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108-612: The City of Toronto has operated an ambulance service directly on an uninterrupted basis since 1883, when the City of Toronto Health Department acquired two ambulances to transport those with infectious diseases to the local sanitarium . Full-time emergency ambulance service began in 1888, with the provision of emergency ambulance service by the Toronto Police Force , which eventually operated four horse-drawn vehicles . Prior to these two municipal initiatives, ambulance service

216-508: A lightbar or in special flush-mount designs (as seen on the Danish ambulance to the right), or may be hidden in a host light (such as a headlamp ) by drilling a hole in the host light's reflector and inserting the emergency light. These hidden lights may not be apparent until they are activated. Additionally, some of the standard lights fitted to an ambulance (e.g. headlamps , tail lamps) may be programmed to flash. Flashing headlights (typically

324-409: A type of cake ), chevrons (arrowheads – often pointed towards the front of the vehicle if on the side, or pointing vertically upwards on the rear) or stripes along the side (these were the first type of retro-reflective device introduced, as the original reflective material, invented by 3M , only came in tape form). In addition to retro-reflective markings, some services now have the vehicles painted in

432-613: A 'test-bed' for research projects involving both EMS and emergency medicine . This has resulted in a service which is extremely research-oriented and interested in outcome-based medicine. While this has provided any number of research opportunities for physicians and emergency medicine residents through the Sunnybrook Centre for Prehospital Medicine (the Base Hospital), it has also permitted paramedics to function as supporting and as lead researchers, and in some cases, as

540-700: A 3.42 or 3.73 axle ratio, while the heavy-duty 2500 and 3500 series vans have either a 3.73 axle or 4.10 axle ratio. 2003–2014 (LU3) Final engine derived from original Chevrolet small-block V8 Standard engine on current production; replaced 4.8L V8 Available only on heavy-duty 2500 and 3500 vans; flex-fuel capability added for 2010 2010–2017 (L20) Available only on 1500 and light-duty 2500 vans 2008–2014 (LMF) Flex-fuel capability added for 2008 Available only on 1500 and light-duty 2500 vans 2010–2020 (L96) 2018–2020 (LC8) Flex-fuel capability added in 2010, and CNG/LPG (propane) option added in 2018 Available only on heavy-duty 2500 and 3500 vans, and standard on

648-480: A Special Operations Division, tasked with the provision of Paramedic services in unusual circumstances. The elements of this unit include: Hospital in-patient beds and Emergency Departments tend to be severely overcrowded, resulting in difficulties for paramedics transferring the care of their patients to hospital staff in a timely manner. Two- to four-hour delays in the transfer of care are commonplace, and six- to eight-hour delays are not unheard of. When this occurs,

756-489: A bright (sometimes fluorescent ) yellow or orange for maximum visual impact, though classic white or red are also common. Fire department-operated ambulances are often painted red to match the fire apparatuses. Another passive marking form is the word ambulance (or local language variant) spelled out in reverse on the front of the vehicle. This enables drivers of other vehicles to more easily identify an approaching ambulance in their rear view mirrors . Ambulances may display

864-612: A composite headlamp assembly. For 1999, a few minor functional changes were made to the model line. In a more noticeable update, Chevrolet retired the Chevrolet Van nameplate entirely, with the cargo van renamed the Express Cargo Van. For 2003, the Express and Savana underwent a mid-cycle revision. Alongside substantial frame and chassis upgrades, the bodywork forward of the windshield was revised. Distinguished by

972-455: A design based on vans or pickup trucks , though others take the form of motorcycles , buses , hearses , aircraft and boats . Ambulances are generally considered emergency vehicles authorized to be equipped with emergency lights and sirens . Generally, vehicles count as an ambulance if they can transport patients. However, it varies by jurisdiction as to whether a non-emergency patient transport vehicle (also called an ambulette )

1080-403: A full-size Chevrolet van since 1964) replaced it as the diesel engine offering. For 2018, an "EcoTec3" 4.3 L V6 was introduced as the base gasoline engine; the same year, CNG/LPG capability was added as an option to the 6.0 L V8. For 2021, the 6.0 L V8 was replaced by an all-new 6.6 L V8 (L8T) first introduced in the 2020 Silverado HD. The 1500 and light-duty 2500 series had

1188-704: A fully qualified doctor on board. Most ambulance services require at least two crew members to be on every ambulance (one to drive, and one to attend the patient). It may be the case that only the attendant need be qualified, and the driver might have no medical training. In some locations, an advanced life support ambulance may be crewed by one paramedic and one technician, or in countries like Australia advanced life support registered paramedics. Common ambulance crew qualifications are: Military ambulances have historically included vehicles based on civilian designs and at times also included armored, but unarmed, vehicle ambulances based upon armoured personnel carriers (APCs). In

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1296-606: A gasoline engine in order to meet emissions requirements. In the United Kingdom, the National Health Service has set a target for all ambulances to be fully electric as part of the Net Zero campaign by 2045. Many regions have prescribed standards which ambulances should, or must, meet in order to be used for their role. These standards may have different levels which reflect the type of patient which

