 For example, in the provinces of Ontario, Quebec and Newfoundland and Labrador, many paramedic services allow Primary Care Paramedics to perform 12-lead ECG interpretation, or initiate intravenous therapy to deliver a few additional medications.The Advanced care paramedic (ACP) is a level of practitioner that is in high demand by many services across Canada.However, Quebec only utilizes this level of practice in a very limited fashion as part of a pilot program in Montreal.