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Paramedics

Toronto Emergency Medical Services is an all-paramedic service providing advanced pre-hospital care across the city. Since 1997, every member of Toronto EMS ambulance crews has been a certified paramedic. This means that above and beyond transportation, we are able to provide immediate, sophisticated patient care onsite and enroute to hospital.


Level I paramedic

The level I paramedic is a community college graduate of an Ambulance and Emergency Care Program, has obtained EMCA certification, and is employed in an ambulance service. The function of a level I paramedic is to provide emergency patient care, cardiopulmonary resuscitation (CPR), patient immobilization, oxygen therapy, basic trauma life support, blood glucose testing, and non-emergency patient care and transportation.

The level I paramedic is certified by a physician to:

  • Operate a semi-automatic external defibrillator
  • Provide blood glucometry
  • Administer drugs including:
    • ASA
    • Epinephrine
    • Glucagon and glucose gel
    • Nitroglycerin
    • Salbutamol


Level I paramedic-ESU

In addition to all Level I paramedic qualifications, the Emergency Support Unit (ESU) designated paramedic has received 240 hours of additional training and licensing to operate all ESU designated ambulance vehicles and equipment.

Level II paramedic

The level II paramedic is a community college graduate of an Ambulance and Emergency Care Program, has obtained EMCA certification with two years of practical experience, and is employed in an ambulance service.
The function of a level II paramedic includes all the responsibilities of the level I paramedic and is further enhanced with additional training and skills.

Additional training includes 120 hours didactic training, 40 hours of clinical training, and 120 hours of preceptorship (supervised service delivery).

The level II paramedic is additionally certified by a physician to:

  • Perform endotracheal tube (ETT) care and maintenance
  • Perform synchronized cardioversion
  • Lead II cardiac rhythm interpretation
  • Provide intravenous therapy
  • Provide manual defibrillation
  • Intraosseous infusion
  • Administer additional drugs


Level III paramedic

The level III paramedic is a community college graduate of an Ambulance and Emergency Care Program, has obtained EMCA certification with three years of practical experience, and is employed in an ambulance service.
The function of a level III paramedic includes all the responsibilities of the level II paramedic and is further enhanced with additional training and skills.

Additional training includes 480 hours didactic and clinical training.

The level III paramedic is additionally certified by a physician to:

  • Perform needle cricothyrotomy
  • Perform chest needle decompression
  • Perform oral or nasal endotracheal intubation
  • Provide advanced assessment
  • Provide lead II and 12 ECG interpretation
  • Provide direct laryngosocopy and foreign object removal using Magill forceps
  • Provide external trancutaneous pacing
  • Administer a full drug list including:
    • Adenosine
    • Amiodarone
    • Atropine
    • Diazepam
    • Dopamine
    • Furosemide
    • IV glucose
    • IV epinephrine
    • Lidocaine
    • sodium bicarbonate

Becoming a paramedic
with Toronto EMS

For information on employment opportunities for paramedics within Toronto Emergency Medical Services, click here.

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