Emergency medical services in Canada
[2] Responsibility for emergency medical services (EMS), as a part of health care in general, lies with the provinces and territories of Canada.
Typically, the provincial/territorial government provides enabling legislation, technical standards, accreditation or licensing,[3] and oversight to a variety of operators, including municipalities, hospitals, and private companies.
[11] Canada is a vast country, and its sheer size dictates that in many cases a helicopter-based air ambulance service is impractical as the distances required exceed the flight range of the aircraft.
In some jurisdictions, not all air ambulance calls are emergencies, since distances to tertiary care centres mean that some patients with lower-acuity medical conditions are also flown.
[13] British Columbia, Alberta, Saskatchewan, Nova Scotia, Ontario, Prince Edward Island, and Yukon are served by highly educated paramedics with advanced skills.
A great deal of the recent advancement in standards of care and procedures has been driven by formal outcome-based research[15] and clinical trials, such as the groundbreaking research work on the management of S-T segment elevation myocardial infarctions (STEMI), undertaken in cooperation with the Ottawa Paramedic Service.
The number and type of medications beyond the minimum standard also varies with the paramedic scope of practice (primary, advanced or critical care).
The Paramedic Association of Canada has produced the National Occupational Competency Profile (NOCP),[22] and several provinces are working toward meeting these standards.
In addition, initiatives by the Paramedic Chiefs of Canada[23] organization are working towards improved interoperability and a best practice approach to the overall management of EMS systems.
Several provinces have started testing using the COPR (Canadian Organization of Paramedic Regulators) licensing exam for both PCP and ACP levels.
Health insurance in Canada is universal and publicly funded, so the cost of emergency ambulance services is covered to some degree.
In some cases, the vehicles are often made to look as much like EMS ambulances as possible,[29] even retaining emergency lights and sirens (which they are forbidden by law to use), and incorporating the word "paramedic" (this term is not protected in Canada yet), variations on "EMS" (in some cases, "event medical services") or spelling variations of "ambulance", such as "ambu-lans", or using the Star of Life logo on their vehicle markings.
These services generally attempt to recruit staff who meet provincial EMS qualification standards, but are under no legal obligation to do so.
Such services are not covered by provincial health insurance, operate on a fee-for-service basis, and are not considered to be a legitimate part of mainstream EMS.