1404-469: A higher hood line, the newer front fascia (developed as an improved crumple zone ) was brought closer in line with the GMT800 full-size pickup trucks introduced for 1999; the model line also introduced a degree of parts commonality between the two model lines. The dashboard underwent a redesign; along with the addition of dual-stage airbags, the interior added multiplex wiring (adding increased functionality to

1512-429: A left -> right pattern for use when the ambulance is parked on the left hand side of the road, indicating to other road users that they should move to the right (away from the ambulance)). Incandescent and LED lights may also be programmed to burn steadily, without flashing, which is required in some provinces. Emergency lights may simply be mounted directly on the body, or may be housed in special fittings, such as in

1620-649: A national trend and drive for the adoption of Paramedic as the publicly recognized title for prehospital emergency care providers. On October 1, the new name came to effect. Uniforms consist of: Of the 242 vehicles in the Toronto Paramedic Services fleet, 150 are CMVSS / Ontario Standard Type III ambulances. Of these, approximately 100 are in service at any time on a typical, mid-week, day shift. These vehicles are currently supplied by Crestline Coach Ltd. . They are mounted on Chevrolet Express van chassis with boxes custom built by Crestline to suit

1728-554: A number of its Merkava main battle tanks with ambulance features in order to allow rescue operations to take place under heavy fire in urban warfare . The modifications were made following a failed rescue attempt in which Palestinian gunmen killed two soldiers who were providing aid for a Palestinian woman in Rafah . Since M-113 armored personnel carriers and regular up-armored ambulances are not sufficiently protected against anti-tank weapons and improvised explosive devices , it

1836-523: A per-accident basis, ambulance collisions tend to involve more people, and result in more injuries. An 11-year retrospective study concluded in 2001 found that although most fatal ambulance crashes in the United States occurred during emergency runs, they typically occurred on improved, straight, dry roads, during clear weather. Furthermore, paramedics are also at risk in ambulances while helping patients, as 27 paramedics died during ambulance trips in

1944-545: A perfectly serviceable body or vehicle (or both) separated from the other and reused. Toronto City Council operates a "Caravan of Hope" project to give retired Toronto ambulances a second life by donating them to the people of El Salvador . Since Ontario laws require ambulances to be retired after just four and a half years in service, the City of Toronto decommissions and auctions around 28 ambulances each year. Chevrolet Express The Chevrolet Express (also known as

2052-644: A red traffic light or stop sign as a yield sign ('give way'), or be permitted to break the speed limit. Generally, the priority of the response to the call will be assigned by the dispatcher, but the priority of the return will be decided by the ambulance crew based on the severity of the patient's illness or injury. Patients in significant danger to life and limb (as determined by triage ) require urgent treatment by advanced medical personnel, and because of this need, emergency ambulances are often fitted with passive and active visual and/or audible warnings to alert road users. Passive visual warnings are usually part of

2160-532: A replacement beyond the 2025-2026 model year. The Chevrolet Express and GMC Savana use the GM GMT600 chassis , developed exclusively for full-size vans. Derived loosely from the GMT400 chassis of the fourth-generation C/K trucks , the model line uses a full-length ladder frame with boxed forward frame rails. The GMT600 chassis was offered in two wheelbases: standard-length 135-inch and extended 155-inch (though

2268-418: A result, medics and other medical personnel attached to military ambulances are usually put through basic military training , on the assumption that they may have to use a weapon. The laws of war do allow non-combatant military personnel to carry individual weapons for protecting themselves and casualties. However, not all militaries exercise this right to their personnel. The Israeli Defense Forces modified

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2376-636: A satellite-based Automatic Vehicle Locating system in order to ensure that the closest appropriate response resource is consistently sent to each emergency call; all emergency response resources are included. 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. The service utilizes “ Language Line ” service to provide instant simultaneous translation of emergency calls in more than 140 languages. Toronto Paramedic Services operates

2484-505: A simultaneous telephone-based translation service which operates in more than 140 languages. 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. The service also operates its own ethnocultural access program. The ' Baby Boom ' generation is aging. As it does so, all of those 'boomers' become net consumers of health care, driving up demand for services. Simultaneously, all of those 'boomers' employed by

2592-796: A single generation since 1996, over 2.5 million examples of the Express and the Savana have been produced. One of the longest-produced designs in American automotive history, the Express/Savana are rivaled only by the Jeep Wagoneer and Dodge Ram Van for longevity. Since 1995, General Motors has assembled the Express and Savana at its Wentzville Assembly facility ( Wentzville, Missouri ). Also, since 2017, GM has sourced commercial cutaway-chassis production from Navistar through its Springfield Assembly Plant ( Springfield, Ohio ). For

2700-550: A stopped ambulance in a dangerous position on the road. Common colours for ambulance warning beacons are blue, red, amber, and white (clear). However the colours may vary by country and sometimes by operator. There are several technologies in use to achieve the flashing effect. These include flashing a light bulb or LED , flashing or rotating halogen , and strobe lights , which are usually brighter than incandescent lights. Each of these can be programmed to flash singly or in groups, and can be programmed to flash in patterns (such as

2808-467: A substantial revision of the existing platform for the 2027 model year (under the model code GMT620); no details of GMT620 were released, though Ultium technology was dropped entirely in favor of retaining a lineup of internal combustion engines. In February 2024, GM abandoned its plans to produce an electric full-size van; the status of the GMT620 redesign is also unknown, leaving the model line without

