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G.3.15 Allied Tiered Response


Paramedic Services Effective Date: April 30, 2022
Topic: Operations Directives Replaces: April 30, 2019
Subject: Allied Tiered Response Policy No. G.3.15.



To confirm roles and responsibilities of staff involved in a Tiered Response event. The medical tiering of resources is not intended to replace the need to respond allied agencies for core roles. 

  • Paramedics
  • Paramedic Superintendents
  • Senior Managers

The capacity for Paramedics to respond to every emergency without delay and in isolation of other agencies is neither realistic nor practical. As such, Paramedic Services has initiated collaborative programs where the capacity of allied agencies can be leveraged to mitigate impact on patient mortality and morbidity.


  1. There are several communities within Manitoulin-Sudbury DSB with Medical Tiered Response Agreements in force. Tiered responses include:

  • Sudden Cardiac Arrest, excluding confirmed DNR events.
  • Unconsciousness
  • Paramedic Service priority 4 response delays of more than 20 minutes. 
  1. Allied agencies may also be responded to motor vehicle collisions with reported injuries, where they have core and medical responsibilities.

  1. Where an allied agency is tiered to any event, personnel will provide medical aid until Paramedic arrival.

  1. In the event where Paramedics require allied agency personnel to operate a Manitoulin-Sudbury DSB ambulance, this must adhere to policy for Allied Agency Operation of Paramedic Services Vehicles. 

The Tiered Response Agreement Template is located on the Manitoulin-Sudbury DSB Website. 


MSDSB Paramedic Services Deployment Plan