The City of Toronto Paramedic Services (TPS; formerly known as Toronto Emergency Medical Services), is the statutory
emergency medical services
Emergency medical services (EMS), also known as ambulance services or paramedic services, are emergency services that provide urgent pre-hospital treatment and stabilisation for serious illness and injuries and transport to definitive care. ...
provider in
Toronto
Toronto ( ; or ) is the capital city of the Canadian province of Ontario. With a recorded population of 2,794,356 in 2021, it is the most populous city in Canada and the fourth most populous city in North America. The city is the ancho ...
,
Ontario
Ontario ( ; ) is one of the thirteen provinces and territories of Canada.Ontario is located in the geographic eastern half of Canada, but it has historically and politically been considered to be part of Central Canada. Located in Central Ca ...
,
Canada
Canada is a country in North America. Its ten provinces and three territories extend from the Atlantic Ocean to the Pacific Ocean and northward into the Arctic Ocean, covering over , making it the world's second-largest country by tot ...
. The service is operated as a division of the
City of Toronto
Toronto ( ; or ) is the capital city of the Provinces and territories of Canada, Canadian province of Ontario. With a recorded population of 2,794,356 in 2021, it is the List of the largest municipalities in Canada by population, most pop ...
, under the Community & Social Services cluster. The service is funded by the municipal
tax base
A tax is a compulsory financial charge or some other type of levy imposed on a taxpayer (an individual or legal entity) by a governmental organization in order to fund government spending and various public expenditures (regional, local, or ...
, and operates similarly to other municipal divisions, such as the
Toronto Parks, Forestry & Recreation division, or the
Toronto Water division, but retains operational independence from other divisions. While under municipal government control, it is subject to provincial
legislation
Legislation is the process or result of enrolled bill, enrolling, enactment of a bill, enacting, or promulgation, promulgating laws by a legislature, parliament, or analogous Government, governing body. Before an item of legislation becomes law i ...
and
licensing
A license (or licence) is an official permission or permit to do, use, or own something (as well as the document of that permission or permit).
A license is granted by a party (licensor) to another party (licensee) as an element of an agreeme ...
. It is not the only service provider in its area; private-for-profit medical transport services also provide routine, non-emergency transports and coverage for special events, but the statutory emergency medical system is the only provider permitted to service emergency calls.
History
The City of Toronto has operated an
ambulance
An ambulance is a medically equipped vehicle which transports patients to treatment facilities, such as hospitals. Typically, out-of-hospital medical care is provided to the patient during the transport.
Ambulances are used to respond to medi ...
service directly on an uninterrupted basis since 1883, when the
City of Toronto Health Department acquired two ambulances to transport those with infectious diseases to the local
sanitarium. Full-time emergency ambulance service began in 1888, with the provision of emergency ambulance service by the
Toronto Police Force, which eventually operated four
horse-drawn vehicle
A horse-drawn vehicle is a mechanized piece of equipment pulled by one horse or by a team of horses. These vehicles typically had two or four wheels and were used to carry passengers and/or a load. They were once common worldwide, but they have m ...
s. Prior to these two municipal initiatives, ambulance service was provided for the young city by a variety of means, including both hospital-based and private companies. This 'broad spectrum' approach to service delivery would continue for more than ninety years.
Toronto may very well be able to claim to have the first formally trained 'ambulance attendants' in North America, with the Toronto Police Force ambulance service staff receiving five days of formal training in their jobs from the
St. John Ambulance Brigade
St John Ambulance is the name of a number of affiliated organisations in different countries which teach and provide first aid and emergency medical services, and are primarily staffed by Volunteering, volunteers. The associations are overseen b ...
in 1889. Training included
first aid
First aid is the first and immediate assistance given to any person with either a minor or serious illness or injury, with care provided to preserve life, prevent the condition from worsening, or to promote recovery. It includes initial in ...
skills,
anatomy
Anatomy () is the branch of biology concerned with the study of the structure of organisms and their parts. Anatomy is a branch of natural science that deals with the structural organization of living things. It is an old science, having its ...
and
physiology
Physiology (; ) is the scientific study of functions and mechanisms in a living system. As a sub-discipline of biology, physiology focuses on how organisms, organ systems, individual organs, cells, and biomolecules carry out the chemical ...
