Toronto EMS - Biblioteka.sk

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Toronto EMS
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Toronto Paramedic Services
Established1975
HeadquartersToronto, Ontario
JurisdictionMunicipal
Employees~1400
ChiefBikram Chawla
Medical directorDr. Morgan Hillier
WebsiteOfficial website

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.[1] 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.[2] 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 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.[3] 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.[4] 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).[5] 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 under the leadership of John Dean, 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,[6] 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 1998 under the leadership of Chief Ron Kelusky, in order to reflect its evolving role from primarily a provider of medical transportation to an actual provider of medical care. It was at that time that the service undertook a rebranding with the unique forward facing A on all of its vehicles.

The service introduced its first paramedics in 1984 (although experiments in pre-hospital advanced life support actually began in 1969).[7] Toronto EMS introduced many other innovations, including the concept of dedicated ground-based critical care transport ambulances in 2000, 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 and at the time was led by Chief Bruce Farr.

In July 2014, Chief Paul Raftis announced that as part of a rebranding effort, Toronto EMS will change its name to Toronto Paramedic Services.[8] 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.[9]

Type III Ambulance
Emergency Response Unit
Special Operations utility unit
Bicycle transport unit
Operational Support unit

Fleet numbering

  • 5XX - Paramedic Supervisor, Rapid Response, Special Operations
  • 4XX,8XX - Ambulance, West
  • 9XX - Ambulance, East
  • ESUXX - Emergency Support Unit

Current fleet

Year Make/Model Type Builder/Modification Origin
2014-2016 Chevrolet Express Cutaway Type III Ambulance Crestline Canada
2010 Ford E-Series Type II Ambulance1 Crestline Canada
2013-2016 Chevrolet Tahoe Supervisor/First Response Rowland United States
2016 Chevrolet Suburban Supervisor2 Rowland United States
2016 Ford Taurus Senior Command Staff3
2003 ElDorado National Escort RE-A Multi Patient Emergency Response Vehicle Crestline United States
2008 ElDorado National Axess Multi Patient Emergency Response Vehicle Crestline United States
2010 ElDorado National Axess Multi Patient Emergency Response Vehicle Crestline United States
1992 MCI 102A2 Highway Coach4 Ex GO Transit Canada
2009 Chevrolet Kodiak C5500 24 Passenger Bus4 United States
2003 Freightliner FL80 Emergency Support Unit Walk-Around Rescue Body Canada
2008 International Durastar Emergency Support Unit Cargo Body United States
2010 Freightliner M2 106 Roll Back5 Emergency Support Unit Pod Truck United States
John Deere Gator Special Events Albion United States
Mikey Cart Special Events Albion
  • United States
  • Canada
1997-2000 Ford E-Series Cutaway Box Truck Logistics Stock United States
2009 Chevrolet Kodiak C5500 Logistics Stock United States
2011-2013 Mercedes-Benz Sprinter Logistics Stock Germany
2006-2012 Chevrolet 2500HD Maintenance/Support Plow/Salter United States

2006 Orion Vii

1 One example in service on Toronto Islands 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

Year Make/Model Type Builder/Modification Origin Status
1908 Horse Drawn Wagon/Carriage Ambulance Petrolia Wagon Works Canada Static display1
1954 Packard Ambulance Henney United States Working display / PR vehicle
1966 Pontiac Bonneville Wagon Ambulance Example United States Working display / PR vehicle
1971-19932 Dodge Ram Van Type II Ambulance United States Working display / PR vehicle
1983-20032 Ford E350 Type II Ambulance Various United States Retired
1990-20052 Ford E350 Cutaway Box Type III Ambulance Crestline United States Retired
1980 Plymouth Volare Wagon First Response United States Retired
1993-20012 Jeep Cherokee First Response United States Retired
2001 Ford Crown Victoria Police Interceptor First Response/Management Stock Canada Retired3
2001-2006 Chevrolet Tahoe First Response/Supervisor Rowland United States Retired3
1981 Chevrolet Impala Wagon Supervisor/First Response Stock United States Retired
1996-20002 Dodge Caravan Supervisor Stock United States Retired
1988 OBI 01.508 Emergency Communications Unit Canada Retired
1963 GMC TDH 4517 Ambulance Bus
  • United States
  • Canada
Retired
1980 OBI 01.504 Ambulance Bus Canada Retired
1980 OBI 01.502 Ambulance Bus Canada Retired
1981 OBI 01.502 Ambulance Bus Canada Retired
1982 OBI 01.502 Ambulance Bus Canada Retired
1986 OBI 01.508 Ambulance Bus Canada Retired
1988 OBI 02.501 Ambulance Bus Canada Retired
GMC Step Van Emergency Support Unit United States Retired
1987 Ford C800 Emergency Power Unit 100 kW Generator and Lighting Unit United States Retired
1985 Ford C800 Emergency Support Unit United States Retired
1976 Chevrolet Suburban Emergency Support Unit Off-Road Rescue United States Retired
1993 Ford F-450 Cutaway Emergency Support Unit Cargo Box United States Retired

