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G.3.16 Multiple Patient Transport


Paramedic Services Effective Date: April 30, 2022
Topic: Operations Directives Replaces: April 30, 2019
Subject: Multiple Patient Transport Policy No. G.3.16.



To ensure Paramedics understand employment requirements when required to transport more than one patient at a time.

  • Paramedics
  • Paramedic Superintendents


  1. Paramedics will ensure the safety and security of each patient during the period from receipt of responsibility to transfer of care. 

  1. On Scene Responses:

  1. When presented with an emergency scene with multiple patients, the Paramedic will consider:
    • The number of patients who can be given appropriate care while en route to a medical facility.
    • The condition of the patients, the time factor and the environmental conditions in relation to the arrival of a second vehicle.
    • The possibility of transporting one or more patients to a point to meet with a second vehicle.
  2. In a situation where the number of patients requiring care exceeds the capabilities of one ambulance, the first ambulance will remain on the scene rendering care until the arrival of a second vehicle. 

  1. Interfacility Responses:

  1. When Paramedics are assigned by dispatch to a multiple patient event, they will assess the condition of each patient and determine if they can be transported together as per the Ambulance Act. The Paramedics have the final decision in approving a multiple patient transfer based on the patient condition.
  2. Patients will not be considered suitable for multiple patient transport where either patient:

    • is assessed as equivalent to a CTAS 1.
    • Has a presentation that may be a source of embarrassment or discomfort
    • Is suspected, or diagnosed with a communicable disease
    • Has in place a valid Do Not Resuscitate (DNR) Order, with an imminent likelihood of cardiorespiratory arrest.
  1. Paramedics have the final decision in approving multiple patient transports.

  • If the Paramedics decide that a patient is not suitable for transfer with another patient, they shall advise the CACC ACO and document their decision as per the Documentation Standards on an incident report. 
  1. Transportation

  1. Paramedics will ensure that:
    • Each patient is informed that they will be travelling with another patient.
    • No patient is left unattended. Assistance must be obtained in the situation where a paramedic crew has two patients without escorts (loading and unloading will be done with the assistance of a hospital porter/attendant or responsible person).
    • Each patient is appropriately covered to avoid exposure.

Manitoulin-Sudbury District Services Board, Emergency First Response – ERV’s, Policy and Procedure

Ministry of Health, Emergency Services Branch, Documentation Standards, The Crown in Right of the Province of Ontario 

Emergency Health Services Branch, Basic Life Support Patient Care Standard

Ambulance Act, R.S.O. 1990, c. A.19 and Regulations, Queens Printer for Ontario