The Ambulance Care Directive (ACD) has been developed as a collaborative initiative between the National Ambulance Service, Dublin Fire Dublin Fire Brigade; Faculty of Paediatrics, RCPI.

The ACD is designed to facilitate the hospital’s advanced treatment plan in the pre-hospital environment. It applies to children and young people less than 18 years with advanced, life limiting incurable conditions.The clear purpose of the ACD process is to relieve NAS staff of the obligation to administer CPR to a child or young person in the community whose parents or legal guardians have agreed with their primary paediatrician that resuscitation would be inappropriate. The ACD fulfils the requirement in the PHECC Clinical Practice Guideline on “End of Life Care”.