Patient Care and Transportation Standards Version 2.2.j (Draft) Sections 1 and 2 Emergency Health Services Branch Ministry of Health and Long-Term Care
To all users of this publication: The information contained in Patient Care & Transportation Standards has been carefully compiled and is believed to be accurate at date of publication. For further information on the Patient Care and Transportation Standards, please contact: Emergency Health Services Branch Ministry of Health and Long-Term Care 5700 Yonge Street, 6th Floor Toronto, ON M2M 4K5 416-327-7900 Queen s Printer for Ontario, 2017 Document Control Version Number (status) Date of Issue Comes into Force Date Brief Description of Change 1.0 April 2007 Original release of document 1.0.1(Draft) Sept 15, 2015 Revisions section A- General 1.0.2 (Draft) September 24, 2015 1.0.3 (Draft) September 29, 2015 1.0.4 (Draft) September 30, 2015 Revisions section B Infections Prevention and Control (formerly Communicable Disease Management) Ongoing revisions and updates to the document Section B Ongoing revisions and updates to the document Section B 1.0.5 (Draft) October 7, 2015 Ongoing revisions and updating document with Section B 1.0.6(Draft) October 23, 2015 Ongoing revisions and updates to the document Section C 1.0.7(Draft) November 23, 2015 Ongoing revisions and updates to the document 1.0.8 (Draft) January 14, 2016 Inserted previous text to include changes from current standard to draft 2.1 (Draft) July 18, 2016 July 18, 2016 Updated to incorporate amended version 2.1 language 2.2.0 (Draft) July 22, 2016 July 22, 2016 Updated to incorporate amended version 2.2 language and changed version
Version Number (status) Date of Issue Comes into Force Date Brief Description of Change 2.2.a July 28, 2016 Updated version control in Document and Document Control Table 2.2.b August 2, 2016 Updated from internal review 2.2.c August 3, 2016 Updated from internal review 2.2.d October 6, 2016 Formatting and updating information 2.2.e October 13, 2016 Updating material in the document 2.2.f October 14, 2016 Updated from internal review 2.2.g Nov 22, 2016 Reformatted the sections 2.2.h Dec 5, 2016 Reformatting sections and update from internal review 2.2.i Dec 15, 2016 Comments from internal review 2.2.j Jan 13, 2017 Sections 1 and 2 Revisions from internal review
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Table of Contents Preamble... 7 Preface... 8 Abbreviation... 8 Definitions... 8 Section 1 General... 9 General... 10 Paramedic Conduct... 10 Section 2 Patient Transport... 11 Patient Transport... 12 Vehicle Staffing Requirements... 12
Patient Care and Transportation Standard Version 2.2.j (Draft) Sections 1 and 2
Preamble i
Emergency Health Services Branch, Ontario Ministry of Health and Long-Term Care Preamble Preface The Patient Care and Transportation Standards (PCTS) is a Ministry of Health and Long-Term Care (MOHLTC) standard which outlines to ambulance service operators and paramedics the minimum mandatory requirements for patient care and transportation needs as required by clause 11(d) of O. Reg. 257/00 under the Ambulance Act. Abbreviation Abbreviation Full Title ACO ALS PCS BLS PCS EHSB EMA ERV ICP MOH-LTC RPAP TMP Ambulance Communications Officer Advance Life Support Patient Care Standards Basic Life Support Patient Care Standards Emergency Health Services Branch Emergency Medical Attendant Emergency Response Vehicle Infection Control Practitioner Ministry of Health & Long-Term Care Routine Practices and Additional Precautions Transport Medicine Physician Definitions Transport Medicine Physician or TMP means a physician appointed under a base hospital program for air ambulance services to provide medical advice to air ambulance services and air ambulance communication services relating to patient care and the transportation of patients by air ambulance. Patient Care and Transportation Standards 8 Version 2.2.j (Draft)
Section 1 General 1
Emergency Health Services Branch, Ontario Ministry of Health and Long-Term Care General The paramedic shall: 1. attend and participate in continuing education and competency maintenance activities as are required to provide patient care and ambulance service delivery in accordance with the regulations; 2. ensure that an ACO is kept informed at all times as to the availability and location of the ambulance or ERV. Paramedic Conduct ** this section will be transfered over to BLS PCS to be included in the Paramedic Conduct Standard the paramedic shall not: i. take or consume any liquor within the meaning of the Liquor Control Act, or any drug which could impair their ability to function while on duty; ii. iii. iv. report for duty while under the influence of any liquor with the meaning of the Liquor Control Act, or any drug which impairs their ability; responds to a request for ambulance service while apparently under the influence of liquor or drugs or is apparently suffering the effect of liquor or drugs; permit a person to smoke any cigar, cigarette, tobacco or other substance while in an ambulance or ERV. Patient Care and Transportation Standards 10 Version 2.2.j (Draft) Sections 1 and 2
Section 2 Patient Transport 2
Patient Transport Each paramedic shall: 1. ensure that each item of equipment transported in an ambulance or ERV is properly restrained; 2. ensure that each patient transported and person travelling in an ambulance or ERV or each person traveling in an ERV is properly restrained; 3. ensure that each person travelling transported in an ERV is properly restrained; 4. ensure to follow every direction or instruction issued by an ACO with respect to the assignment of calls to ambulances or ERVs. ensure that the driver of an ambulance, in which a patient is being transported, shall transport the patient to a health care facility as directed by an ACO ordering the movements of the ambulance. In the absence of a direction from an ACO, the driver will transport the patient to the closest health care receiving facility that can provide the appropriate care apparently required by the patient. Vehicle Staffing Requirements Each operator and paramedic employed or engaged as a volunteer by an operator shall ensure that: 1. each ambulance that is designated as an ERV is staffed with one person who is qualified as a paramedic under the regulations. 2. each ambulance that is designated by an ambulance service operator as a primary care paramedic ambulance is staffed with at least one person two people who are qualified as primary care paramedics; or one EMA when responding to a request for ambulance service or while transporting a patient; Each ambulance responding to a request for service is staffed with at least one primary care paramedic and one EMA as qualified under the regulations; 3. each ambulance that is designated by an ambulance service operator as an advanced care paramedic ambulance is staffed with at least one person who is qualified as an advanced care paramedic and one primary care paramedic; when responding to a request for ambulance service or while transporting a patient. 4. each ambulance that is designated as a critical care paramedic ambulance is staffed with at least one person who is qualified as a critical care paramedic and one primary or advanced care paramedic; Patient Care and Transportation Standards 12 Version 2.2.j (Draft) Sections 1 and 2
Emergency Health Services Branch, Ontario Ministry of Health and Long-Term Care 5. where an ambulance is designated as an air ambulance, then each paramedic shall also be qualified as a flight paramedic. 6. Notwithstanding (1), (2), (3) and (4) above, an air ambulance may be staffed with only one paramedic if: 1. the request is for an inter-facility transfer; 2. the patient requires a level of care that can be provided by a single paramedic, as determined by the TMP; 3. the paramedic is available exclusively for patient care throughout the transport; AND 4. there is no undue risk to patient safety by using a single paramedic, as determined by the TMP. 7. Notwithstanding (1), (2), (3) and (4) above, an air ambulance may be staffed with only one paramedic if: 1. the request is for an inter-facility transfer; AND 2. there is a dedicated medically-responsible escort or team that is provided by the sending facility. Patient Care and Transportation Standards 13 Version 2.2.j (Draft) Sections 1 and 2