. Such training for ambulance attendants was unheard of at that time, outside of military circles. The police
constables
A constable is a person holding a particular office, most commonly in criminal law enforcement. The office of constable can vary significantly in different jurisdictions. A constable is commonly the rank of an officer within the police. Other peop ...
assigned to the ambulance also did regular
policing, when not required for ambulance calls. As the city grew and technology progressed, so did the ambulance service. The first motorized ambulance was actually purchased by a local
funeral home
A funeral home, funeral parlor or mortuary, is a business that provides burial and funeral services for the dead and their families. These services may include a prepared wake and funeral, and the provision of a chapel for the funeral.
Services
...
in 1911, and the Toronto Police Ambulance Service began the conversion from horse-drawn to motorized vehicles in 1913, with the process largely completed by 1918. Over the years, the two City of Toronto departments would have their services supplemented by more than 130 individual ambulance operators, most of them private companies, and in suburban areas by several of the tiny, local
fire departments
A fire department (American English) or fire brigade (Commonwealth English), also known as a fire authority, fire district, fire and rescue, or fire service in some areas, is an organization that provides fire prevention and fire suppression se ...
. The two municipal services would finally be merged in 1933, when the Toronto Police Department turned the operation of their ambulances over to the Department of Public Health, and ended their involvement in the city's ambulance service.
This service would grow again in 1953, as the result of the creation of the municipality of
Metropolitan Toronto
The Municipality of Metropolitan Toronto was an upper-tier level of municipal government in Ontario, Canada, from 1953 to 1998. It was made up of the old city of Toronto and numerous townships, towns and villages that surrounded Toronto, whic ...
, dramatically expanding the required service area. Service would continue in this fashion until 1967, when the amalgamated City's suburban fire departments surrendered their ambulances, resulting in the evolution of the Department of Public Health Ambulance Service into the City-operated Department of Emergency Services (DES). Some private companies, and one operated by the provincial government, would continue to operate in 'Metro' Toronto until 1975, although with centralized dispatch services provided by DES.
The Metropolitan Toronto Department of Ambulance Services was created in 1975, and absorbed the five remaining private ambulance companies and single provincial service, providing a single, unified ambulance service in
Metro Toronto
The Municipality of Metropolitan Toronto was an upper-tier level of municipal government in Ontario, Canada, from 1953 to 1998. It was made up of the old city of Toronto and numerous townships, towns and villages that surrounded Toronto, which ...
. Known colloquially as ''Metro Toronto Ambulance'' or simply ''Metro Ambulance'' (although never its official name) the service provided ambulance services from 1975 to 1998.
Metropolitan Toronto was restructured during 1998, transforming it from a regional government overseeing six member municipalities into a single, unified city, and many municipal and regional services were restructured as a result. Metro Ambulance became Toronto Ambulance then Toronto Emergency Medical Services in order to reflect its evolving role from primarily a provider of medical transportation to an actual provider of medical care.
The service introduced its first
paramedics
A paramedic is a registered healthcare professional who works autonomously across a range of health and care settings and may specialise in clinical practice, as well as in education, leadership, and research.
Not all ambulance personnel are p ...
in 1984 (although experiments in pre-hospital advanced life support actually began in 1969). Toronto EMS introduced many other innovations, including the concept of dedicated ground-based critical care transport ambulances, as well as many specialty support units described in this article, many of which were originally conceived and pioneered by the service.
As of April 2005, the departments and commissioners were replaced by divisions under the City Manager (and Deputy Managers). Toronto EMS now operates under the city's Emergency Medical Services Division. It is the largest municipal EMS operation in Canada.
