Emergency Health Services Branch

Paramedic Practice Documents

The Ministry of Health and Long-Term Care (MOHLTC), through the Emergency Health Services Branch (EHSB), 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 EHSB 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.

Patient Care Documents incorporated by reference

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

Standards Version In Force As Of
Advanced Life Support Patient Care Standards version 4.3 July 17, 2017
version 4.4 December 11, 2017
Ambulance Service Communicable Disease Standards version 2.0 August 1, 2015
Basic Life Support Patient Care Standards version 2.0 January 1, 2007
version 3.0.1 December 11, 2017
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 3.2 July 17, 2017
version 3.3 December 11, 2017
Training Bulletins Issue Date In Force As Of
Training Bulletin No. 108
DNR Standard, version 1.0
November 29, 2007 February 1, 2008
Training Bulletin No.110
Revised Paramedic Prompt Card for Acute Stroke Protocol, version 1.0
February 23, 2011 September 1, 2011
Training Bulletin No.111
Deceased Patient Standard, version 1.0
December 30, 2010 March 1, 2011
Training Bulletin No. 113
Field Trauma Triage and Air Ambulance Utilization Standards, version 1.0
June 23, 2014 June 1, 2015
Training Bulletin No. 116
Child in Need of Protection Standard, version 1.0
March 31, 2015 June 1, 2015
Training Bulletin No. 118
STEMI Hospital Bypass Protocol, version 1.0
February 1, 2016 February 1, 2017

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 2015-2016, version 15.0
October 31, 2016 N/A
Training Bulletin No. 105
Personal medical information programs, version 1.0
July 26, 2005 N/A
Training Bulletin No. 106
Summary of Major Revisions BLS PCS (version 2.0), version 1.0
October 20, 2006 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) 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 EHSB 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
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
Training Bulletins Version In Force As Of
Training Bulletin No. 117
Infectious Disease Physicians Consultation Process Training Bulletin
version 1.0 August 25, 2015
Manuals and Guides Version In Force As Of
Ambulance Call Report (ACR) Completion Manual version 2.2 June 1, 2003


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Emergency Health Services Branch
5700 Yonge Street, 6th Floor
Toronto, Ontario
Canada M2M 4K5
Telephone: 416-327-7820
1-800-461-6431 (Toll-free in Ontario only)
Fax: : 416-327-7911
Email : CertificationExams@ontario.ca