FAQs

An Ornge Transport Medicine Physician will determine the paramedic level of care that is required based on the anticipated clinical care required by the patient during transport, and any medical escorts from the Sending Healthcare Facility who may be accompanying and providing clinical care to patients during transport.  Ornge primarily provides three (3) levels of care:  

• Primary Care Paramedics (PCP) provide a basic level of care directed at symptom relief. 
• Advanced Care Flight Paramedics (ACP-f) are capable of advanced resuscitation, and able to transport patients on mechanical ventilation and/or on multiple infusions. Specifically, ACP-F cannot provide Propofol infusions but can maintain other sedative functions.
• Critical Care Paramedics (CCP) are also capable of advanced resuscitation, and able to transport patients on mechanical ventilation and/or on multiple infusions. They are further capable of using an expanded scope of medications than ACP-f, such as Propofol and Epinephrine infusions, as well as clinically managing more complex patient populations (e.g. neonatal, obstetrical, ECMO, intra-aortic balloon pump (IABP) etc.).

You may view Ornge’s Clinical Practice Guidelines for each level of care by downloading the Ornge: Clinical Practice App from the Apple App Store.

It is the policy of the Ministry of Health that no interfacility patient transfer takes place without a sending facility first obtaining a Medical Transfer (MT) Authorization Number from Provincial Transfer Authorization Centre (PTAC). This policy also applies to patients being transported from a healthcare facility to and from a private doctors’ or dentists’ office for treatment.

To obtain an MT number, please follow the steps under ‘How do I book a patient transport?’

Note: Life threatening emergencies DO NOT require a Medical Transfer Authorization Number to transfer.

Transport plans may change for a variety of reasons such as weather, aircraft availability and ground transport delays.

In addition, similar to an Emergency Department, Ornge must prioritize transports according to urgency.  The Operations Control Centre considers the medical condition of each patient as well as other transport-related needs.  As part of this process, a Transport Medicine Physician assesses each patient’s the urgency and level of care, and patients are triaged on this basis.

 The Operations Control Centre will apprise your care provider of any changes/delays and provide expected timelines.

Ornge provides medical transport services to patients who require the ongoing administration of medications and/or blood products that is beyond the scope of practice of a land Primary Care Paramedic or require specialized equipment or monitoring devices during transport (e.g. ventilator, external pacemaker, multi-channel infusion pump, hemodynamic or invasive monitoring and intra-aortic balloon pump). 

For primary care transfers, the one-way travel distance must be greater than 240 km (150 km for CritiCall Life or Limb transfers) and the patient must meet the requirements of the Ambulance Act (i.e. a physician or healthcare provider has determined that the patient requires care during transport, and requires a stretcher or is ambulatory but not clinically suitable for a scheduled commercial flight).

There may be circumstances where a request for service does not meet these guidelines. Ornge will assist health care professionals in determining the right level of care with the right type of vehicle.

Ornge is responsible for the provision of aero-medical services to residents in the Province of Ontario for treatment within the Province of Ontario. When treatment and/or procedures not available in Ontario are required by an Ontario resident, a transfer to a location outside of the province is coordinated by CritiCall or the hospital.

In the event that a non-Ontario resident requires aero-medical transportation while in Ontario, the same processes apply, including transporting the patient to the most appropriate medical facility (as determined by CritiCall or the hospital), subject to the same permissions for transfer to a location outside of Ontario. Non-Ontario residents may be billed for the cost of transport. Information regarding ambulance service billing for Ontario residents, visitors from other provinces and visitors from other countries is available in the Ambulance Service Billing section of the Ontario Ministry of Health website.

Should an Ontario hospital require transport of a non-Ontario patient, who does not meet the criteria for Ornge services to a facility in the United States, Ornge recommends contacting an aviation charter company. Ornge is not responsible for fees associated with these services. For more information, please visit the OHIP Out of Country Services page on the Ministry of Health website.