2916-650: Is 887. 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. Toronto Paramedic Services participates in the community-wide 9-1-1 system, and triages emergency calls using the Advanced Medical Priority Dispatch System . The system uses Computer-Aided Dispatch , including Tritech VisiCAD, augmented by PDS and Optima Live software and technology. The service utilizes

3024-499: Is a medically-equipped vehicle used to transport patients to treatment facilities , such as hospitals . Typically, out-of-hospital medical care is provided to the patient during the transport. Ambulances are used to respond to medical emergencies by emergency medical services (EMS), and can rapidly transport paramedics and other first responders , carry equipment for administering emergency care , and transport patients to hospital or other definitive care. Most ambulances use

3132-533: Is a major factor in their effective use. When an ambulance is retired, it may be donated or sold to another EMS provider. Alternately, it may be adapted into a storage and transport vehicle for crime scene identification equipment, a command post at community events, or support vehicle, such as a logistics unit. Others are refurbished and resold, or may just have their emergency equipment removed to be sold to private businesses or individuals, who then can use them as small recreational vehicles . They may also have

3240-725: Is a reference to early medical care where patients were moved by lifting or wheeling. The word originally meant a moving hospital, which follows an army in its movements. Ambulances ( ambulancias in Spanish) were first used for emergency transport in 1487 by the Spanish forces during the siege of Málaga by the Catholic Monarchs against the Emirate of Granada. During the American Civil War vehicles for conveying

3348-693: Is a van chassis-cab with a custom-made rear compartment, used for ALS and rescue. Type IV is for ad hoc patient transfer using smaller utility vehicles selected for maneuverability in special environments such as dense crowds at events; these are uncommon and are not subject to federal regulations in the United States. The move towards standardisation is now reaching countries without a history of prescriptive codes, such as India, which approved its first national standard for ambulance construction in 2013. Ambulances, like other emergency vehicles , are required to operate in most weather conditions, including those during which civilian drivers often elect to stay off

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3456-530: Is based on a heavy truck chassis-cab with a custom rear compartment that is often referred to as a "box" or "module", primarily used for Advanced Life Support (ALS) or Mobile Intensive Care Unit (MICU), as well as rescue work. Type II is based on a commercial heavy-duty van with few modifications except for a raised roof and a secondary air conditioning unit for the rear of the vehicle, primarily used for Basic Life Support (BLS) and transfer of patients, though they are occasionally also used for ALS and rescue. Type III

3564-502: Is bounded roughly by Steeles Avenue to the north, Eglinton Avenue to the south, Yonge Street to the east, and Highway 427 & Mississauga border to the west. The District 2 Hub is located at 20 Station (2430 Lawrence Ave E). The Northeast quadrant is bounded roughly by Steeles Avenue to the north, Eglinton Avenue to the south, the Scarborough-Pickering Townline and Rouge River to the east, and Yonge Street to

3672-488: Is counted as an ambulance. These vehicles are not usually (although there are exceptions) equipped with life-support equipment, and are usually crewed by staff with fewer qualifications than the crew of emergency ambulances. Conversely, EMS agencies may also have nontransporting EMS vehicles that cannot transport patients. The term ambulance comes from the Latin word ambulare as meaning 'to walk or move about' which

3780-551: Is put on to the empty chassis of the ambulance, and then finished off. Modern ambulances are typically powered by internal combustion engines , which can be powered by any conventional fuel, including diesel , gasoline or liquefied petroleum gas , depending on the preference of the operator and the availability of different options. Colder regions often use gasoline-powered engines, as diesels can be difficult to start when they are cold. Warmer regions may favor diesel engines, as they are more efficient and more durable. Diesel power

3888-533: Is similar to the KKK-A-1822F and NFPA 1917–2019 specifications. The decision on which of the current (3) standards to require is left up to each individual state legislature or EMS director. Some states have no specific requirement, while others specify which standard is acceptable. Others, yet, allow the end user to decide which standard to comply to. In the United States and Canada, there are four types of ambulances: Type I, Type II, Type III, and Type IV. Type I

3996-468: Is sometimes chosen due to safety concerns, after a series of fires involving gasoline-powered ambulances during the 1980s. These fires were ultimately attributed in part to gasoline's higher volatility in comparison to diesel fuel. The type of engine may be determined by the manufacturer: in the past two decades, Ford would only sell vehicles for ambulance conversion if they are diesel-powered. Beginning in 2010, Ford will sell its ambulance chassis with

4104-461: Is supplemented by well-developed Paramedic Services in neighbouring communities on three sides, with Lake Ontario providing the southern boundary of the service area. Air ambulance operations are provided within the City of Toronto by Ornge , a privately owned air ambulance contractor, under contract to the Government of Ontario. Based upon information provided by Toronto Paramedic Services,

4212-412: Is unable to alert pedestrians, those not using a compatible radio or even have it turned off. In the United States, the cost of an ambulance ride may be paid for from several sources, and this will depend on the local situation type of service being provided, by whom, and to whom. There are differing levels of qualification that the ambulance crew may hold, from holding no formal qualification to having

