British Columbia Ambulance Service


The British Columbia Ambulance Service is the sole ambulance service and provider of pre-hospital emergency care in the province of British Columbia. BCAS is managed by British Columbia Emergency Health Services and falls under the jurisdiction of the Provincial Health Services Authority. The service is tasked with the provision of emergency medical response province-wide. Today, BC Ambulance is among the largest Emergency Medical Services provider in Canada and North America. The fleet consists of more than 500 ground ambulances operating from 183 stations across the province along with 80 support vehicles. BCAS provides inter-facility patient transfer services in circumstances where a patient needs to be moved between health care facilities for treatment. BCAS also operates an Air Evac program that utilizes both fixed-wing and rotary aircraft.

History

Prior to 1974, ambulance services in British Columbia was provided by a mixture of volunteer ambulance brigades, fire departments, funeral homes, and private operators. As a result of recommendations made by the Foulkes Commission's report on health care, titled "Health Security for British Columbians" released in 1973, the Government of British Columbia created the Emergency Health Services Commission, which in turn created the BC Ambulance Service on July 4, 1974.

Governance

In British Columbia, responsibility for the provision of ambulance services is granted to British Columbia Emergency Health Services under the auspices of the Emergency and Health Services Act. BCEHS reports to PHSA. The members of the Emergency Health Services Commission act as a Board of Directors to the BC Ambulance Service. The commission membership consists of health service administrators, medical professionals, and government representatives. BCEHS is also responsible for the operation of the BC Patient Transfer Network, which assists physicians when it is necessary to transfer a patient to a higher level of care.
The Emergency Medical Assistants Licensing Board is an independent regulatory body responsible for licensing Paramedics.

Organization

There are 183 ambulance stations in British Columbia, including the transfer fleet. Stations may be staffed with part-time paramedics, part-time and full-time paramedics, or only full-time paramedics, depending on where the station is located and the number of calls its crews are dispatched to. Each station is headed up by a Unit Chief, who acts as supervisor for the crew at the station. The Unit Chief also handles the day-to-day administrative duties required by the station, including payroll management, overseeing station and ambulance maintenance, and crew scheduling.
Each station falls under the responsibility of a District Supervisor. The District Supervisor has responsibility for the operations of all of the stations within a given district. The size of the district, and the number of stations it encompasses, varies depending on factors such as geography, station size and number of paramedics.
Each BCAS district is part of a larger region, which is headed by a Manager. Each District Supervisor is accountable to the Manager for that specific region. In some regions, a Program Manager works alongside the Manager with day-to-day activities. The District Supervisors are accountable to the Manager of the region, who in turn reports to the executive management team of the BC Ambulance Service.
The BCAS provincial headquarters is located in Victoria, BC. It is staffed by an executive management team, and other support services. Directors and Senior Executive Directors are members of the executive management team, and are in charge of specific functions pertinent to the operations of BCAS, but not day-to-day functionality. The final responsibility for BCAS operations lies with the service's Chief Operating Officer. The Chief Operating Officer is accountable to the Executive Officer, BC Emergency Health Services, who in turn reports to the Board of BC Emergency Health Services. BC Emergency Health Services is a subsidized agency of the BC Provincial Health Services Authority.

