Emergency Health Services

Paramedic Practice Documents

The Ministry of Health (MOH), Emergency Health Services (EHS), is responsible under the Ambulance Act for publishing standards for patient care, documentation, safety, equipment requirements and transportation. These requirements are outlined in various paramedic practice documents: Standards, Training Bulletins, Manuals and Guides.

  • Standards set the requisites for paramedic practice; many are incorporated by reference in O. Reg 257/00 as made under the Ambulance Act
  • Training Bulletins provide clarification regarding current issues or make amendments to existing Standards
  • Manuals and Guides further direct practice

Click on the document titles in the tables below to access a copy of the document. If the document is in a non-accessible format, clicking on the link will automatically initiate an email to EHS to allow you to request a copy of the document.

As per Ontario government services standards, all emails will be acknowledged within two business days and answered within 15 business days.

Living Standard Project

In February 2015 a more streamlined process, the Living Standard Project, was established to update, maintain, and disseminate paramedic practice documents. This process recognizes that development and maintenance is a cyclical process in which publication of a revised version is both the end of one process and the start of another. Documents are reviewed on set maintenance cycles, but requests for change can also be made on an ad hoc basis. To request a Change Request Form, please email ParamedicStandards@ontario.ca.

Version numbers may have up to three numeric digits and one alpha value (i.e. 0.0.1.a) depending on the document’s state (but always a minimum of two):

  • The first numeric digit will indicate the full update version number
  • The second numeric digit will indicate the partial update version number
  • The third numeric digit will indicate the update due to a reissue after a publication error (if applicable)
  • The alpha value (listed after the numeric digits) will indicate the draft version number (if applicable)

Documents which stakeholders and the public can comment on are posted on the Proposed changes to documents page.

Patient Care Documents incorporated by reference

The Standards listed in this table are incorporated by reference into O. Reg 257/00 as made under the Ambulance Act. Once a new version of a standard comes into force, it replaces the existing, in force version.

Standards Version In Force As Of
Advanced Life Support Patient Care Standards version 4.6.1 October 23, 2019
Ambulance Service Communicable Disease Standards version 2.0 August 1, 2015

Basic Life Support Patient Care Standards

version 3.2 September 3, 2019
Ontario Ambulance Documentation Standards version 3.0 April 1, 2017
Patient Care and Transportation Standards version 2.2 July 22, 2016
Provincial Equipment Standards for Ontario Ambulance Services version 3.4 May 1, 2018

Other Patient Care Documents, Manuals and Guides

The documents in the table below provide clarification regarding current issues and also address such things as safety, equipment requirements and additional direction for practice.

Training Bulletins Issue Date In Force As Of
Training Bulletin No. 101
Influenza Educational Review 2019-2020, version 18.0
October 17, 2019 N/A
Training Bulletin No. 105
Personal medical information programs, version 1.0
July 26, 2005 N/A
Training Bulletin No. 109
Penetrating Chest Injuries, version 1.0
March 26, 2010 N/A
Training Bulletin No. 112
Excited Delirium, version 1.0
February 28, 2012 N/A
Training Bulletin No. 114
Ebola Virus Disease, version 4.0
September 20, 2015 N/A
Training Bulletin No. 115
Ambulance Service Communicable Disease Standards (version 2.0), version 1.0
November 21, 2014 N/A
Training Bulletin No. 119
Basic Life Support Patient Care Standards, version 3.0, version 1.0
July 20, 2016 N/A
Manuals and Guides Version In Force As Of
Ambulance Call Report (ACR) Codes version 3.0 N/A
Ambulance Call Report (ACR) Completion Manual version 3.0 April 1, 2017
Infection Prevention and Control Best Practices Manual for Land Ambulance Paramedics version 1.0 March 30, 2007
Prehospital CTAS Paramedic Guide version 2.0 December 31, 2016

Paramedic Practice Documents Archive

Once a new version of a paramedic practice document comes into force, the previous version will be archived here.

To request a copy of any of the archived paramedic practice documents (documents incorporated by reference), click on the document title. If the document is in a non-accessible format, clicking on the link will automatically initiate an email to EHS to allow you to request a copy of the document.

.
Standards Version In Force As Of
Advanced Life Support Patient Care Standards version 3.3 February 1, 2016
Amendment to version 3.3 (Opioid Toxicity Medical Directives) December 23, 2016
version 3.4 February 1, 2017
Amendment to version 3.4 (Opioid Toxicity Medical Directives) February 1, 2017
version 4.3 July 17, 2017
version 4.5 May 1, 2018
version 4.6 September 3, 2019
Basic Life Support Patient Care Standards version 2.0 January 1, 2007
version 3.0.1 December 11, 2017
version 3.1 March 1, 2018
Ontario Ambulance Documentation Standards version 2.0 April 1, 2000
version 2.1 July 1, 2016
Patient Care and Transportation Standards version 2.0 October 1, 2007
version 2.1 July 18, 2016
Provincial Equipment Standards for Ontario Ambulance Services version 2.3 February 1, 2016
version 3.2 July 17, 2017
version 3.3 December 11, 2017
Training Bulletins Version In Force As Of
Training Bulletin No. 106
Summary of Major Revisions BLS PCS (version 2.0), version 1.0
October 20, 2006 N/A
Training Bulletin No. 108
DNR Standard
version 1.0 February 1, 2008
Training Bulletin No.110
Revised Paramedic Prompt Card for Acute Stroke Protocol
version 1.0 September 1, 2011
Training Bulletin No.111
Deceased Patient Standard
version 1.0 March 1, 2011
Training Bulletin No. 113
Field Trauma Triage and Air Ambulance Utilization Standards
version 1.0 June 1, 2015
Training Bulletin No. 116
Child in Need of Protection Standard
version 1.0 June 1, 2015
Training Bulletin No. 117
Infectious Disease Physicians Consultation Process Training Bulletin
version 1.0 August 25, 2015
Training Bulletin No. 118
STEMI Hospital Bypass Protocol
version 1.0 February 1, 2017
Manuals and Guides Version In Force As Of
Ambulance Call Report (ACR) Completion Manual version 2.2 June 1, 2003


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For More Information

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