4320-576: Is usually sufficient. Since laws of war demand ambulances be marked with one of the Emblems of the Red Cross not to mount offensive weapons , military ambulances are often unarmed. It is a generally accepted practice in most countries to classify the personnel attached to military vehicles marked as ambulances as non-combatants ; however, this does not always exempt medical personnel from coming under fire – accidental or deliberate. As

4428-449: The 2019 model year, higher-trim passenger vans received lane departure warning systems and collision alert warning features. An all-wheel drive option was offered for the model years 2003–2014 on 1500 and light-duty 2500 vans (below 8,500 lbs GVWR). AWD vans came exclusively with a 135" wheelbase and GM's 5.3L V8. For 2022, the Express entered its 26th year of production, overtaking the 1971-1996 Chevrolet Van in production longevity. As

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4536-580: The GMC Savana ) is a series of full-size vans produced by General Motors since 1996. The successor to the Chevrolet G-series van , the Express is produced in passenger and cargo variants. Alongside the standard van body, the line is offered as a cutaway van chassis ; the latter vehicle is a chassis cab variant developed for commercial-grade applications, including ambulances , buses , motorhomes , and small trucks . In production for

4644-538: The Order of St John , the Order of Malta Ambulance Corps and Malteser International often use the Maltese cross to identify their ambulances. This is especially important in countries such as Australia, where St. John Ambulance operate one state and one territory ambulance service, and all of Australia's other ambulance services use variations on a red Maltese cross. Fire service operated ambulances may display

4752-603: The Second World War vehicles such as the Hanomag Sd Kfz 251 half-track were pressed into service as ad hoc ambulances , and in more recent times purpose-built AFVs such as the U.S. M1133 medical evacuation vehicle serve the exclusive purpose of armored medical vehicles. Civilian based designs may be painted in appropriate colors, depending on the operational requirements (i.e. camouflage for field use, white for United Nations peacekeeping , etc.). For example,

4860-473: The St. John Ambulance Brigade in 1889. Training included first aid skills, anatomy and physiology . Such training for ambulance attendants was unheard of at that time, outside of military circles. The police constables assigned to the ambulance also did regular policing , when not required for ambulance calls. As the city grew and technology progressed, so did the ambulance service. The first motorized ambulance

4968-951: The United States military currently employs the M113, the M577 , the M1133 Stryker medical evacuation vehicle (MEV), and the RG-33 heavily armored ground ambulance (HAGA) as treatment and evacuation vehicles, with contracts to incorporate the newly designed M2A0 armored medical evacuation vehicle (AMEV), a variant of the M2 Bradley fighting vehicle (formerly known as the ATTV). Some navies operate ocean-going hospital ships to lend medical assistance in high casualty situations such as wars or natural disasters. These hospital ships fulfill

5076-675: The 1996 model year, Chevrolet replaced the G-series Chevrolet Van with the Chevrolet Express (retaining Chevrolet Van for cargo vans). The first all-new design for the General Motors full-size van line since 1971, the model line was offered in passenger-van and cargo-van variants (the latter initially retained the Chevrolet Van name), with GMC replacing the Vandura/Rally with the Savana. Alongside

5184-415: The 2014 model year. Since its 2003 model revision, the Express has seen incremental updates to the model line. The light-duty 2500 vans (below 8,500 pounds GVWR) were discontinued for 2006. For 2008, the Express passenger van received side-curtain airbags and standard stability control (introduced for 3500-series vans for 2005 ); the steering wheel, seats, and gauge cluster were also redesigned. For 2011,

5292-457: The 4500 chassis First V8 direct-injection gasoline engine used by model line Available only on 2500 and 3500 vans, and standard on the 4500 chassis Available only on 3500 vans Highest-displacement V8 ever factory-offered in a full-size van Available only on 3500 vans First inline-4 in full-size van since 1964 2011–2016 (LLM) Replaced by 2.8L I4 turbo-diesel Also offered on the 4500 chassis Far more aerodynamic than its predecessor,

5400-463: The 6.5 L turbo-diesel was offered in a GM full-size van for the first time. All engines were paired with a 4-speed overdrive automatic transmission, carried over from the previous van; the 1500 and light-duty 2500 series (below 8,500 pounds GVWR) used a 4L60E transmission while the heavy-duty 2500 and 3500 series (above 8,500 pounds GVWR) used a heavier-duty 4L80E unit. For 2001, the Vortec 7400

5508-607: The 640 km (246 sq mi) of the City of Toronto. Emergency service headquarters (which is shared with Toronto Fire Services, but both services operate independently) is located at 4330 Dufferin Street in Toronto. This facility includes administrative offices, some education facilities, the Communications Centre, Fleet Maintenance, Planning and Operational Support, and Materials Management/Logistics.The service

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5616-535: The British Royal Army Medical Corps has a fleet of white ambulances, based on production trucks. Military helicopters have also served both as ad hoc and purpose-built air ambulances since they are extremely useful for MEDEVAC . In terms of equipment, military ambulances are barebones, often being nothing more than a box on wheels with racks to place manual stretchers, though for the operational conditions and level of care involved this

