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The Basic Life Support Patient Care Standards (the “Standards”) is the Ministry of Health and Long-Term Care (MOHLTC) standard by which paramedics shall provide the minimum mandatory level of patient care in Ontario.

When providing patient care as per the Standards, a paramedic shall ensure that the patient simultaneously receives care in accordance with the Advanced Life Support Patient Care Standards (ALS PCS).


For the purposes of the Standards the following definitions apply:


Paramedic has the same definition as set out in the Ambulance Act (Ontario) and for the purposes of the Standards includes an Emergency Medical Attendant as defined under the Ambulance Act (Ontario) and Regulation 257/00, as may be amended from time to time.


Patient refers to an individual for whom a request for ambulance service was made and who a paramedic has made contact with for the purpose of assessment, patient care and/or transport, regardless of whether or not an assessment is conducted, patient care is provided, or the patient is transported by ambulance.


General statements intended to provide information and guidance with respect to formulation of working assessments, or, directing principles of preferred practices applicable to specific clinical circumstances where a standard is not feasible or practical.


In creating the Standards, an assessment-based approach was utilized, e.g. a standard was developed for assessment and management of shortness of breath, rather than for asthma.

The Standards is composed of a number of sections, divided based on category (e.g. Medical Standards, Trauma Standards, etc.). Respective sections contain various discrete standards.

The majority of standards begin with a foreword that states: “the paramedic shall”. These standards then itemize differing actions, each of which is intended to be read while considering the standard’s foreword. It is expected that the paramedic perform all listed actions in a standard unless otherwise stated.

The Standards is applicable at all times when a paramedic is on duty. Additionally, a paramedic will follow any required applicable acts (e.g. Personal Health Information Protection Act, 2004 (Ontario)), regulations, or standards while off duty (including the Standards, as applicable).

It is understood that the Standards will apply to all calls for service. A patient will be present. A paramedic will have a partner, unless on-scene alone in a first response situation (e.g. Emergency Response Vehicle). A paramedic will have fully operational patient care equipment as per the Provincial Equipment Standards for Ontario Ambulance Services.

There may be circumstances and situations in which complying with the Standards is not clinically justified, possible or prudent as a result of extenuating circumstances. Paramedics shall use all knowledge, training, skill and clinical judgment to mitigate any extenuating circumstances. Paramedics shall document in accordance with the Ontario Ambulance Documentation Standards and the Ambulance Call Report Completion Manual.

Extenuating circumstances may include:

  1. Scene conditions
  2. Overwhelmed resources (e.g. multi-casualty incident)
  3. Equipment failure
  4. Safety concerns
  5. Patient location
  6. Distance from receiving facility
  7. Others not specified (e.g. language barrier)


Clinical research is fundamental to the practice of medicine and the development of safer, more effective treatment options for patients. At times, research protocols require temporary changes to patient care standards. Changes to patient care standards will be approved and introduced by the MOHLTC.

Quality Assurance

Ambulance service operators shall have a quality assurance program in place to oversee care provided by paramedics under the Standards.

Commonly Used Abbreviations

To see the list of common abbreviations click the link below.

Common Abbreviations


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