Emergency Health Services

Patient Care Models

The Ontario government is launching new 9-1-1 models of care in 33 municipalities across the province. These new models of care will ensure paramedics have more options to provide safe and appropriate treatment for patients while helping to protect hospital capacity as part of Ontario’s COVID-19 response.

Regions or Pilot Project Lead Organization Ambulance Services Model Type Eligible Patients Description
Central East Ontario
  • Kawartha Lakes Paramedic Service;
  • Region of Durham Paramedic Services;
  • Haliburton County Paramedic Service;
  • Northumberland Paramedics;
  • Peterborough County/City Paramedics
Treat and Refer Model Palliative Care Patients Palliative care patients calling 9-1-1 will have the option to be treated on-scene for pain and symptom management, including pain or dyspnea, hallucinations or agitation, terminal congested breathing, and nausea or vomiting. Following treatment on-scene, patients have the option for paramedics to coordinate the patient’s follow-up care directly with the patient’s primary palliative care provider or with a local hospice for further treatment and wrap-around care.

Paramedics are trained to administer a range of medications to address the above symptoms:

  • Morphine
  • Hydromorphone
  • Salbutamol
  • Haloperidol
  • Midazolam
  • Ondansetron
  • Dimenhydrinate
  • Glycopyrrolate
  • Atropine
Centre for Paramedic Education and Research
  • Brant & Brantford Paramedic Service;
  • Guelph-Wellington Paramedic Service;
  • Haldimand County Paramedic Service;
  • Norfolk County Paramedic Service;
  • Six Nations Paramedic Service;
  • Region of Waterloo Paramedic Services
Treat and Refer Model Palliative Care Patients Palliative care patients calling 9-1-1 will have the option to be treated on-scene for pain and symptom management, including pain or dyspnea, hallucinations or agitation, terminal congested breathing, and nausea or vomiting. Following treatment on-scene, patients have the option for paramedics to coordinate the patient’s follow-up care directly with the patient’s primary palliative care provider or with a local hospice for further treatment and wrap-around care.

Paramedics are trained to administer a range of medications to address the above symptoms:

  • Morphine
  • Hydromorphone
  • Salbutamol
  • Haloperidol
  • Midazolam
  • Ondansetron
  • Dimenhydrinate
  • Glycopyrrolate
  • Atropine
Hamilton
  • Hamilton Paramedic Service
Treat and Refer Model Palliative Care Patients Palliative care patients calling 9-1-1 will have the option to be treated on-scene for pain and symptom management, including pain or dyspnea, hallucinations or agitation, terminal congested breathing, and nausea or vomiting. Following treatment on-scene, patients have the option for paramedics to coordinate the patient’s follow-up care directly with the patient’s primary palliative care provider or with a local hospice for further treatment and wrap-around care.

Paramedics are trained to administer a range of medications to address the above symptoms:

  • Morphine
  • Hydromorphone
  • Salbutamol
  • Haloperidol
  • Midazolam
  • Ondansetron
  • Dimenhydrinate
  • Glycopyrrolate
  • Atropine
Health Sciences North
  • Cochrane District Social Services Administration Board;
  • Weeneebayko Area Health Authority;
  • Manitoulin-Sudbury District Services Board;
  • City of Greater Sudbury Emergency Services;
  • Algoma District Paramedic Services;
  • Nipissing, Temagami, and Mattawa Emergency Medical Service;
  • Parry Sound District Emergency Medical Service;
  • District of Timiskaming Emergency Medical Services;
  • Sault Ste. Marie Paramedic Services
Treat and Refer Model Palliative Care Patients Palliative care patients calling 9-1-1 will have the option to be treated on-scene for pain and symptom management, including pain or dyspnea, hallucinations or agitation, terminal congested breathing, and nausea or vomiting. Following treatment on-scene, patients have the option for paramedics to coordinate the patient’s follow-up care directly with the patient’s primary palliative care provider or with a local hospice for further treatment and wrap-around care.