In July 2014, Chief Paul Raftis announced that as part of a rebranding effort, Toronto EMS will change its name to Toronto Paramedic Services. The change follows a national trend and drive for the adoption of Paramedic as the publicly recognized title for prehospital emergency care providers. On October 1, the new name came to effect.
Uniforms
Uniforms consist of:
* Dark navy short or long sleeve police style shirt with departmental crest, reflective stripes around arms and Toronto Paramedic in reflective print on chest and back.
*
Chartreuse
Chartreuse () may refer to:
Food and drink
* Chartreuse (liqueur), a French liqueur
* Chartreuse (dish), a French dish of vegetables or meat tightly wrapped in vegetable leaves and cooked in a mould
Religion
* Carthusians, a Catholic religi ...
high visibility jacket
High-visibility clothing, sometimes shortened to hi vis or hi viz, is any clothing worn that is highly luminescent in its natural matt property or a color that is easily discernible from any background. It is most commonly worn on the torso and ...
with Toronto Paramedic in reflective print on back as well as job title (Paramedic, Supervisor etc...) front and back.
* Dark navy cargo pants with reflective stripes around lower leg.
* White shirts for Supervisory/Management staff.
* Bicycle helmet and shorts for bike crews.
*
Hard hat
A hard hat is a type of helmet predominantly used in workplace environments such as industrial or construction sites to protect the head from injury due to falling objects, impact with other objects, debris, rain, and electric shock. Suspensio ...
with visor as required (construction sites,
vehicle extrication
Vehicle extrication is the process of removing a vehicle from around a person who has been involved in a motor vehicle collision, when conventional means of exit are impossible or inadvisable. A delicate approach is needed to minimize injury to th ...
etc...).
* Black
safety boots
Safety is the state of being "safe", the condition of being protected from harm or other danger. Safety can also refer to the control of recognized hazards in order to achieve an acceptable level of risk.
Meanings
There are two slightly dif ...
/shoes.
*
FR Military style tactical shirt/pants, gloves,
Ballistic helmet
A combat helmet or battle helmet is a type of helmet. It is a piece of personal armor designed specifically to protect the head during combat. Modern combat helmets are mainly designed to protect from shrapnel and fragments, offer some protec ...
/riot helmet and
Ballistic vest
A bulletproof vest, also known as a ballistic vest or a bullet-resistant vest, is an item of body armor that helps absorb the impact and reduce or stop penetration to the torso from firearm-fired projectiles and fragmentation from explosions. ...
for tactical units.
*
HAZMAT
Dangerous goods, abbreviated DG, are substances that when transported are a risk to health, safety, property or the environment. Certain dangerous goods that pose risks even when not being transported are known as hazardous materials ( syllabi ...
suits for CBRNE units.
*
Dress uniform
Full dress uniform, also known as a ceremonial dress uniform or parade dress uniform, is the most formal type of uniforms used by military, police, fire and other public uniformed services for official parades, ceremonies, and receptions, incl ...
consisting of dark navy pants and tunic, white shirt, navy tie and
forage cap
Forage cap is the designation given to various types of military undress, fatigue or working headwear. These varied widely in form, according to country or period. The coloured peaked cap worn by the modern British Army for parade and other dress o ...
. Paramedic uniforms have
royal blue
Royal blue is a deep and vivid shade of blue. It is said to have been created by clothiers in Rode, Somerset, a consortium of whom won a competition to make a dress for Queen Charlotte, consort of King George III.
Brightness
The ''Oxford En ...
cap band and striping on pants. Management staff have black maple laurels as well as gold piping on cap peak. Striping is orange-gold for the
honour guard
A guard of honour ( GB), also honor guard ( US), also ceremonial guard, is a group of people, usually military in nature, appointed to receive or guard a head of state or other dignitaries, the fallen in war, or to attend at state ceremonials, ...
.