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.com
2Multiple 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.[10] These are categorized as follows:

  • 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) - 23 positions. In addition to Level III training, CCTU requires an additional 1,142 hours of training and 480 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)[12]
  • 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.[13] 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.[14]

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 stations, geographically distributed across the 640 km2 (246 sq mi) 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 providing the southern boundary of the service area. Air ambulance operations are provided within the City of Toronto by Ornge, 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.[9] Using the AMPDS system, which triages 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.

Station Neighbourhood Address Vehicles Deployed Notes
01 Multifunction Station Downsview-Roding-CFB 1300 Wilson Ave BLS, ALS, ARU/PRU, Supervisor, Logistics and Administrative Post 01 & 01-Logistics in the same building
11 Station Yorkdale-Glen Park 1135 Caledonia Rd BLS N/A
12 Station Mount Olive-Silverstone-Jamestown 1535 Albion Rd BLS, ALS N/A
13 Station Willowridge-Martingrove-Richview 555 Martin Grove Rd BLS N/A
14 Station West Humber-Clairville 321 Rexdale Blvd BLS N/A
15 Station Glenfield-Jane Heights 2753 Jane St BLS, ALS Shared with Toronto Fire Station 142
17 Station/Post Humber Summit 50 Toryork Dr BLS N/A
18 Station Forest Hill 643 Eglinton Ave W BLS, ALS N/A
19 Station Weston 2015 Lawrence Ave W BLS, ALS Shared with Toronto Fire Station 442

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.

Station Neighbourhood Address Vehicles Deployed Notes
20 Station Dorset Park 2430 Lawrence Ave E BLS, ALS, ARU, Supervisor N/A
21 Station Wexford-Maryvale 887 Pharmacy Ave BLS, ALS 21 Station crews are controlled by the Southeast dispatcher.
22 Station Scarborough Village 3100 Eglinton Ave E BLS 22 Station crews are controlled by the Southeast dispatcher.
23 Station Don Valley Village/Henry Farm 115 Parkway Forest Dr BLS, ALS Shared with Toronto Fire Station 115
24 Station L'Amoreaux 3061 Birchmount Rd BLS N/A
25 Station Rouge 8500 Sheppard Ave E BLS, ALS Shared with Toronto Fire Station 212
26 Station West Hill 4331 Lawrence Ave E BLS, ALS, ARU Shared with Toronto Police 43 Division
26 Post Centennial Scarborough 5318 Lawrence Ave E ARU Shared with Toronto Fire Station 215
27 Station Milliken/Malvern 900 Tapscott Rd BLS Shared with Toronto Fire Station 211
28 Station Bendale 2900 Lawrence Ave E BLS N/A
29 Station Agincourt 4560 Sheppard Ave E BLS, ALS, ARU Shared with Toronto Fire Station 243

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.

Zdroj:https://en.wikipedia.org?pojem=Toronto_EMS
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Station Neighbourhood Address Vehicles Deployed Notes
30 Station Weston-Pelham Park 100 Turnberry Ave BLS, PRU, Supervisor N/A
31 Station Kingsway South 4219 Dundas St W BLS, ALS, ARU N/A
32 Station High Park 9 Clendenan Ave BLS N/A
33 Station Dovercourt-Wallace Emerson-Junction 760 Dovercourt Rd BLS, ALS N/A
34 Station Annex 674 Markham St BLS N/A
35 Station Liberty Village/CNE Grounds 265 Manitoba Dr BLS, Special Events Carts (Only during CNE) N/A
36 Station Waterfront Communities 339 Queens Quay W BLS, Marine Medic Shared with Toronto Fire/Marine Station 334
37 Station Parkdale