The Toronto EMS Communications Centre processes about 334,000 calls per year and responds to approximately 265,000 requests for service resulting in transport of about 182,000 patients per year or about 500 per day.
When the pick up location is confirmed, the information from the display is downloaded into the ambulance service’s Computer Aided Dispatch system (CAD). The Emergency Medical Dispatcher (EMD) will then ask the caller a series of questions to prioritize the emergency call. Once a priority has been decided, the call is sent to the dispatcher for paramedic assignment.
Initially, a caller will contact a 911 operator who will direct them to one of three emergency service operators; police, ambulance or fire service, depending on the nature of the emergency. When the call is directed to the Toronto EMS Communications Centre, the caller’s address and telephone number are displayed to the call receiver.
The EMD will continue to ask some scene-specific questions (e.g. entrance location) and then provide the caller with instructions on how to help the patient prior to the arrival of paramedics. These instructions include basic first aid and depending on the severity of the patient could also give callers instructions on CPR, use of an automatic external defibrillator, administration of epi-pens or ASA, and assist choking patients. Many EMDs have also been able to supply callers with instructions on the delivery of a child, earning them a “Stork Pin” to celebrate this occasion.
You will also receive instructions from the EMD to do a couple of important things that will assist the paramedics when they arrive. Those instructions include unlocking doors, turning on lights, putting away any pets and gathering medication and/or doctors’ information.
Ambulance call receivers determine call priority through the use of the Advanced Medical Priority Dispatch System (AMPDS), an expert system used to identify the nature and seriousness of the call. Using the AMPDS questioning sequence, the patient’s condition is evaluated and the appropriate response option selected. Once this is done, the ambulance dispatch form is updated and the ambulance dispatcher relays the details of the call to the responding paramedics. The call receiver may stay on the line with the caller and provide pre-arrival assistance and support. This assistance may include providing the caller with instructions for Cardiopulmonary Resuscitation (CPR), the Heimlich manoeuvre for a choking patient, or coaching the caller in the delivery of a baby.
Part of our success as an Emergency Service is dependent on our partnerships. On a day-to-day basis Toronto EMS works alongside the Toronto Police Service and Toronto Fire Services as we respond to emergency calls in the city. The Toronto EMS Communications Centre also works with a number of agencies to assist in providing service to the citizens and visitors of Toronto.
While processing an emergency call, it may be determined that the caller could be better served by speaking with a registered nurse from Telehealth Ontario. Telehealth Ontario is a free service that callers can be connected with to get health advice or general health information from a registered nurse.
Toronto EMS subscribes to a translation service which offers access, 24 hours a day, to interpreters of 170 languages. The caller and the ambulance call receiver are conferenced with the interpreter to determine the appropriate response.
Toronto EMS works with colleagues at the Ontario Poison Centre to assist patients dealing with a potential health issues related to accidental poisoning while paramedics are enroute.
Distress Centre of Toronto
Toronto EMS processes many calls for people who are dealing with mental health issues. To better serve patients, Toronto EMS partnered with the Distress Centre of Toronto to provide support to high-risk callers while help is enroute.
At present, there are 36 ambulance stations located throughout the approximately 632 square kilometres of Toronto. As well as selecting notifying and supporting the paramedics who respond to the requests for emergency service, the ambulance dispatchers ensure the optimal distribution of available paramedic crews throughout the city, 24 hours a day, every day. This is accomplished by mobile deployment of ambulances in response to by the demand which fluctuates throughout the day as workers from the suburban bedroom communities commute to their workplaces in Toronto and then leave at the end of the day. It is estimated that the city’s normal population of 2.5 million people could increase by another 1.5 million during a typical business day.
The Toronto EMS Communications Centre is responsible for coordinating and dispatching non-emergency patient transfers originating in Toronto. This includes those with destinations within the City of Toronto and elsewhere throughout the province. A small fleet of ambulances and two multi-patient buses are used by two dispatchers who focus their efforts on providing non-emergency service. Advanced booking of non-emergency calls is encouraged and can be accommodated up to thirty-one days in advance of the date on which service is needed. Transfers with destinations out of the city are coordinated by another dispatcher, and transport is provided by either a Toronto EMS ambulance or an ambulance based close to the destination.