Fleet
Of the 242 vehicles in the Toronto Paramedic Services fleet, 150 are CMVSS / Ontario Standard Type III ambulances. Of these, approximately 100 are in service at any time on a typical, mid-week, day shift. These vehicles are currently supplied b
Crestline Coach Ltd. They are mounted on
Chevrolet Express
Chevrolet ( ), colloquially referred to as Chevy and formally the Chevrolet Motor Division of General Motors Company, is an American automobile division of the American manufacturer General Motors (GM). Louis Chevrolet (1878–1941) and oust ...
van chassis with boxes custom built by
Crestline to suit the needs of the service. The department currently employs
Chevrolet Tahoe
The Chevrolet Tahoe, and its badge engineered GMC Yukon counterpart, are full-size SUVs from General Motors, offered since 1994 and 1991, respectively. Since 1982, Chevrolet and GMC sold two different-sized SUVs under their 'Blazer' and 'Jimmy ...
SUVs for First Response and supervisory vehicles as well as an assortment of fully equipped but unmarked vehicles (Primarily
Dodge Caravan
The Dodge Caravan (and the long-wheelbase Dodge Grand Caravan) is a series of minivans that was manufactured by Chrysler from the 1984 to 2020 model years. The Dodge version of the Chrysler minivans, the Caravan was marketed as both a passenger v ...
and
Ford Taurus
The Ford Taurus is an automobile that was manufactured by the Ford Motor Company in the United States from the 1986 to 2019 model years. Introduced in late 1985 for the 1986 model year, six generations were produced over 34 years; a brief hiat ...
) for senior management. Toronto Paramedic Services currently operates a fleet of custom built busses and equipment support vehicles for use during mass-casualty or large-scale events. Toronto Paramedic Services operates its own repair facilities, located at the service's Headquarters complex. All maintenance and repair work (with the exception of body work), and all equipment, radio, and medical electronics maintenance and repairs are performed on site by service staff.
[As reported by TPS in their Service Information Profile (internal document)]
Fleet numbering
* 5XX - Paramedic Supervisor, Rapid Response, Special Operations
* 4XX,8XX - Ambulance, West
* 9XX - Ambulance, East
* ESUXX - Emergency Support Unit
Current fleet
2006 Orion Vii
1 One example in service on Toronto Islands
The Toronto Islands are a chain of 15 small islands in Lake Ontario, south of mainland Toronto, Ontario, Canada.
Comprising the only group of islands in the western part of Lake Ontario, the Toronto Islands are located just offshore from the ...
due to road width restrictions
2 Special Operations
3 Unmarked, issued to senior operations staff
4 Used for transporting large groups/special teams for events or deployment
5 Equipped with multiple, mission specific pods
Historic/retired vehicles
1 Vehicle actually owned by Lambton County
Lambton County is a county in Southwestern Ontario, Canada. It is bordered on the north by Lake Huron, which is drained by the St. Clair River, the county's western border and part of the Canada-United States border. To the south is Lake Saint Cla ...
heritage museum. Previously on display at Toronto EMS HQ. Similar to vehicles that would have been operated in Toronto during Late 19th/Early 20th century. http://www.horsedrawnambulance.com
2Multiple model years used by department until final retirement.
3 Examples may still be in service as utility vehicles
Staff
Toronto
Toronto ( ; or ) is the capital city of the Canadian province of Ontario. With a recorded population of 2,794,356 in 2021, it is the most populous city in Canada and the fourth most populous city in North America. The city is the ancho ...
Paramedic Services has 1,207 members including paramedics and other support staff. These are categorized as follows:
* Paramedics
::* Level I - Primary Care Paramedic (PCP) - 428 positions. Must complete 1,400 hours of training in a
community college
A community college is a type of educational institution. The term can have different meanings in different countries: many community colleges have an "open enrollment" for students who have graduated from high school (also known as senior sec ...
prior to employment. Successful completion of provincial
certification
Certification is the provision by an independent body of written assurance (a certificate) that the product, service or system in question meets specific requirements. It is the formal attestation or confirmation of certain characteristics of a ...
exams is also required.
::* Level II - Primary Care Paramedic Enhanced - 151 positions. Requires an additional 572 hours of training in order to use an expanded skill set and scope of practice.