Ambulance stations list

As of July 2018
DistrictAmbulance StationLocationNotes
North EastStation 751Atlin
North EastStation 757Dease Lake
North EastStation 858Fort Nelson
North EastStation 860Fort St John
North EastStation 862Hudsons Hope
North EastStation 852Chetwynd
North EastStation 856Dawson Creek
North EastStation 858Tumbler Ridge
SkeenaStation 643Stewart
SkeenaStation 679Hazelton
SkeenaStation 674Kitwanga
SkeenaStation 769Smithers
SkeenaStation 756Granisle
SkeenaStation 690Masset
SkeenaStation 651Clements
SkeenaStation 681Sandspit
SkeenaStation 687Queen Charlotte Island
SkeenaStation 684Prince Rupert
SkeenaStation 645Terrace
SkeenaStation 623Kitimat
SkeenaStation 767Houston
North FraserStation 532Mackenzie
North FraserStation 503Bear Lake
North FraserStation 761Fort St James
North FraserStation 753Burns Lake
North FraserStation 773Southside
North FraserStation 763Fraser Lake
North FraserStation 771Vanderhoof
North FraserStation 535Prince George Hart Hwy
North FraserStation 531Prince George Edmonton
North FraserStation 580Prince GeorgeCritical Care Transport Station
Chilcotin RobsonStation 227Bella Coola
Chilcotin RobsonStation 309Anahim Lake
Chilcotin RobsonStation 353Alexis Creek
Chilcotin RobsonStation 348Williams Lake
Chilcotin RobsonStation 538Quesnel
Chilcotin RobsonStation 550Wells
Chilcotin RobsonStation 525McBride
Chilcotin RobsonStation 533Valemount
North IslandStation 226Bella Bella
North IslandStation 126Port Hardy
North IslandStation 132Sointula
North IslandStation 102Alert Bay
North IslandStation 129Port McNeill
North IslandStation 172Port Alice
North IslandStation 131Sayward
North IslandStation 135Zeballos
North IslandStation 133Tahsis
North IslandStation 155Gold River
North IslandStation 108Campbell River
ComoxStation 170Quadra Island
ComoxStation 169Cortes Island
ComoxStation 229Powell River
ComoxStation 136Tofino
ComoxStation 134Ucluelet
ComoxStation 150Courtenay
ComoxAnnex 150Comox
ComoxStation 151Cumberland
ComoxStation 171Denman Island
ComoxStation 228Texada Island
ComoxStation 124Port Alberni
Central IslandStation 173Bowser
Central IslandStation 138Qualicum Beach
Central IslandStation 130Parksville
Central IslandStation 122/180Nanaimo NorthCritical Care Paramedic Station
Central IslandStation 120Nanaimo South
Central IslandStation 153Gabriola Island
Central IslandStation 159Ladysmith
CowichanStation 115Port Renfrew
CowichanStation 119Lake Cowichan
CowichanStation 149Chemainus
CowichanStation 152Duncan
CowichanStation 103Ganges
CowichanStation 117Galianols
CowichanStation 104Maynels
CowichanStation 114Penderls
CowichanStation 137Mill Bay
Greater VictoriaStation 107Sooke
Greater VictoriaStation 106Sidney
Greater VictoriaStation 105Central Saanich
Greater VictoriaAnnex 121Victoria - Royal Oak
Greater VictoriaStation 109Langford - West ShoreDispatch
Greater VictoriaAnnex 125Victoria - Shelbourne
Greater VictoriaStation 140Victoria Central Reporting Station
Greater VictoriaAnnex 127Victoria - Esquimalt
Greater VictoriaAnnex 118Victoria - Downtown
Greater VictoriaAnnex 112Victoria - Royal JubileePermanently CLOSED
Cariboo FraserStation 327100 Mile House
Cariboo FraserStation 308Clinton
Cariboo FraserStation 313Gold Bridge
Cariboo FraserStation 304Seton Portage
Cariboo FraserStation 318Lillooet
Cariboo FraserStation 303Ashcroft
Cariboo FraserStation 321Lytton
Cariboo FraserStation 204Boston Bar
Cariboo FraserStation 214Hope
ThompsonStation 338Blue River
ThompsonStation 335Clearwater
ThompsonStation 306Barriere
ThompsonStation 307Chase
ThompsonStation 333Sicamous
ThompsonStation 336Revelstoke
ThompsonStation 332Salmon Arm
ThompsonStation 311Enderby
ThompsonStation 302Armstrong
Kootenay EastStation 409Field
Kootenay EastStation 413Golden
