Through the operator certification requirements set in Ontario Regulation 257/00, Ontario's land ambulances are required to contain the equipment listed in the ”Provincial Equipment Standards for Ontario Ambulance Services” published by the Ministry of Health and Long-Term Care as may be amended from time-to-time.

Items of equipment being evaluated through a field trial or pilot project funded or approved by the ministry, may be used in conjunction with the items listed in the Provincial Equipment Standards for Ontario Ambulance Services.

As long as an ambulance is equipped with all of the items appearing in these equipment standards, an operator may also carry other items of equipment.

If an operator chooses to provide additional equipment in an ambulance that is not required by these equipment standards, or has not been approved by the Director of the Emergency Health Services Branch as part of a field trial or pilot project :

• the operator assumes full financial and other responsibility with respect to the purchase, implementation, staff training, continuing medical education, maintenance and use of the additional item of equipment.
• additional equipment must be properly restrained in the ambulance or emergency response vehicle in accordance with the ”Land Ambulance Patient Care and Transportation Standards”, and any modification to the Original Equipment Manufacturer (OEM) chassis or conversion must be completed using approved OEM practices, (Ontario Provincial Ambulance and Emergency Vehicle Standards, Sec. 15.1), relating to equipment and accessories installed in an ambulance.
• if a new item of equipment is to be added to the list of equipment carried in an ambulance, and that item of equipment is to be used in the performance of an Advanced Life Support procedure, the new item of equipment must function in such a way as to ensure that Paramedics can provide care in accordance with the requirements for the Advanced Life Support Patient Care Standards. The operator assumes full financial and other responsibility with respect to any patient care procedures not specified in the Patient Care Standards.
• It is strongly recommended that a review of such equipment be undertaken by the local base hospital(s) Medical Director prior to implementing the new item.

A person or organization seeking to have an item of patient care equipment considered for equivalency, as meeting the standard, should seek the assistance of a scientifically or technically qualified person or agency such as the Canadian Standards Association, or the Underwriters' Laboratories of Canada to evaluate the equivalency of the proposed substitute product against the Provincial Equipment Standards for Ontario Ambulance Services. Once equivalency is determined the operator of the service needs to file a true copy of the equivalency document with each certified ambulance service where the item of equipment is to be used.

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