[3] Prior to these two municipal initiatives, ambulance service was provided for the young city by a variety of means, including both hospital-based and private companies.

Toronto may very well be able to claim to have the first formally trained 'ambulance attendants' in North America, with the Toronto Police Force ambulance service staff receiving five days of formal training in their jobs from the St. John Ambulance Brigade in 1889.

The service introduced its first paramedics in 1984 (although experiments in pre-hospital advanced life support actually began in 1969).

[7] Toronto EMS introduced many other innovations, including the concept of dedicated ground-based critical care transport ambulances in 1998, as well as many specialty support units described in this article, many of which were originally conceived and pioneered by the service.

It is the largest municipal EMS operation in Canada and at the time was led by Chief Bruce Farr.

[8] The change follows a national trend and drive for the adoption of Paramedic as the publicly recognized title for prehospital emergency care providers.

Uniforms consist of: Of the 242 vehicles in the Toronto Paramedic Services fleet, 150 are CMVSS / Ontario Standard Type III ambulances.

They are mounted on Chevrolet Express van chassis with boxes custom built by Crestline to suit the needs of the service.

Toronto Paramedic Services currently operates a fleet of custom built busses and equipment support vehicles for use during mass-casualty or large-scale events.

[9] 2006 Orion Vii 1 One example in service on Toronto Islands due to road width restrictions2 Special Operations3 Unmarked, issued to senior operations staff4 Used for transporting large groups/special teams for events or deployment5 Equipped with multiple, mission specific pods 1 Vehicle actually owned by Lambton County heritage museum.

Toronto Paramedic Services operates its own Communications and System Control Centre (called a Central Ambulance Communications Center or CACC "Kaack"), including emergency medical dispatch, patient distribution and system oversight.

The system uses Computer-Aided Dispatch, including Tritech VisiCAD, augmented by PDS and Optima Live software and technology.

The service utilizes a 700 mHz P25 Phase II trunking radio system for dispatch purposes.

The Control Centre has direct landline contact with the 9-1-1 Center, all other emergency services, all acute care hospitals, and all Paramedic Stations.

Based upon information provided by Toronto Paramedic Services, the service processed in excess of 535,000 calls through its Control Centre in 2007 (the most recent year for which complete data is available), resulting in 223,769 emergency calls being dispatched.

The Southwest quadrant is bounded roughly by Eglinton Avenue to the north, Lake Ontario to the south, Yonge Street to the east, and Etobicoke Creek to the west.

The Southeast quadrant is bounded roughly by Eglinton Avenue to the north, Lake Ontario to the south and east, and Yonge Street to the west.

Multiple stakeholders and various levels of government are currently seeking solutions to this problem, but have, so far, experienced only limited success.

[19] This service is used by Emergency Medical Dispatchers processing 9-1-1 calls, or by paramedics treating patients in the field, on a daily basis.