September 22, 1999
To:Community Services Committee
From:Barry Gutteridge, Commissioner, Works and Emergency Services
Ron Kelusky, General Manager, Toronto Ambulance
Subject:Toronto Ambulance Marine EMS Rescue Program
Purpose:
To advise City Council on the benefits of a pilot project established in cooperation between the Toronto Police Service
Marine Unit and Toronto Ambulance.
Recommendations:
It is recommended that:
The following report be received for information.
Council Reference/Background/History:
In May of 1999, Toronto Ambulance met with Toronto Police Services to develop a joint program to improve emergency
medical response to the Toronto Islands and the 60,000 people who every day use the waterfront areas of the City of
Toronto. Discussions took place with the Unit Commander to the Toronto Police Marine Unit, Staff Inspector Edward
Hegney, and a pilot program was undertaken to increase the level of medical training of police officers and to assign
paramedics to work along side marine unit personnel.
Comments and/or Discussion and/or Justification:
Toronto Police Services operate a fleet of high-speed watercraft for a wide variety of public safety duties. By placing a
paramedic aboard each of two prime response craft, the quality of emergency response could be greatly improved. On July
15, 1999, the pilot Marine EMS Rescue Program was officially launched.
The program serves the dual purpose of increasing the level of basic medical training of the Marine Unit Police Officer and
providing an opportunity for paramedics to be assigned to marine unit vessels, 17 hours per day. The 55 officers assigned
to the Marine Unit were trained by Toronto Ambulance in automated external defibrillation (AED), cardio pulmonary
resuscitation (CPR), Advanced First Aid (tailored to waterfront rescue) and Airway Management. The defibrillation
component of the program was considered part of the City of Toronto's Cardiac Safe City Program approved by City
Council in December, 1998. Toronto Ambulance and the Police Services equipped the Marine Unit with 3 fully automatic
defibrillators and other essential medical equipment was fully upgraded. In October, Marine Unit Officers will be trained to
Level I Basic Trauma Life Support (BTLS), and will continue to receive periodic continuing education and upgrading to
permit them to work as effective partners with their on-board paramedics.
A total of 10 paramedics were selected for assignment to the Marine EMS Rescue Program. The Toronto Police Service
provided training to the paramedics to integrate them effectively into the daily operations of the Marine Unit. Paramedics
assigned to the unit function as a full team member with a police boat crew, and assume medical command of any
patient-related incident. Paramedics do not perform any law enforcement duties.
In addition, Toronto Police Services are providing training for the paramedics as Level I Search and Rescue Technicians
(SARTech), River Rescue, Ice Rescue and basic elements of boat safety and waterfront rescue. Paramedics are currently
assigned to the Marine Unit from 07:00 to 00:00 hours, 7 days a week.
To improve Toronto Ambulance's capabilities, the Marine Unit's new command boat is being designed to accommodate
two complete paramedic workstations, with the capacity to manage two critical and several non-critical patients
simultaneously. These workstations are equipped with a full range of ambulance paramedic equipment including cardiac
monitoring, IV and drug administration, oxygen, suction, automatic ventilators, and various other monitoring equipment.
Despite its size, this boat will be among the fastest craft in the police fleet and will have the capacity to care for patients
over a long distance transport, such as from an accident at the mid-point of the lake.
In addition, when the craft is delivered this fall, Toronto Ambulance will use the new boat as its prime resource in
transporting patients from the Toronto Island community and parklands to waiting ambulances on the city-side. Toronto
Ambulance already provides on-island paramedic service throughout the navigation season, and will now provide direct
response to island community homes by its paramedics in all seasons through the use of appropriate parts of the police fleet
including ice boats. As such, this represents a significant improvement in service to this community, which has previously
relied upon first-aid services only.
This program proved itself within the first week of operation, when a paramedic delivered directly to a patient by police
boat saved the life of a man who had collapsed from a life-threatening reaction to bee stings. Through the immediate
administration of appropriate drugs, the man was resuscitated and transported to hospital by Toronto Ambulance.
The success of the program lead to a reassessment of the emergency medical response plan to the Toronto Island
community and the complete waterfront area from Pickering through to Mississauga. At present, the program is being
assessed to determine if paramedic staffing will be extended to all seasons given the needs of the Toronto Island
community and the need for river and ice rescue during the winter months.
Conclusion:
The pilot Marine EMS/Rescue Program has a been a major success. Over an eight-week period, the program responded to
over 100 medical emergencies including the near-drowning at Ashbridges Bay, two cardiac arrests, other medical and
trauma emergencies and a number of special events such as Caribana, the International Air Show and the off-shore boat
races. It also represents a major upgrade of Toronto Ambulance Services to the Toronto Island community and associated
parklands.
Contact Name:
Ronald L. Kelusky
General Manager, Toronto Ambulance
Telephone: (416) 397-9240
Ronald L. KeluskyBarry Gutteridge
General ManagerCommissioner
Toronto AmbulanceWorks and Emergency Services