Kootenay EastStation 411Invermere
Kootenay EastStation 405Elkford
Kootenay EastStation 414Kimberley
Kootenay EastStation 428Sparwood
Kootenay EastStation 406Fernie
Kootenay EastStation 403Cranbrook
Kootenay EastStation 404Creston
Kootenay WestStation 419Nakusp
Kootenay WestStation 422New Denver
Kootenay WestStation 412Kaslo
Kootenay WestStation 423Riondel
Kootenay WestStation 427Winlaw
Kootenay WestStation 421Nelson
Kootenay WestStation 402Castlegar
Kootenay WestStation 426Salmo
Kootenay WestStation 417Fruitvale
Kootenay WestStation 424Rossland
Kootenay WestStation 431Trail
Okanagan SouthStation 408Grand Forks
Okanagan SouthStation 410Greenwood
Okanagan SouthStation 415Midway
Okanagan SouthStation 328Osoyoos
Okanagan SouthStation 326Oliver
Okanagan SouthStation 317Keremeos
Okanagan SouthStation 330Princeton
Okanagan SouthStation 329Penticton
Okanagan SouthStation 334Summerland
Central OkanaganStation 342Peachland
Central OkanaganStation 339West Kelowna
Central OkanaganStation 340Kelowna Lawrence
Central OkanaganStation 341Kelowna Mills Road
Central OkanaganStation 380Kelowna International AirportCritical Care Transport Station
Central OkanaganStation 343Lake Country Winfield
Okanagan NorthStation 407Edgewood
Okanagan NorthStation 320Lumby
Okanagan NorthStation 337Vernon
Okanagan NorthStation 314Kamloops SouthDispatch
Okanagan NorthStation 315Kamloops North
Okanagan NorthStation 370Critical Care Transport Station
ThompsonStation 324Merritt
ThompsonStation 319Logan Lake
Sea to Sky/SunshineStation 219Pemberton
Sea to Sky/SunshineStation 224Whistler
Sea to Sky/SunshineStation 222Squamish
Sea to Sky/SunshineStation 265Madeira Park
Sea to Sky/SunshineStation 235Sechelt
Sea to Sky/SunshineStation 268Gibsons
Sea to Sky/SunshineStation 225Bowen Island
Fraser ValleyStation 203Agassiz
Fraser ValleyStation 206Chilliwack
Fraser ValleyStation 202Abbotsford
Fraser ValleyStation 205Abbotsford Mt LehmanCritical Care Paramedic Station
Fraser ValleyStation 215Mission
Fraser ValleyStation 252Langley
Fraser ValleyStation 267North Langley
Fraser ValleyStation 257Maple Ridge
Surrey/North Delta/TricitiesStation 254White Rock
Surrey/North Delta/TricitiesStation 253Cloverdale
Surrey/North Delta/TricitiesStation 264Nordel Logistics CentrePermanently CLOSED
Surrey/North Delta/TricitiesStation 266North Delta
Surrey/North Delta/TricitiesStation 249Surrey
Surrey/North Delta/TricitiesStation 247New West Rousseau
Surrey/North Delta/TricitiesStation 259Port Moody
Surrey/North Delta/TricitiesStation 263Port Coquitlam
South Delta/Richmond/BurnabyAnnex 251Delta Tsawwassen
South Delta/Richmond/BurnabyStation 251Delta
South Delta/Richmond/BurnabyStation 269South Richmond
South Delta/Richmond/BurnabyStation 250Richmond
South Delta/Richmond/BurnabyStation 280Critical Care Transport Station
South Delta/Richmond/BurnabyStation 270Richmond Airport
South Delta/Richmond/BurnabyStation 244Vancouver W 59th
South Delta/Richmond/BurnabyStation 240Burnaby Buller AveDispatch/ Special Operations
South Delta/Richmond/BurnabyStation 246Vancouver OrmidalePermanently CLOSED
South Delta/Richmond/BurnabyStation 245Vancouver E King Edward
South Delta/Richmond/BurnabyStation 258Burnaby
South Delta/Richmond/BurnabyStation 260New West 12thPermanently CLOSED
Vancouver/North ShoreStation 233Lions Bay
Vancouver/North ShoreStation 255West Vancouver
Vancouver/North ShoreStation 256North Vancouver
Vancouver/North ShoreAnnex 256North Vancouver
Vancouver/North ShoreStation 262Vancouver UBC
Vancouver/North ShoreStation 242Richards StPermanently CLOSED
Vancouver/North ShoreStation 248Vancouver E Cordova
Vancouver/North ShoreStation 261Vancouver W 7th
Vancouver/North ShoreStation 243Vancouver Arbutus
Vancouver/North ShoreStation 283Infant Transport Team Station

