When the pick up location is confirmed, the information from the display is downloaded into the ambulance service’s Computer Aided Dispatch system (CAD) and an emergency pre-alert is directed to the Emergency Medical Dispatcher for unit assignment. While the call receiver is questioning the caller as to the nature of the problem, the dispatcher is notifying a paramedic crew of the pick up location.
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.
Toronto EMS subscribes to a translation service which offers access, 24 hours a day, to interpreters of 140 languages. The caller and the ambulance call receiver are conferenced with the interpreter to determine the appropriate response.
Poison Control and hazardous materials (Hazmat) services are also available to the communications centre if their need is identified.
The status of hospital emergency departments is monitored in the Communications Centre.
This information is used to ensure quick attention for patients requiring critical care and to help in equally distributing patients requiring less critical care.
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 all 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.