::* Level III - Advanced Care Paramedic (ACP) - 290 positions. In addition Level II training requires a further 360 hours of training and 480 hours of
preceptorship.
::* CCTU - Critical Care Paramedic (CCP) - 18 positions. In addition to Level III training, CCTU requires an additional 1,142 hours of training and 240 hours of preceptorship. Typically work only on Critical Care Transport ambulances, pictured right.
::* Paramedic Superintendent - Paramedic Superintendent - Unknown Amount. The Superintendant is above the ranks of the following, they are considered a staff member within the department. They train, evaluate, and interview our paramedics. Trainers are known as F.T.O, Field training officers.
::* Paramedic commander - Paramedic commander - Unknown amount. This is the highest-ranking paramedic to most likely find on duty. They are classified as a very high-ranking unit they are equivalent to a chief superintendent within Toronto Police services. They are the highest ranking unit aside from the Deputy chief, and chief themselves.
The total number of paramedics is 887.
* Other staff
::* Management staff - 72 positions.
::* Support staff - 134 positions.
::* Emergency Medical Dispatchers - 125 positions. (the Toronto Paramedic Services trains its own EMDs)
::* Other support roles/not specified - 6 positions.
Communications
Toronto Paramedic Services operates its own Communications and System Control Centre (called a Central Ambulance Communications Center or CACC "Kaack"), including emergency medical dispatch, patient distribution and system oversight. Toronto Paramedic Services participates in the community-wide 9-1-1 system, and triages emergency calls using the
Advanced Medical Priority Dispatch System
The Medical Priority Dispatch System (MPDS), sometimes referred to as the Advanced Medical Priority Dispatch System (AMPDS) is a unified system used to dispatch appropriate aid to medical emergencies including systematized caller interrogation and ...
. The system uses
Computer-Aided Dispatch
Computer-aided dispatch (CAD), also called computer-assisted dispatch, is a method of dispatching taxicabs, couriers, field service technicians, mass transit vehicles or emergency services assisted by computer. It can either be used to send messag ...
, including Tritech VisiCAD, augmented by PDS and Optima Live software and technology. The service utilizes a satellite-based
Automatic Vehicle Locating system in order to ensure that the closest appropriate response resource is consistently sent to each emergency call; all emergency response resources are included. The service utilizes a 700 mHz P25 Phase II
trunking
In telecommunications, trunking is a technology for providing network access to multiple clients simultaneously by sharing a set of circuits, carriers, channels, or frequencies, instead of providing individual circuits or channels for each clie ...
radio system for dispatch purposes. The Control Centre has direct landline contact with the 9-1-1 Center, all other emergency services, all acute care hospitals, and all Paramedic Stations. The service utilizes “
Language Line” service to provide instant simultaneous translation of emergency calls in more than 140 languages. Toronto Paramedic Services operates the largest EMS Communications Centre in Canada, which was recently accredited as an International Centre of Excellence by the International Academy of Emergency Dispatch.
Operations
![TorontoEMSactionshot](https://upload.wikimedia.org/wikipedia/commons/7/7e/TorontoEMSactionshot.JPG)
Service is provided to a residential population of approximately 3.2 million people, which rises to approximately 5 million on most business days.
Toronto Paramedic Services operates a total of 41 stations, geographically distributed across the of the City of Toronto. Emergency service headquarters (which is shared with Toronto Fire Services, but both services operate independently) is located at 4330 Dufferin Street in Toronto. This facility includes administrative offices, some education facilities, the Communications Centre, Fleet Maintenance, Planning and Operational Support, and Materials Management/Logistics.The service is supplemented by well-developed Paramedic Services in neighbouring communities on three sides, with
Lake Ontario
Lake Ontario is one of the five Great Lakes of North America. It is bounded on the north, west, and southwest by the Canadian province of Ontario, and on the south and east by the U.S. state of New York. The Canada–United States border sp ...
providing the southern boundary of the service area.