Staff

As of 2018, the BCAS employs 4,750 part-time and full-time paramedics and dispatchers. This includes management and administrative employees in the BCAS.

Emergency medical communication centres

The BCAS operates four Communication centres located throughout the province. The Vancouver Island Communications Centre, located in Victoria British Columbia is responsible for all ground ambulance deployment for Vancouver Island and the Gulf Islands; the Lower Mainland Region Ambulance Communication Centre deploys all ground ambulances in the Lower Mainland, the Sunshine Coast, as far east as Boston Bar and as far north as Pemberton; and the Interior and Northern BC Communications Centre deploys resources to the remainder of the province, including the southern interior and northern BC. The fourth Communication centre, the Provincial Air Ambulance Coordination Centre, is located in Victoria and has responsibility for coordinating and deploying of all air ambulance resources, whether they are used for scene responses, or for inter-facility transfers.
Each Communication centre is staffed with a mixture of Emergency Medical Call Takers and Emergency Medical Dispatchers. The Vancouver Communication system is the largest of the four Centres. A Communication Supervisor who is a bargaining unit member, provides line supervisory support to Communication centre staff, with a Director and a Communication Superintendent managing the centre. Other centres have a Charge EMD in the role of Supervisor, with a Superintendent managing the Centre. Training for EMCTs and EMDs is provided in-house by the BC Ambulance Service.
The BC Ambulance Service utilizes the Advanced Medical Priority Dispatch System to triage calls and a customized Resource Allocation Plan to allocate First Responders, Primary Care Paramedics, and Advanced Care Paramedics to calls as needed.
Within the Metro Vancouver region, BCAS utilizes the E-Comm Wide-Area Radio Network for one-stop communication between police and fire agencies.

Fleet

Ground response

BCAS operates a variety of ground vehicles for ground transport. Most ambulances operated by BCAS are Type III ambulances with some Type I ambulances being used in remote communities. Some Type II ambulances based on the Mercedes-Benz Sprinter chassis are in use following their acquisition during the 2010 Winter Olympics. SUV's are also used as response units by some Advanced Care Paramedics. These response units carry their Advanced Life Support equipment and medications in the SUV and then transport the patient in a Basic Life Support ambulance. Critical Care Paramedics also have ground ambulances available for when aircraft is grounded or when responding to an area where it is not possible to land a helicopter. BCAS operates a number of other support vehicles to respond to HAZMAT, mass casualty, and public events. These vehicles include pickup trucks, gators, bicycles, and retired Type III ambulances. BCAS supervisors drive SUV's, Dodge Chargers, or Mini- Vans.
Ambulances are marked on the side to indicate what kind of paramedics are operating the ambulance:
Marking On The AmbulanceQualifications Of Staff Operating The AmbulanceVehicle Type
EMERGENCY PARAMEDICEmergency Medical Responder/Primary Care ParamedicType III Ground Ambulance
COMMUNITY PARAMEDICINEPrimary Care ParamedicCommunity Paramedic Unit
ADVANCED LIFE SUPPORT UNIT
EMERGENCY PARAMEDIC		Advanced Care ParamedicType III Ground Ambulance
PARAMEDIC SPECIALISTAdvanced Care Paramedic / Critical Care ParamedicParamedic Response Unit
INFANT TRANSPORT PARAMEDICInfant Transport Team paramedic
CRITICAL CARE PARAMEDICCritical Care Paramedic
CRITICAL CARE TRANSPORTCritical Care Paramedic
CRITICAL CARE FLIGHT PARAMEDICCritical Care Paramedic
TRANSFER AMBULANCEEmergency Medical Responder/Primary Care Paramedic
BC AMBULANCE SERVICE SUPERVISORUnit Chief / District SupervisorParamedic Response Unit

