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Responsibility for Care

While on scene, the highest level paramedic shall assess the patient and make a decision on the level of care required, and on the level of paramedic required for the care of the patient.  The highest level paramedic is the ultimate patient care authority on the scene.  If there is any disagreement between paramedics, the Base Hospital physician may be contacted.  It is expected that when an intervention has been performed, the paramedic most appropriate for that intervention will remain responsible for the patient.

In all patient care, the highest level of paramedic is responsible for the care of the patient, including decisions on the level of care required during transport. A paramedic may choose to assign aspects of care and procedures to an alternate level paramedic, as long as the care and procedures are within that paramedic’s scope of practice. Paramedics must alert the highest level paramedic of any change of patient status.

When transferring care from one level of paramedic to another, paramedics shall provide:

  1. current CTAS level;
  2. a history of the patient’s current problem(s) and relevant past medical history;
  3. pertinent physical findings;
  4. a summary of management at scene/en route;
  5. the patient’s response to treatment, including most recent vital signs; and
  6. the reason for transfer in cases of inter-facility

The transfer of responsibility of patient care is a critical juncture along the clinical care continuum. When transferring patient care to another health care provider (e.g. nurse, physician, etc.), a paramedic must comply with the BLS PCS regarding such transfers.


Ministry of Health and Long-Term Care
5700 Yonge Street, 6th Floor
Toronto, ON M2M 4K5