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From the Grey Zone presentation: Remember that a Trauma TOR is called for after the 1st analysis versus a Medical TOR (or direction/pronouncement) wherein the Mandatory Provincial Patch Point (as of ALS-PCS v5.0)  is after 20 minutes of resuscitation” Remember that you may patch early (e.g. following the 4th analysis) to consider TOR if there are extenuating circumstances; surrounding egress, prolonged transport or significant clinical limitations where the paramedic considers ongoing resuscitation to be futile.