Airevac response

The BCAS is responsible for the delivery of air ambulance services throughout the province of British Columbia. Critical care paramedics are deployed from bases in Prince George, Richmond, Kelowna and Kamloops, Nanaimo, Langley and Vancouver. Each team is composed of two CCPs who transport all Adult patients and some pediatric patients. The infant transport team based out of BC Children's Hospital in Vancouver handles the critical care infant, child, and maternity transports. The ITT have completed advanced training and provide emergency medical care to pediatric, neo-natal and high-risk obstetric patients.
The BC Ambulance Service air ambulance fleet consists of six fixed-wing aircraft, five Beechcraft Super King Air 350 turboprops and one Cessna Citation Encore jet. Additional aircraft are chartered on an as-needed basis. The BCAS also operates four dedicated air ambulance helicopters, two based in Vancouver and one based in both Prince Rupert and Kamloops. BCAS also utilizes approximately 40 pre-qualified charter carriers throughout British Columbia.

Training

Paramedics in BC obtain their initial training before employment by pursuing either their EMR or PCP License at their own cost.
EMR training is available through a variety of instructional agencies throughout the province. EMR courses that are approved by the include those offered by the College of the Rockies, Paramedic Academy of the Justice Institute of BC, , St. John Ambulance , the , , , Vancouver Island University Centre for Continuing Studies and Okanagan College Continuing Studies.
Primary Care Paramedic training is offered by the Paramedic Academy under the School of Health Sciences at the Justice Institute of BC, and through . Advanced Care Paramedic training is only available through the Paramedic Academy.
All ITT and CCP training is conducted 'in-house' by BCAS Clinical Education Division in conjunction with BC Women's, BC Children's, Vancouver General, St. Paul's hospitals and BCIT.
The EMA Licensing Board maintains a list of approved training agencies available to potential students. Those students who do not complete one of the approved courses will not be permitted to apply for a licensing examination.
Clinical Education is the Division of BC Ambulance Service that provides Paramedic development once a Paramedic has been hired. The main goal of the Clinical Education Division is to support the delivery of quality patient care through curriculum development and course presentation. A new employee can expect to be offered about 11 courses of paid training in their first six months of service. These courses may include:
In addition, new employees must pass a driving preceptorship prior to being allowed to drive Code 3. BCAS fosters an environment of lifelong learning and offers a combination of face-to-face and online educational opportunities for Paramedic development.

Licensing and qualifications

Paramedics qualified in British Columbia are broadly referred to as Emergency Medical Assistants and are licensed by the Emergency Medical Assistants Licensing Board, a government regulatory agency, under one of five categories:
EMR and PCP are Basic Life Support qualifications while ACP is an Advanced Life Support qualification; ITT has some pediatric advanced protocols; CCP has a whole different scope of practice. BCAS treatment guidelines are universal, which a qualified practitioner may employ at any time, up to his or her license qualification, within the provincial borders, given that the required equipment is at hand. Licensing qualifications and endorsements can be found in the under and .

Emergency medical responder

An emergency medical responder licensee is qualified to deliver a limited number of medications, under the class of 'symptom relief', including ASA, nitrous oxide, nitroglycerin, naloxone, and oral glucose. They are also qualified in the use of an automated external defibrillator and may monitor an existing IV line. Their protocols include cardiac arrest, cardiac chest pain, diabetic emergencies, and management of pain using nitrous oxide. The "Schedule 2" endorsements appear as "symptom relief" and "iv maint".

