On behalf of the PCC Board of Directors and steering committee, we are pleased to present this report, Principles and Enabling Factors Guiding Paramedicine in Canada. The healthcare system is under significant and increasing strain, and paramedicine systems are struggling to maintain service levels as transfer-of-care delays in emergency departments lengthen and call volumes grow. Demands are outpacing resources. We believe that the present state of paramedicine as well as the profession itself are not viable: they require urgent changes to meet the needs of patients and their communities, the healthcare system, and our providers. Although those challenges are great, so too are the opportunities.