toronto paramedic services toronto paramedic services the city of toronto paramedic services (tps; formerly known as toronto emergency medical services), is the statutory emergency medical services provider in toronto, ontario, canada. the service is operated as a division of the city of toronto, under the community & social services cluster. the service is funded by the municipal tax base, 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 and licensing. 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. toronto paramedic servicesestablished1975headquarterstoronto, ontariojurisdictionmunicipalemployees~1400chiefbikram chawla (acting)medical directordr. morgan hillierwebsiteofficial website history the city of toronto has operated an ambulance 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 vehicles. 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 in 1889. training included first aid skills, anatomy and physiology. such training for ambulance attendants was unheard of at that time, outside of military circles. the police constables 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 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. 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, 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. 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 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 high visibility jacket 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 with visor as required (construction sites, vehicle extrication etc...). black safety boots/shoes. fr military style tactical shirt/pants, gloves, ballistic helmet/riot helmet and ballistic vest for tactical units. hazmat suits for cbrne units. dress uniform consisting of dark navy pants and tunic, white shirt, navy tie and forage cap. paramedic uniforms have royal blue 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. 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 by crestline coach ltd. . they are mounted on chevrolet express van chassis with boxes custom built by crestline to suit the needs of the service. the department currently employs chevrolet tahoe suvs for first response and supervisory vehicles as well as an assortment of fully equipped but unmarked vehicles (primarily dodge caravan and ford taurus) 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. type iii ambulanceemergency response unitmulti-casualty transport unit special operations utility unitbicycle transport unitoperational support unit fleet numbering 5xx - paramedic supervisor, rapid response, special operations 4xx,8xx - ambulance, west 9xx - ambulance, east esuxx - emergency support unit current fleet yearmake/modeltypebuilder/modificationorigin 2014-2016chevrolet express cutawaytype iii ambulancecrestline canada 2010ford e-seriestype ii ambulance1crestline canada 2013-2016chevrolet tahoesupervisor/first responserowland united states 2016chevrolet suburbansupervisor2rowland united states 2016ford taurussenior command staff3 2003eldorado national escort re-amulti patient emergency response vehiclecrestline united states 2008eldorado national axessmulti patient emergency response vehiclecrestline united states 2010eldorado national axessmulti patient emergency response vehiclecrestline united states 1992mci 102a2highway coach4ex go transit canada 2009chevrolet kodiak c550024 passenger bus4 united states 2003freightliner fl80emergency support unitwalk-around rescue body canada 2008international durastaremergency support unitcargo body united states 2010freightliner m2 106 roll back5emergency support unitpod truck united states john deere gatorspecial eventsalbion united states mikey cartspecial eventsalbion united states canada 1997-2000ford e-series cutaway box trucklogisticsstock united states 2009chevrolet kodiak c5500logisticsstock united states 2011-2013mercedes-benz sprinterlogisticsstock germany 2006-2012chevrolet 2500hdmaintenance/supportplow/salter united states 2006 orion vii 1 one example in service on toronto islands due to road width restrictions2 special operations3 unmarked, issued to senior operations staff4 used for transporting large groups/special teams for events or deployment5 equipped with multiple, mission specific pods historic/retired vehicles yearmake/modeltypebuilder/modificationoriginstatus 1908horse drawn wagon/carriageambulancepetrolia wagon works canadastatic display1 1954packardambulancehenney united statesworking display/pr vehicle 1966pontiac bonneville wagonambulanceexample united statesworking display/pr vehicle 1971-19932dodge ram vantype ii ambulance united statesworking display / pr vehicle 1983-20032ford e350type ii ambulancevarious united statesretired 1990-20052ford e350 cutaway boxtype iii ambulancecrestline united statesretired 1980plymouth volare wagonfirst response united statesretired 1993-20012jeep cherokeefirst response united statesretired 2001ford crown victoria police interceptorfirst response/managementstock canadaretired3 2001-2006chevrolet tahoefirst response/supervisorrowland united statesretired3 1981chevrolet impala wagonsupervisor/first responsestock united statesretired 1996-20002dodge caravansupervisorstock united statesretired 1988obi 01.508emergency communications unit canadaretired 1963gmc tdh 4517ambulance bus united states canadaretired 1980obi 01.504ambulance bus canadaretired 1980obi 01.502ambulance bus canadaretired 1981obi 01.502ambulance bus canadaretired 1982obi 01.502ambulance bus canadaretired 1986obi 01.508ambulance bus canadaretired 1988obi 02.501ambulance bus canadaretired gmc step vanemergency support unit united statesretired 1987ford c800emergency power unit100 kw generator and lighting unit united statesretired 1985ford c800emergency support unit united statesretired 1976chevrolet suburbanemergency support unitoff-road rescue united statesretired 1993ford f-450 cutawayemergency support unitcargo box united statesretired 1 vehicle actually owned by lambton county 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.com2multiple model years used by department until final retirement. 3 examples may still be in service as utility vehicles staff critical care paramedic ambulance toronto 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 prior to employment. successful completion of provincial certification 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 superintendent 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 system uses computer-aided dispatch, 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 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 paramedics prepare to transport patient. 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