5724-576: The Chevrolet Express derived much of exterior styling from the Chevrolet Astro mid-size van (including its flush-mounted exterior glass ), deriving its grille from multiple trims of the Chevrolet C/K pickup trucks. Similar to the APV minivans , the Express adopted high-mounted taillamps next to the rear windows, placed above the rear door hinges. In a design advancement for the market segment,

5832-452: The Cross of St. Florian (often incorrectly called a Maltese cross) as this cross is frequently used as a fire department logo (St. Florian being the patron saint of firefighters ). The active visual warnings are usually in the form of flashing lights. These flash in order to attract the attention of other road users as the ambulance approaches, or to provide warning to motorists approaching

5940-454: The GMT610 adopted a three-section fully-boxed frame. With slight modifications, the GMT610 also adopted the front suspension of the GMT800 pickup trucks, with short-long arm front suspension (rear-wheel drive) and torsion-bar front springs (all-wheel drive). In another change, four-wheel disc brakes were introduced, standardizing anti-lock brakes (ABS). In a first for the full-size van segment,

6048-447: The GMT610 platform was also offered with full-time all-wheel drive as an option. The Chevrolet Express and GMC Savana were initially available with five engine options. Shared with C/K pickup trucks, a 4.3 L V6 was standard, while 5.0 L, 5.7 L, 6.5 L turbo-diesel , and 7.4 L V8s were options. All gasoline engines adopted the "Vortec" port-fuel injection upgrades for 1996, increasing power and torque outputs;

6156-603: The LS-series engines) were introduced, with the Express and Savana receiving the 5.3 L V8 (on light-duty vans) and the 4.8 L and 6.0 L V8s (on heavy-duty vans). For 2006, the Express and Savana were once again offered with a diesel engine option, adopting a detuned version of the 6.6 L Duramax V8 (LGH) from the Chevrolet Kodiak and GMC TopKick. For 2008, the 5.3 L V8 gained flex-fuel (E85) capability. For 2010, 2500- and 3500-series vans used

6264-504: The Red Cross member organization use a red Star of David , but this does not have recognition beyond Israeli borders, where they must use the Red Crystal. The Star of Life is widely used, and was originally designed and governed by the U.S. National Highway Traffic Safety Administration , because the Red Cross symbol is legally protected by both National and international law. Ambulance services with historical origins such as

6372-756: The Spanish, and civilian variants were put into operation during the 1830s. Advances in technology throughout the 19th and 20th centuries led to modern self-powered ambulances. Ambulances can be grouped into types depending on whether or not they transport patients, and under what conditions. In some cases, ambulances may fulfill more than one function (such as combining emergency ambulance care with patient transport: Ambulances can be based on many types of vehicle although emergency and disaster conditions may lead to other vehicles serving as makeshift ambulances: Ambulance design must take into account local conditions and infrastructure. Maintained roads are necessary for road-going ambulances to arrive on scene and then transport

6480-754: The US between 1991 and 2006. In addition to the equipment directly used for the treatment of patients, ambulances may be fitted with a range of additional equipment which is used in order to facilitate patient care. This could include: In parts of the world that lack a high level of infrastructure, ambulances are designed to meet local conditions, being built using intermediate technology . Ambulances can also be trailers, which are pulled by bicycles, motorcycles, tractors, or animals. Animal-powered ambulances can be particularly useful in regions that are subject to flooding. Motorcycles fitted with sidecars (or motorcycle ambulances ) are also used, though they are subject to some of

6588-676: The United States, standards for ambulance design have existed since 1976, where the standard is published by the General Services Administration and known as KKK-A-1822. This standard has been revised several times, and is currently in version 'F' change notice #13, known as KKK-A-1822F. The National Fire Protection Association has also published a design standard, NFPA 1917 , which offers an alternative to KKK-A-1822F. The Commission on Accreditation of Ambulance Services (CAAS) has published its Ground Vehicle Standard for Ambulances v2.0, effective July 2019. This standard

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6696-555: The ambulance is expected to transport (for instance specifying a different standard for routine patient transport than high dependency), or may base standards on the size of vehicle. For instance, in Europe, the European Committee for Standardization publishes the standard CEN 1789 , which specifies minimum compliance levels across the build of ambulance, including crash resistance, equipment levels, and exterior marking. In

6804-494: The ambulance that may interfere with patient care and radio communications. Ambulances can additionally be fitted with airhorn audible warnings to augment the effectiveness of the siren system, or may be fitted with extremely loud two-tone air horns as their primary siren. A recent development is the use of the RDS system of car radios . The ambulance is fitted with a short range FM transmitter, set to RDS code 31, which interrupts

6912-487: The appropriate hospital of the ambulance's pending arrival, or, in cases where physicians do not form part of the ambulance's crew, to confer with a physician for medical oversight. Ambulances often have two stages of manufacturing. The first is frequently the manufacture of light or medium truck chassis-cabs or full-size vans (or in some places, cars) such as Mercedes-Benz , Nissan , Toyota , or Ford . The second manufacturer (known as second stage manufacturer ) modifies

7020-571: The city's Chinese community. As another little known fact of community involvement by paramedics, all of the floats in the city's annual Santa Claus Parade (one of North America's largest), are driven by volunteers from Toronto Paramedic Services, including both paramedics and a variety of other staff. Paramedicine in Canada Emergency Services in Toronto Employee association Ambulance An ambulance

