Directive (all MRPs)
• Specimen Collection for Antibiotic Resistant Organisms (AROs) - (All MRPs)

Stroke Prevention Clinic Physicians

• Ambulatory Rehabilitation Centre Referral - Medical Directive (all MRPs)
• Medic Emergency Situations at Lakeridge Health Medical Directive (all MRPs)
• Respiratory Distress - Respiratory Therapy Medical Directive (all MRPs)
• Stroke Prevention Clinic Diagnostic – Medical Directive

Surgeons (Hospital Wide)

• Adult Pre-Operative Testing Grid - Surgeons
• Ambulatory Rehabilitation Centre Referral - Medical Directive (all MRPs)
• Diet Texture by Speech Language Pathologists (all MRPs)
• Initiation of Peripheral Intravenous in the Operating Room and Endoscopy Suite
• Medic Emergency Situations at Lakeridge Health Medical Directive (all MRPs)
• Pre-operative COVID-LHO Rapid Testing for Admitted Surgical Adult Patients Requiring Continuous Positive Airway Pressure (CPAP) Therapy Devices
• Respiratory Distress - Respiratory Therapy Medical Directive (all MRPs)

Thoracic Surgeons

• Adult Pre-Operative Testing Grid - Thoracic Surgeons
• Adult Enteral Tube Feeding Medical Directive
• Ambulatory Rehabilitation Centre Referral - Medical Directive (all MRPs)
• Diagnostic Testing for Lung Patients Prior to their First Surgical Consult Visit within Thoracic Diagnostic Assessment Program
• Diet Texture by Speech Language Pathologists (all MRPs)
• Emergency Situations Medical Directives (all MRPs)
• Initiation of Peripheral Intravenous in the Operating Room and Endoscopy Suite
• Medic Emergency Situations at Lakeridge Health Medical Directive (all MRPs)
• Parenteral Nutrition (Adult & Paediatric) (all MRPs)
• Initiation of Intravenous in Endoscopy Suite
• Respiratory Distress - Respiratory Therapy Medical Directive (all MRPs)
• Specimen Collection for Antibiotic Resistant Organisms (AROs) - (All MRPs)

All Associate, Active, Courtesy Workload and Locum Physicians not listed above

• Adult Intubation by Registered Respiratory Therapist
• Ambulatory Rehabilitation Centre Referral - Medical Directive (all MRPs)
• Diet Texture by Speech Language Pathologists (all MRPs)
• Emergency Situations Medical Directives (all MRPs)
• Medic Emergency Situations at Lakeridge Health Medical Directive (all MRPs)
• Oral Nutrition Therapy
• Parenteral Nutrition (Adult & Paediatric) (all MRPs)
• Respiratory Distress - Respiratory Therapy Medical Directive (all MRPs)
• Adult Enteral Tube Feeding Medical Directive
• Specimen Collection for Antibiotic Resistant Organisms (AROs) - (All MRPs)