Air ambulance
Air medical services is a comprehensive term covering the use of air transportation, aeroplane or helicopter, to move patients to and from healthcare facilities and accident scenes. Personnel provide comprehensive prehospital and emergency and cri ...
operations are provided within the City of Toronto by
Ornge
Ornge (formerly Ontario Air Ambulance Corporation and Ontario Air Ambulance Service) is a Canadian not-for-profit corporation and registered charity that provides air ambulance and associated ground transportation services for the province of ...
, a privately owned air ambulance contractor, under contract to the Government of Ontario.
Based upon information provided by Toronto Paramedic Services, the service processed in excess of 535,000 calls through its Control Centre in 2007 (the most recent year for which complete data is available), resulting in 223,769 emergency calls being dispatched.
Using the
AMPDS system, which
triage
In medicine, triage () is a practice invoked when acute care cannot be provided for lack of resources. The process rations care towards those who are most in need of immediate care, and who benefit most from it. More generally it refers to prio ...
s calls by severity for dispatch purposes, the actual dispatch volume by category for that same year was:
: Echo: 4,311
: Delta: 76,595
: Charlie: 31,126
: Bravo: 64,572
: Alpha: 36,674
: Non-Emerg: 25,775
Ambulance Stations
District 1 - Northwest
The District 1 Hub is located at 01 Station (1300 Wilson Ave). The Northwest quadrant is bounded roughly by Steeles Avenue to the north, Eglinton Avenue to the south, Yonge Street to the east, and Highway 427 & Mississauga border to the west.
District 2 - Northeast
The District 2 Hub is located at 20 Station (2430 Lawrence Ave E). The Northeast quadrant is bounded roughly by Steeles Avenue to the north, Eglinton Avenue to the south, the Scarborough-Pickering Townline and Rouge River to the east, and Yonge Street to the west.
District 3 - Southwest
The District 3 Hub is located at 30 Station (100 Turnberry Ave). The Southwest quadrant is bounded roughly by Eglinton Avenue to the north, Lake Ontario to the south, Yonge Street to the east, and Etobicoke Creek to the west.
District 4 - Southeast
The District 4 Hub is located at 42 Station (1535 Kingston Rd). The Southeast quadrant is bounded roughly by Eglinton Avenue to the north, Lake Ontario to the south and east, and Yonge Street to the west.
District 5 - Special Operations
The District 5 Hub is located at 55 Station (5700 Bathurst St). District 5 has stations in multiple quadrants and is responsible for Toronto Paramedic Services’ special operations teams, which include: Response Units, Marine Unit, Critical Care Transport Unit (CCTU), CBRNE, ETF, Bike Unit, and Emergency Support Units.
Special operations
In addition to regular operations, Toronto Paramedic Services staffs a Special Operations Division, tasked with the provision of Paramedic services in unusual circumstances. The elements of this unit include:
*Tactical Unit - Cross-trained paramedics providing medical support to the
Toronto Police Emergency Task Force.
*Marine Unit - Cross-trained paramedics staffing the patrol vessels of the
Toronto Police Marine Unit in order to provide support for Toronto Police personnel, EMS services on the waters of Lake Ontario, and EMS service to the
Toronto Islands
The Toronto Islands are a chain of 15 small islands in Lake Ontario, south of mainland Toronto, Ontario, Canada.
Comprising the only group of islands in the western part of Lake Ontario, the Toronto Islands are located just offshore from the ...
.
*
HUSAR - Specially-trained paramedics operate together with elements of the
Toronto Fire Services
Toronto Fire Services (TFS) provides fire protection, technical rescue services, hazardous materials response, and first responder emergency medical assistance in Toronto, Ontario, Canada. Toronto Fire Services is currently the largest municipal f ...
and
Toronto Police Service
The Toronto Police Service (TPS) is a municipal police force in Toronto, Ontario, Canada, and the primary agency responsible for providing law enforcement and policing services in Toronto. Established in 1834, it was the first local police ser ...
to provide a joint-service Heavy Urban Search and Rescue team.
