The City of Toronto Paramedic Services (TPS; formerly known as Toronto Emergency Medical Services) is the statutory emergency medical services provider in Toronto, Ontario, Canada. The service is operated as a division of the City of Toronto, under the Community & Social Services cluster. The service is funded by the municipal tax base, and operates similarly to other municipal divisions, such as the Toronto Parks, Forestry & Recreation division, or the Toronto Water division, but retains operational independence from other divisions. While under municipal government control, it is subject to provincial legislation and licensing. It is not the only service provider in its area; private-for-profit medical transport services also provide routine, non-emergency transports and coverage for special events, but the statutory emergency medical system is the only provider permitted to service emergency calls.
History 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 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 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 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 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 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 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 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 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 1998, as well as many specialty support units described in this article, many of which were originally conceived and pioneered by 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 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
Uniforms consist of:
Dark navy short or long sleeve police style shirt with departmental crest, reflective stripes around arms and Toronto Paramedic in reflective print on chest and back. Chartreuse high visibility jacket with Toronto Paramedic in reflective print on back as well as job title (Paramedic, Supervisor etc...) front and back. Certain Specialized Operations teams have their own distinctive coloured jackets: CBRNE paramedics wear Orange, Critical Care paramedics wear Red and Tactical paramedics wear Black. Dark navy cargo pants with reflective stripes around lower leg. White shirts for Supervisory/Management staff. Bicycle helmet and shorts for bike crews. Hard hat with visor as required (construction sites, vehicle extrication etc...). Black safety boots/shoes. FR Military style tactical shirt/pants, gloves, Ballistic helmet/riot helmet and Ballistic vest for tactical units. HAZMAT suits for CBRNE units. Dress uniform consisting of dark navy pants and tunic, white shirt, navy tie and forage cap. Paramedic uniforms have royal blue cap band and striping on pants. Management staff have black maple laurels as well as gold piping on cap peak. Striping is orange-gold for the honour guard.
Fleet 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 the needs of the service, As of 2025, new ambulances are built on the Crestline Fleetmax 2.0 ambulance platform. 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 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.As reported by TPS in their Service Information Profile (internal document)
Fleet numbering 5XX - Paramedic Supervisor, Rapid Response, Special Operations 4XX,8XX - Ambulance, West 9XX - Ambulance, East ESUXX - Emergency Support Unit
Current fleet Year Make/Model Type Builder/Modification Origin2025–Chevrolet Express CutawayType III AmbulanceCrestlineCanada 2014–2016 Chevrolet Express Cutaway Type III Ambulance Crestline Canada 2010 Ford E-Series Type II Ambulance1 Crestline Canada 2013–2016 Chevrolet Tahoe Supervisor/First Response Rowland United States 2016 Chevrolet Suburban Supervisor2 Rowland United States 2016 Ford Taurus Senior Command Staff3 2003 ElDorado National Escort RE-A Multi Patient Emergency Response Vehicle Crestline United States 2008 ElDorado National Axess Multi Patient Emergency Response Vehicle Crestline United States 2010 ElDorado National Axess Multi Patient Emergency Response Vehicle Crestline United States 1992 MCI 102A2 Highway Coach4 Ex GO Transit Canada 2009 Chevrolet Kodiak C5500 24 Passenger Bus4 United States 2003 Freightliner FL80 Emergency Support Unit Walk-Around Rescue Body Canada 2008 International Durastar Emergency Support Unit Cargo Body United States 2010 Freightliner M2 106 Roll Back5 Emergency Support Unit Pod Truck United States John Deere Gator Special Events Albion United States Mikey Cart Special Events Albion 1997–2000 Ford E-Series Cutaway Box Truck Logistics Stock United States 2009 Chevrolet Kodiak C5500 Logistics Stock United States 2011–2013 Mercedes-Benz Sprinter Logistics Stock Germany 2006–2012 Chevrolet 2500HD Maintenance/Support Plow/Salter United States2006 Orion Vii 1 One example in service on Toronto Islands due to road width restrictions2 Special Operations3 Unmarked, issued to senior operations staff4 Used for transporting large groups/special teams for events or deployment5 Equipped with multiple, mission specific pods
Historic/retired vehicles Year Make/Model Type Builder/Modification Origin Status 1908 Horse Drawn Wagon/Carriage Ambulance Petrolia Wagon Works Canada Static display1 1954 Packard Ambulance Henney United States Working display / PR vehicle 1966 Pontiac Bonneville Wagon Ambulance Example United States Working display / PR vehicle 1971–19932 Dodge Ram Van Type II Ambulance United States Working display / PR vehicle 1983–20032 Ford E350 Type II Ambulance Various United States Retired 1990–20052 Ford E350 Cutaway Box Type III Ambulance Crestline United States Retired 1980 Plymouth Volare Wagon First Response United States Retired 1993–20012 Jeep Cherokee First Response United States Retired 2001 Ford Crown Victoria Police Interceptor First Response/Management Stock Canada Retired3 2001–2006 Chevrolet Tahoe First Response/Supervisor Rowland United States Retired3 1981 Chevrolet Impala Wagon Supervisor/First Response Stock United States Retired 1996–20002 Dodge Caravan Supervisor Stock United States Retired 1988 OBI 01.508 Emergency Communications Unit Canada Retired 1963 GMC TDH 4517 Ambulance Bus Retired 1980 OBI 01.504 Ambulance Bus Canada Retired 1980 OBI 01.502 Ambulance Bus Canada Retired 1981 OBI 01.502 Ambulance Bus Canada Retired 1982 OBI 01.502 Ambulance Bus Canada Retired 1986 OBI 01.508 Ambulance Bus Canada Retired 1988 OBI 02.501 Ambulance Bus Canada Retired GMC Step Van Emergency Support Unit United States Retired 1987 Ford C800 Emergency Power Unit 100 kW Generator and Lighting Unit United States Retired 1985 Ford C800 Emergency Support Unit United States Retired 1976 Chevrolet Suburban Emergency Support Unit Off-Road Rescue United States Retired 1993 Ford F-450 Cutaway Emergency Support Unit Cargo Box United States Retired