7128-418: The community which they serve. At the 'grass roots' level, Toronto's paramedics and EMDs fund a children's breakfast club, ensuring a nutritious breakfast for the children who live in several of the city's housing projects. Paramedics also participate in a variety of other events in the community, including their enthusiastic (and occasionally successful) participation in the dragon boat races staged annually by

7236-497: The criteria of an ambulance (transporting the sick or injured), although the capabilities of a hospital ship are more on par with a Mobile Army Surgical Hospital . In line with the laws of war , these ships can display a prominent Red Cross or Red Crescent to confer protection under the appropriate Geneva Convention . However, this designation has not always protected hospital ships from enemy fire. Ambulettes provide patient transport service for non-emergency situations. Scheduling

7344-497: The dashboard received upgrades (including Bluetooth compatibility and a USB port). For 2013, higher-trim passenger vans received an optional navigation system, rearview camera, and parking assist system. For 2015, all radios became digitally tuned and a 120-volt outlet was added to the dash. For 2018, the Express dropped sealed-beam headlights from all models, adopting the four composite headlamps of higher-trim passenger vans. A blind spot monitoring system also became optional. For

7452-559: The design becomes more important, as does the nature of the skills required to properly operate the vehicle. Cost-effectiveness can be a high priority. Emergency ambulances are highly likely to be involved in hazardous situations, including incidents such as a road traffic collision , as these emergencies create people who are likely to be in need of treatment. They are required to gain access to patients as quickly as possible, and in many countries, are given dispensation from obeying certain traffic laws. For instance, they may be able to treat

7560-416: The design of the vehicle, and involve the use of high contrast patterns. Older ambulances (and those in developing countries ) are more likely to have their pattern painted on, whereas modern ambulances generally carry retro-reflective designs, which reflects light from car headlights or torches. Popular patterns include 'checker board' (alternate coloured squares, sometimes called ' Battenburg ', named after

7668-415: The first substantial redesign of the model line in 25 years, GM predicted substantial growth in the full-size segment through the end of the 1990s. In a major functional change, the front axle was moved forward 10 inches, effectively moving the front wheels out of the passenger compartment; along with improving front legroom, the design allowed a reduction in step-in height (improving access). While sharing

7776-467: The front are often fitted as well to increase visibility for the driver. In order to increase safety, it is best practice to have 360° coverage with the active warnings, improving the chance of the vehicle being seen from all sides. In some countries, such as the United States, this may be mandatory. The roof, front grille, sides and rear of the body, and front fenders are common places to mount emergency lights. A certain balance must be made when deciding on

7884-421: The front or roof of the ambulance. Most modern ambulances are now fitted with electronic sirens, producing a range of different noises which ambulance operators can use to attract more attention to themselves, particularly when proceeding through an intersection or in heavy traffic. The speakers for modern sirens can be integral to the lightbar, or they may be hidden in or flush to the grill to reduce noise inside

7992-402: The high beams, flashed alternately) are known as a wig-wag . Additional white lights may be placed strategically around the vehicle to illuminate the area around it when it is dark, almost always at the rear for loading and unloading stretchers and often at the sides as well. In areas very far North or South where there are times of year with long periods of darkness, additional driving lights at

8100-474: The interior electrical system). The Express and Savana offered with 60/40 split panel doors on the passenger-side of the vehicle; in a first (since the Corvair cargo van ), an option was added for the driver-side to receive the same split panel doors; this option was limited to the standard-length body (requiring doors on both sides). The option for the driver-side split 60/40 panel doors was available through

8208-542: The largest EMS Communications Centre in Canada, which was recently accredited as an International Centre of Excellence by the International Academy of Emergency Dispatch. Service is provided to a residential population of approximately 3.2 million people, which rises to approximately 5 million on most business days. Toronto Paramedic Services operates a total of 41 stations, geographically distributed across

8316-602: The latter was only available on the 2500 and 3500 series). A replacement for the 110-inch short-wheelbase van (discontinued after 1992) was not included as part of the GMT600 design, as the short-body van had functionally been superseded by the Chevrolet Astro/GMC Safari mid-size vans. For 2003, the GMT600 chassis underwent a substantial revision and was redesignated GMT610. In line with the GMT800 chassis,

8424-456: The municipal tax base and fifty percent from the provincial government. The funding of Toronto Paramedic Services is based upon its census population, not its business day population. As a result, there are always more people requiring EMS services than the system has been funded for. Language barriers and cultural misperceptions in Toronto's multicultural landscape are commonplace for Toronto's paramedics . The service subscribes to Language Line,

8532-554: The music format had been phased out of automobiles (in favor of Bluetooth-based content), the CD player was discontinued as an option. As of current production, the GMT610 platform is anticipated to be produced in its current form through the 2026 model year. Originally intended for replacement by a fully-electric vehicle (using GM Ultium battery technology) derived from the BrightDrop Zevo , plans were later revised in favor of

8640-585: The name of their owner or operator, and an emergency telephone number for the ambulance service. Ambulances may also carry an emblem (either as part of the passive warning markings or not), such as a Red Cross, Red Crescent or Red Crystal (collective known as the Protective Symbols ). These are symbols laid down by the Geneva Convention , and all countries signatory to it agree to restrict their use to either (1) Military Ambulances or (2)