Primary care paramedic

The vast majority of paramedics in BC are primary care paramedic.
In addition to the EMR guidelines, PCP licensees have increased treatment guidelines. PCP-qualified paramedics may also be endorsed for CPAP, intravenous cannulation and will have an additional guidelines for hypovolemia as well as enhancements to the anaphylaxis, diabetic, opioid OD guidelines. Additional PCP-level medications include salbutamol, glucagon, epinephrine, diphenhydramine, thiamine, dextrose 10%, tranexamic acid, and normal saline.
BCAS Medical Leadership has introduced 'Treatment Guidelines', which is a more generalized framework within which paramedics can operate with more flexibility and clinical decision making.

Infant transport team

Infant transport team paramedics are specifically trained for critical care of perinatal, neonatal and pediatric patients. They respond as an equally qualified team of two and sometimes take a physician with them for critically ill patients. When dispatched on street calls these are targeted response ambulances that often assist or intervene when necessary, but can hand a more stable patient off to a layered or co-responding PCP ambulance. The team currently consists of only 26 specially trained paramedics for the entire province.
In addition to the PCP guidelines and medications, they may also administer Acetaminophen, Adenosine, Atropine Sulphate, Calcium Chloride, Dextrose 50%, Dimenhydrinate , Hemabate, Indomethacin, Lorazepam, Magnesium Sulphate, Midazolam , Morphine Sulphate, Ondansetron, Oxytocin, Sodium Bicarbonate and Out-of-Scope medications with orders from a CCTA. ITT paramedics have their own unique set of prehospital treatment guidelines that mirror ACP guidelines in the areas of pediatrics, having the ability to treat respiratory/cardiac arrest and disrhythmias. The ITT practitioner also has adult ACLS guidelines and intubation in the event they encounter an adult cardiac arrest.
Their additional training and skills include the use and monitoring of Incubators, Endotracheal Intubation, Intraosseous Access, nasogastric tube insertion and suctioning, manual defibrillation, cardioversion, chest decompression, Venous pressure monitoring, Arterial & Central Line Monitoring, Chest Tube Management, transthoracic pacing, Blood Product Infusion, IV Infusion Devices, 'IV with Medication' Maintenance, Mechanical Ventilation, Foreign body removal with laryngoscope, ET/IO/PR drug administration, Central & Parenteral Line Management, Venous & Arterial blood sample collection, point of collection analysis of ABG's and chemistry using the I-Stat, Lab & X-ray interpretation.
The ITT paramedics also transport pediatric and adult ECMO patients with a perfusionist from BC Children's.
While there are some areas of overlap between ACP and ITT, the additional ITT 'Airevac' class of skills that are not included in the standard ACP skill-set are Venous Pressure Monitoring, Arterial & Central Line Monitoring, Chest Tube Management, Blood Product Infusion, Mechanical Ventilation, nitric oxide delivery systems and Out-of-Scope Medications by orders.

Advanced care paramedic

Although there are relatively few advanced care paramedic -staffed ambulances compared to PCP, the majority of the population is covered by ALS service. These are targeted response units with two ACP-qualified paramedics. They are able to defer transport of a more stable patient to a layered or co-responding PCP ambulance. This ensures that most patients have access to ACP but that the resource is not tied up on a call they are not needed on. It also ensures that ACP-qualified paramedics treat a "critical mass" of the most acutely ill patients, thereby maintaining their high skill level.
ACP paramedics have protocols to administer all PCP plus Adenosine, Calcium Chloride, Dextrose 50%, Dimenhydrinate, Ipratropium Bromide, Lidocaine, Morphine Sulphate, Midazolam, Ketamine, Fentanyl, and Amiodarone. Their additional skills include synchronized cardioversion, airway isolation devices, endotracheal intubation, end-tidal CO2 monitoring, external jugular vein cannulation, transcutaneous pacing, IV colloid/crytalloid volume expanders, nasopharangeal airways, needle thoracentesis and surgical or needle cricothyrotomy.