*
CBRNE
Chemical, biological, radiological and nuclear defence (CBRN defence) are protective measures taken in situations in which chemical, biological, radiological or nuclear warfare (including terrorism) hazards may be present. CBRN defence consist ...
(Chemical, Biological, Radioactive, Nuclear & Explosive) - Specially-trained paramedics operate together with elements of the Toronto Police Service and Toronto Fire Services to provide a joint-service Terrorism/Hazardous Materials Response team.
*Public Safety Unit - Cross-trained paramedics providing medical support to the Toronto Police Public Order Unit
*Emergency Response Unit - Single paramedics in
SUVs
A sport utility vehicle (SUV) is a car classification that combines elements of road-going passenger cars with features from off-road vehicles, such as raised ground clearance and four-wheel drive.
There is no commonly agreed-upon definitio ...
, tasked solely with response to high priority emergency calls.
*Bicycle Unit - Paramedics equipped with mountain bikes, capable of providing either BLS or ALS services in off-road areas, or at special events. Team also works in concert with the Toronto Police bike team to provide first response capabilities in the
Entertainment District
An entertainment district is a type of arts district with a high concentration of movie theaters, theatres or other entertainment venues. Such areas may be officially designated by local governments with functional zoning regulations, as well as ...
on weekend nights.
*Emergency Support Unit - Paramedics trained to operate the service's busses and equipment trucks. These respond to all potential
Mass Casualty Incidents (fires, multi-patient car accidents etc...), support for large crowd situations such as festivals and parades as well as responding to all calls involving aircraft at
Toronto Pearson International Airport
Lester B. Pearson International Airport , commonly known as Toronto Pearson International Airport, is an international airport located in Mississauga, Ontario, Canada. It is the main airport serving Toronto, its metropolitan area, and the surro ...
=Challenges=
As a result of how Canada's universal healthcare system is set up, hospital in-patient beds and
Emergency Departments
An emergency department (ED), also known as an accident and emergency department (A&E), emergency room (ER), emergency ward (EW) or casualty department, is a medical treatment facility specializing in emergency medicine, the acute care of pati ...
tend to be severely overcrowded, resulting in difficulties for paramedics transferring the care of their patients to hospital staff in a timely manner. Two- to four-hour delays in the transfer of care are commonplace, and six- to eight-hour delays are not unheard of. When this occurs, the service's ability to provide service to emergency calls in a timely manner will often degrade, because of decreased unit availability. Multiple stakeholders and various levels of government are currently seeking solutions to this problem, but have, so far, experienced only limited success.
The funding for Toronto Paramedic Services occurs as a result of a mixed formula, with fifty percent of funding coming from the municipal tax base and fifty percent from the provincial government. The funding of Toronto Paramedic Services is based upon its census population, not its business day population. As a result, there are always more people requiring EMS services than the system has been funded for.
Language barriers and cultural misperceptions in Toronto's multicultural landscape are commonplace for Toronto's
paramedics
A paramedic is a registered healthcare professional who works autonomously across a range of health and care settings and may specialise in clinical practice, as well as in education, leadership, and research.
Not all ambulance personnel are p ...
. The service subscribes to Language Line, a simultaneous telephone-based translation service which operates in more than 140 languages. This service is used by
Emergency Medical Dispatcher
An emergency medical dispatcher is a professional telecommunicator, tasked with the gathering of information related to medical emergencies, the provision of assistance and instructions by voice, prior to the arrival of emergency medical service ...
s processing
9-1-1
, usually written 911, is an emergency telephone number for the United States, Canada, Mexico, Panama, Palau, Argentina, Philippines, Jordan, as well as the North American Numbering Plan (NANP), one of eight N11 codes. Like other emergency nu ...
calls, or by paramedics treating patients in the field, on a daily basis. The service also operates its own ethnocultural access program.
The '
Baby Boom
A baby boom is a period marked by a significant increase of birth rate. This demographic phenomenon is usually ascribed within certain geographical bounds of defined national and cultural populations. People born during these periods are often ca ...