8748-434: The national Red Cross or Red Crescent society. Use by any other person, organization or agency is in breach of international law. The protective symbols are designed to indicate to all people (especially combatants in the case of war) that the vehicle is neutral and is not to be fired upon, hence giving protection to the medics and their casualties, although this has not always been adhered to. In Israel, Magen David Adom ,

8856-493: The needs of the service. The department currently employs Chevrolet Tahoe SUVs for First Response and supervisory vehicles as well as an assortment of fully equipped but unmarked vehicles (Primarily Dodge Caravan and Ford Taurus ) for senior management. Toronto Paramedic Services currently operates a fleet of custom built busses and equipment support vehicles for use during mass-casualty or large-scale events. Toronto Paramedic Services operates its own repair facilities, located at

8964-494: The number and location of lights: too few and the ambulance may not be noticed easily, too many and it becomes a massive distraction for other road users more than it is already, increasing the risk of local accidents. In addition to visual warnings, ambulances can be fitted with audible warnings , sometimes known as sirens , which can alert people and vehicles to the presence of an ambulance before they can be seen. The first audible warnings were mechanical bells, mounted to either

9072-500: The patient to a hospital, though in rugged areas four-wheel drive or all-terrain vehicles can be used. Fuel must be available and service facilities are necessary to maintain the vehicle . Methods of summoning (e.g. telephone) and dispatching ambulances usually rely on electronic equipment, which itself often relies on an intact power grid . Similarly, modern ambulances are equipped with two-way radios or cellular telephones to enable them to contact hospitals, either to notify

9180-521: The principal researcher of their own projects. All research conducted at Toronto EMS is pre-approved by the University of Toronto Research Ethics Committee , and the findings of research conducted at Toronto EMS, by both physicians and paramedics, has been published in respected, peer-reviewed , international journals . Toronto paramedics are heavily involved in various community programs and partnerships. Toronto's paramedics are active participants in

9288-479: The radio of all cars within range, in the manner of a traffic broadcast, but in such a way that the user of the receiving radio is unable to opt-out of the message (as with traffic broadcasts). This feature is built into every RDS radio for use in national emergency broadcast systems, but short-range units on emergency vehicles can prove an effective means of alerting traffic to their presence. It is, however, unlikely that this system could replace audible warnings, as it

9396-689: The required service area. Service would continue in this fashion until 1967, when the amalgamated City's suburban fire departments surrendered their ambulances, resulting in the evolution of the Department of Public Health Ambulance Service into the City-operated Department of Emergency Services (DES). Some private companies, and one operated by the provincial government, would continue to operate in 'Metro' Toronto until 1975, although with centralized dispatch services provided by DES. The Metropolitan Toronto Department of Ambulance Services

9504-493: The road. Also, the ambulance crew's responsibilities to their patient often preclude their use of safety devices such as seat belts . Research has shown that ambulances are more likely to be involved in motor vehicle collisions resulting in injury or death than either fire trucks or police cars . Unrestrained occupants, particularly those riding in the patient-care compartment, are particularly vulnerable. When compared to civilian vehicles of similar size, one study found that on

9612-454: The same engine sizes as the previous model line, the size of the engine cover was reduced, further increasing front passenger space. On all vehicles below 8,500 lbs GVWR (1500 and 2500 series), the Express was introduced with standard dual airbags; for 1997, dual airbags were standardized for all versions of the model line. Cargo and base models were equipped with a single sealed beam halogen headlamp on each side. The LS trim changed this to

9720-415: The same limitations as more traditional over-the-road ambulances. The level of care provided by these ambulances varies between merely providing transport to a medical clinic to providing on-scene and continuing care during transport. The design of intermediate technology ambulances must take into account not only the operation and maintenance of the ambulance, but its construction as well. The robustness of

9828-445: The service in the early 1970s are reaching the end of their careers and retiring. Since subsequent generations are typically much smaller, the service is experiencing difficulty in recruiting suitably trained replacement staff, just as demand for services is increasing. Over the years, the presence of such a large system and call volume, along with a commitment to consistently capture high quality data, has permitted Toronto EMS to become

9936-484: 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. Using the AMPDS system, which triages calls by severity for dispatch purposes, the actual dispatch volume by category for that same year was: The District 1 Hub is located at 01 Station (1300 Wilson Ave). The Northwest quadrant

10044-1032: The service's Headquarters complex. All maintenance and repair work (with the exception of body work), and all equipment, radio, and medical electronics maintenance and repairs are performed on site by service staff. 2006 Orion Vii One example in service on Toronto Islands due to road width restrictions Special Operations Unmarked, issued to senior operations staff Used for transporting large groups/special teams for events or deployment Equipped with multiple, mission specific pods Vehicle actually owned by Lambton County heritage museum. Previously on display at Toronto EMS HQ. Similar to vehicles that would have been operated in Toronto during Late 19th/Early 20th century. http://www.horsedrawnambulance.com Multiple model years used by department until final retirement. Examples may still be in service as utility vehicles Toronto Paramedic Services has 1,207 members including paramedics and other support staff. These are categorized as follows: The total number of paramedics