Critical care paramedic

Critical care paramedic are paired in British Columbia.
To become qualified at this level, experienced ACP paramedics take further training consisting of a portion of the CCRN program through BCIT, followed by an intensive hospital-based program through St. Paul's Hospital. Next, there is a work experience portion, and finally, CCP licensure. Formerly, an ACP could take a much shorter course and receive a "Full Schedule 2" endorsement.
CCP's have standard operating guidelines for common critical patients; SIRS/Sepsis, RSI, Chest decompression, Ventilation strategies using the LTV 1000 and 1200, ACS and coronary care, etc. CCP paramedics sometimes take an intensivist with them, but consult with Critical Care Transport advisors.
CCP qualifications follow the NOCP guidelines as endorsed by the Paramedic Association of Canada. In addition to standard ACP protocols, the CCP can perform Schedule 2 ACP skills and procedures as well as administer virtually any medication following assessment and consult with the Critical Care Transport Advisor. CCTAs are essential to both the air-evacuation and ground critical care transport programs.

Labour mobility

With the introduction of the Trade, Investment and Labour Mobility Agreement, the process of transferring one's license between provincial jurisdictions has been streamlined.

Research initiatives

Rank and qualification insignia

The BC Ambulance Service is a uniformed organization and as such, has a similar rank structure to most police or fire departments. The medical qualifications of a uniformed member are denoted with collar insignia, commonly known as 'collar dogs', while rank is denoted using epaulettes. Excluded management and administrative employees in regional offices and provincial headquarters do not wear uniforms.
Current qualifications designated by collar dogs include EMR, PCP, ACP, ITT, EMCT and EMD. The EMR and PCP levels are shown on bronze and silver circles, respectively, forming the BCAS logo, along with a circumform bar below, denoting the EMR or PCP qualification. ACP and ITT paramedics are recognized with gold caducei, with either "ALS" or "Neonatology" imprinted upon them. CCP have a gold coloured shield with blue star of life and CCP on it. Within the Communication Centres, EMD and EMCT are designated by gold and silver shields, respectively.
For rank insignia, Paramedics and dispatchers who hold the position of Unit Chief or Charge Dispatcher wear a black epaulette with three gold stripes. District Supervisors and Dispatch Supervisors wear the same coloured epaulette with four gold stripes while Dispatch Officers wear two gold stripes. Ranks above District Supervisor are management positions and are distinguished by a varying number of pips on their epaulette. District and Platoon Superintendents wear an epaulette with three pips, Managers wear one pip and one crown, Directors wear two pips and one crown and the Executive Director of a region will wear three pips plus a crown. Each station and dispatch centre has a staff member designated as its Occupational Safety & Health representative. These paramedics and dispatchers are identified with a black epaulette with a single royal blue bar. Staff who are designated as OSH representatives hold no supervisory authority, but are available to assist staff with safe work practices. BC Ambulance instructional staff wear a black epalette with the word "INSTRUCTOR" embroidered in gold, facing laterally.
Shoulder flashes for field staff are navy blue with a navy blue trim, and include the British Columbia Coat of Arms, with the words "Ambulance" above, and "British Columbia" below, both in white.

Other pins and insignia

Ambulance paramedics, emergency medical call-takers, and emergency medical dispatchers are members of the Local 873 of the . Provincial headquarters and administrative staff are members of the .

Wages and benefits

Wages are paid according to license qualification, years of service and supervisory status.
Paramedic Wage ScaleJanuary 2018-----
Experience PayEMRPCPPCP-IVACPITTCCP
Base$24.08$25.64$26.41$34.84$40.81$40.81
1 Year$25.91$27.49$28.26$36.74$42.72$42.72
2 Years$27.76$29.34$30.11$38.41$44.39$44.39
3 Years$29.85$31.39$32.16$38.94$44.92$44.92
10 Years$30.16$31.70$32.47$39.25$45.23$45.23
15 Years$30.47$32.01$32.78$39.56$45.54$45.54
20 Years$30.77$32.31$33.08$39.86$45.84$45.84
25 Years$31.11$32.65$33.42$40.20$46.18$46.18

Community involvement