Paramedics are trained to administer a range of medications to address the above symptoms:

  • Morphine
  • Hydromorphone
  • Salbutamol
  • Haloperidol
  • Midazolam
  • Ondansetron
  • Dimenhydrinate
  • Glycopyrrolate
  • Atropine
Regional Paramedic Program of Eastern Ontario
  • Hastings-Quinte Paramedic Services;
  • Lennox and Addington Paramedic Service;
  • Frontenac Paramedic Services;
  • Leeds Grenville Paramedic Service;
  • Renfrew County Paramedic Service;
  • Lanark County Paramedic Service;
  • Cornwall SDG Paramedic Services;
  • Ottawa Paramedic Services;
  • Prescott and Russell Paramedic Services
Treat and Refer Model Palliative Care Patients Palliative care patients calling 9-1-1 will have the option to be treated on-scene for pain and symptom management, including pain or dyspnea, hallucinations or agitation, terminal congested breathing, and nausea or vomiting. Following treatment on-scene, patients have the option for paramedics to coordinate the patient’s follow-up care directly with the patient’s primary palliative care provider or with a local hospice for further treatment and wrap-around care.

Paramedics are trained to administer a range of medications to address the above symptoms:

  • Morphine
  • Hydromorphone
  • Salbutamol
  • Haloperidol
  • Midazolam
  • Ondansetron
  • Dimenhydrinate
  • Glycopyrrolate
  • Atropine
York Region
  • York Region Paramedic Service
Treat and Refer Model Palliative Care Patients Palliative care patients calling 9-1-1 will have the option to be treated on-scene for pain and symptom management, including pain or dyspnea, hallucinations or agitation, terminal congested breathing, and nausea or vomiting. Following treatment on-scene, patients have the option for paramedics to coordinate the patient’s follow-up care directly with the patient’s primary palliative care provider or with a local hospice for further treatment and wrap-around care.

Paramedics are trained to administer a range of medications to address the above symptoms:

  • Morphine
  • Hydromorphone
  • Salbutamol
  • Haloperidol
  • Midazolam
  • Ondansetron
  • Dimenhydrinate
  • Glycopyrrolate
  • Atropine
Dufferin County
  • Dufferin County Paramedic Service
Alternate Destination Palliative Care Patients Paramedics are able to assess the patient on-scene, including establishing baseline vital signs (e.g. checking blood pressure, heart rate, etc.) and confirming patient consent before assisting in transporting palliative care patients directly to a hospice that they are registered with instead of to the hospital.
Guelph-Wellington
  • Guelph Wellington Paramedic Service
Alternate Destination Palliative Care Patients For palliative care patients, paramedics are able to assess the patient on-scene, including establishing baseline vital signs (e.g. checking blood pressure, heart rate, etc.) and confirming patient consent before assisting in transporting palliative care patients directly to a hospice that they are registered with instead of to the hospital.
Alternate Destination Mental Health and Addictions Patients For patients experiencing symptoms of mental health and addictions challenges, paramedics are also able to provide an on-scene assessment to mental health and addictions patients, including determining if the patient is medically stable and conduct an assessment for appropriateness to be directly transported to and treated at a crisis centre, or other community-based care setting with patient consent.
Middlesex-London
  • Middlesex-London Paramedic Services *
*Middlesex-London Paramedic Services began operating their pilot in 2020.
Alternate Destination Mental Health and Addictions Patients Paramedics are able to provide an on-scene assessment to mental health and addictions patients, including determining if the patient is medically stable and conduct an assessment for appropriateness to be transported to and treated at a crisis centre, or other community-based clinic. If the patient consents, paramedics will be permitted to transport patients directly to the Centre for Mental Health and Addictions in London, Ontario.

The majority of the new models for palliative care patients being piloted are based on the “Ontario Palliative Care Network’s Competency Framework for Paramedics” which is designed to equip paramedics with the skills and knowledge to respond to palliative care needs. The model is federally supported by the Canadian Partnership Against Cancer and Healthcare Excellence Canada (previously the Canadian Foundation for Healthcare Improvement).

Please contact your local municipality for further details regarding program rollout and availability in your region.  A complete listing of Ontario municipalities, including contact information, is available online at www.ontario.ca/page/list-ontario-municipalities

For More Information

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