10152-420: The service's ability to provide service to emergency calls in a timely manner will often degrade, because of decreased unit availability. Multiple stakeholders and various levels of government are currently seeking solutions to this problem, but have, so far, experienced only limited success. The funding for Toronto Paramedic Services occurs as a result of a mixed formula, with fifty percent of funding coming from

10260-479: The service. As of April 2005, the departments and commissioners were replaced by divisions under the city manager (and deputy managers). Toronto EMS now operates under the city's Emergency Medical Services Division. It is the largest municipal EMS operation in Canada and at the time was led by Chief Bruce Farr. In July 2014, Chief Paul Raftis announced that as part of a rebranding effort, Toronto EMS will change its name to Toronto Paramedic Services. The change follows

10368-405: The six-speed 6L90 transmission, and the 4.8 L and 6.0 L V8s gained flex-fuel (E85 capability). Coinciding with the discontinuation of the 1500 series, the Vortec 4300 V6 (the final engine derived from the original Chevrolet small-block V8) was discontinued in 2014. After 2016, the 6.6 L Duramax diesel V8 was discontinued; a 2.8 L inline-4 Duramax (the first four-cylinder in

10476-493: The tiny, local fire departments . The two municipal services would finally be merged in 1933, when the Toronto Police Department turned the operation of their ambulances over to the Department of Public Health, and ended their involvement in the city's ambulance service. This service would grow again in 1953, as the result of the creation of the municipality of Metropolitan Toronto , dramatically expanding

10584-403: The vehicle (which is sometimes purchased incomplete, having no body or interior behind the driver's seat ) and turns it into an ambulance by adding bodywork, emergency vehicle equipment , and interior fittings. This is done by one of two methods – either coachbuilding , where the modifications are started from scratch and built on to the vehicle, or using a modular system, where a pre-built 'box'

10692-434: The west. The District 3 Hub is located at 30 Station (100 Turnberry Ave). 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 District 4 Hub is located at 42 Station (1535 Kingston Rd). The Southeast quadrant is bounded roughly by Eglinton Avenue to the north, Lake Ontario to the south and east, and Yonge Street to

10800-405: The west. The District 5 Hub is located at 55 Station (5700 Bathurst St). District 5 has stations in multiple quadrants and is responsible for Toronto Paramedic Services’ special operations teams, which include: Response Units, Marine Unit, Critical Care Transport Unit (CCTU), CBRNE, ETF, Bike Unit, and Emergency Support Units. In addition to regular operations, Toronto Paramedic Services staffs

10908-669: The wounded off the field of battle were called ambulance wagons. Field hospitals were still called ambulances during the Franco-Prussian War of 1870 and in the Serbo-Turkish war of 1876 even though the wagons were first referred to as ambulances about 1854 during the Crimean War . The history of the ambulance begins in ancient times , with the use of carts to transport incurable patients by force. Ambulances were first used for emergency transport in 1487 by

11016-507: Was actually purchased by a local funeral home in 1911, and the Toronto Police Ambulance Service began the conversion from horse-drawn to motorized vehicles in 1913, with the process largely completed by 1918. Over the years, the two City of Toronto departments would have their services supplemented by more than 130 individual ambulance operators, most of them private companies, and in suburban areas by several of

11124-518: Was at that time that the service undertook a rebranding with the unique forward facing A on all of its vehicles. The service introduced its first paramedics in 1984 (although experiments in pre-hospital advanced life support actually began in 1969). Toronto EMS introduced many other innovations, including the concept of dedicated ground-based critical care transport ambulances in 2000, as well as many specialty support units described in this article, many of which were originally conceived and pioneered by

11232-466: Was created in 1975 under the leadership of John Dean, and absorbed the five remaining private ambulance companies and single provincial service, providing a single, unified ambulance service in Metro Toronto . Known colloquially as Metro Toronto Ambulance or simply Metro Ambulance (although never its official name) the service provided ambulance services from 1975 to 1998. Metropolitan Toronto

11340-464: Was decided to use the heavily armored Merkava tank. Its rear door enables the evacuation of critically wounded soldiers. Israel did not remove the Merkava's weaponry, claiming that weapons were more effective protection than emblems since Palestinian militants would disregard any symbols of protection and fire at ambulances anyway. For use as ground ambulances and treatment & evacuation vehicles,

11448-565: Was provided for the young city by a variety of means, including both hospital-based and private companies. This 'broad spectrum' approach to service delivery would continue for more than ninety years. 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

11556-410: Was replaced by the longer-stroke Vortec 8100 (at 496 cubic inches, this is the largest-displacement engine ever factory-marketed by Chevrolet); the engine was offered for the Express through 2002. For 2003, the engine lineup underwent a series of revisions. The 4.3 L V6 was retained but was only available on the 1500 and light-duty 2500 series. The "Generation III" small-block V8 engines (based on

11664-474: Was restructured during 1998, transforming it from a regional government overseeing six member municipalities into a single, unified city, and many municipal and regional services were restructured as a result. Metro Ambulance became Toronto Ambulance then Toronto Emergency Medical Services in 1998 under the leadership of Chief Ron Kelusky, in order to reflect its evolving role from primarily a provider of medical transportation to an actual provider of medical care. It

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