Ministry of the
Solicitor General

OFM - 04-19-12

Advanced Medical Assistance Responses Public Fire Safety Guidelines

Public Fire Safety Guidelines

Subject Coding

PFSG 04-19-12


Emergency Response


January 1998


Advanced Medical Assistance Responses


Under Review


To familiarize policy makers with the requirements of providing advanced medical assistance response capabilities


  • Fire department participation in medical assistance responses varies greatly from municipality to municipality.
  • These activities range from training fire fighters in first aid and cardiopulmonary resuscitation (CPR) , to operating first response units (pumpers, rescue vans) and further to advanced life support response units (equipped with resuscitators, automatic defibrillators) and personnel; and providing public education and training of citizens in the techniques of first aid and CPR.


  • Medical assistance responses are often referred to, among other things, as "ambulance assist calls" and "tiered responses".
  • These are widespread terms, and the specific medical assistance response program of any particular municipality may include or exclude either term.
  • The basic functions of an advanced medical assistance response include the following:
  • program organization and management
  • medical direction
  • human resources
  • training
  • communications
  • emergency response
  • transportation
  • care facilities
  • equipment
  • planning
  • research
  • public information
  • public education
  • inter-agency relationships


For the purposes of this guideline only, an advanced medical assistance response is defined as:
"the provision of treatment to citizens and fire fighters, including first aid and CPR and other elementary procedures for which the fire fighters are trained and equipped, including the utilization of oxygen resuscitators, automatic defibrillators and delegated medications prior to the arrival of the ambulance service, or transfer to a hospital or other health care facility".


  • Municipal fire departments seem to be a natural source of medical aid responsibility, because they often have a sizeable body of reliable, trained, and disciplined personnel operating within an existing command structure, operating from fire stations strategically located throughout the communities, and holding the confidence of the public.
  • In many instances, fire departments have faster response time capabilities than the ambulance service(s), thus bringing pressure upon policy makers to provide such services.

Service Delivery Considerations

Prior to a final determination as to whether or not to provide such a service, or the implementation of same, the following subject matter must be addressed:


  • The fire service role in the provision of advanced medical assistance responses is usually part of an overall plan for emergency medical services, and the functions provided by the fire department are integrated within such a system


  • In addition to duties at fires and other core services, the impact on fire department resources and the departments continued ability to perform its fire control responsibilities should be a prime consideration before undertaking advanced medical assistance responses


  • Are additional, specialized or modified vehicles required?


  • Who is to provide and maintain the required specialized equipment?


  • First aid and CPR training/certification, at what level(s) would be required?
  • Re-certification with its associated training upgrades and costs are important considerations
  • What other specialized training/qualifications may be required by provincial agencies such as the Ministry of Health, or others?

Goals and Objectives

  • How would the goals and objectives of such a program impact on or coalesce with fire department and corporate goals and objectives?

Operational Guidelines

  • automatic defibrillators and protocols
  • oxygen resuscitators and protocols

Response criteria

  • Is the department able to meet the provincial ministry response criteria for such a program?


  • the costs of providing such a program, together with any possible revenues, should be seriously considered in relation to the overall objectives of the department

Codes, Standards, Best Practices

Codes, Standards and Best Practices resources available to assist in establishing local policy on this assessment are listed below. All are available at . Please feel free to copy and distribute this document. We ask that the document not be altered in any way, that the Office of the Fire Marshal be credited and that the documents be used for non-commercial purposes only.


  • Defibrillation Guidelines ONT 1994
  • Tiered Response Guidelines ONT 1997

See also PFSG
04-18-12 Basic Medical Assistance Responses