' generation is aging. As it does so, all of those 'boomers' become net consumers of health care, driving up demand for services. Simultaneously, all of those 'boomers' employed by the service in the early 1970s are reaching the end of their careers and retiring. Since subsequent generations are typically much smaller, the service is experiencing difficulty in recruiting suitably trained replacement staff, just as demand for services is increasing.
Research
Over the years, the presence of such a large system and call volume, along with a commitment to consistently capture high quality data, has permitted Toronto EMS to become a 'test-bed' for research projects involving both EMS and
emergency medicine
Emergency medicine is the medical speciality concerned with the care of illnesses or injuries requiring immediate medical attention. Emergency physicians (often called “ER doctors” in the United States) continuously learn to care for unsche ...
. This has resulted in a service which is extremely research-oriented and interested in outcome-based medicine. While this has provided any number of research opportunities for physicians and emergency medicine
residents through the Toronto Base Hospital program, it has also permitted paramedics to function as supporting and as lead researchers, and in some cases, as the principal researcher of their own projects. All research conducted at Toronto EMS is pre-approved by the
University of Toronto Research Ethics Committee, and the findings of research conducted at Toronto EMS, by both physicians and paramedics, has been published in respected,
peer-reviewed
Peer review is the evaluation of work by one or more people with similar competencies as the producers of the work (peers). It functions as a form of self-regulation by qualified members of a profession within the relevant field. Peer review ...
, international
journals.
Community involvement
Toronto paramedics are heavily involved in various community programs and partnerships. Toronto's paramedics are active participants in the community which they serve. At the 'grass roots' level, Toronto's paramedics and EMDs fund a children's breakfast club, ensuring a nutritious breakfast for the children who live in several of the city's housing projects. Paramedics also participate in a variety of other events in the community, including their enthusiastic (and occasionally successful) participation in the
dragon boat
A dragon boat is a human-powered watercraft originating from the Pearl River Delta region of China's southern Guangdong Province. These were made of teak, but in other parts of China, different kinds of wood are used. It is one of a family of t ...
races staged annually by the city's Chinese community. As another little known fact of community involvement by paramedics, all of the floats in the city's annual
Santa Claus Parade
Santa Claus parades, also called Christmas parades, are parades held in some countries to celebrate the official opening of the Christmas season with the arrival of Santa Claus who always appears in the last float.
The parades usually include them ...
(one of North America's largest), are driven by volunteers from Toronto Paramedic Services, including both paramedics and a variety of other staff.
See also
Paramedicine in Canada
*
List of EMS Services in Ontario
This is a list of Emergency Medical Services providers in the Canadian province of Ontario.
In 1999 The Government of Ontario downloaded responsibility for the provision of Land Ambulance Services. In the southern half of the province, the respon ...
*
Paramedics in Canada
A paramedic is a healthcare professional, providing pre-hospital assessment and medical care to people with acute illnesses or injuries. In Canada, the title paramedic generally refers to those who work on land ambulances or air ambulances p ...
*
Emergency Medical Services in Canada
Emergency medical services in Canada are the responsibility of each Canadian province or territory. The services, including both ambulance and paramedic services, may be provided directly by the province, contracted to a private provider, o ...
Emergency Services in Toronto
*
Toronto Police Service
The Toronto Police Service (TPS) is a municipal police force in Toronto, Ontario, Canada, and the primary agency responsible for providing law enforcement and policing services in Toronto. Established in 1834, it was the first local police ser ...
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Toronto Fire Services
Toronto Fire Services (TFS) provides fire protection, technical rescue services, hazardous materials response, and first responder emergency medical assistance in Toronto, Ontario, Canada. Toronto Fire Services is currently the largest municipal f ...
Employee association
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Toronto Paramedic Association
The Toronto Paramedic Association (TPA) was founded in 1992 to be a glee club and represent the interests of paramedics employed by Toronto Paramedic Services (TPS). During initial stages of development, membership consisted largely of Advanced C ...
References
External links
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{{Metro Toronto Government
EMS
Ambulance services in Canada