Short answer: depends on where you are.
As was previously stated, some places have a have a private ambulance company (AMR, and Rural/Metro being the two largest) do their transports. Some are large companies (AMR), and others are very small, non-profit companies (such as the one we work with). Most of Connecticut does this. The local fire department may respond and begin treatment while the ambulance is on its way. Which may take a very, very, very long time (ask Hartford, CT). Others, such as our ambulance, is very prompt with their responses and we don’t have to do anything.
In other places, the fire department runs the ambulance. Thats kind of self explanatory, I think. Its also a very common arrangement.
Then, you have places like Boston, where the ambulance is a seperate municipal department (Boston EMS).
Or, Be like Fairhaven, MA, where the police department runs the ambulance.
As for staffing, it varies from volunteer where the EMTs have to respond to the station to get the ambulance, to paid where someone is with the ambulance all the time. Every variation you can think of in between is used.
Levels of EMS (very generalized):
- First Aid/CPR: Duh.
- First Responder: What I am. Everything in first aid/CPR, plus I can give oxygen, and tie people to longboards. Thank god I don’t have to do it often. My class time was about 24 hours.
- EMT Basic: First Responder plus the ability to transport. Class time: 100 hours
- EMT Intermediate: Basic plus you can stick needles in people. Can’t put stuff in the needle, but you can stick people (at least thats what I understand of it). Class time: not sure, but its a goodly amount.
- Paramedic, aka Advanced Life Support (ALS), or EMT-P: Everything short of surgery, but nearly everything has to be OKed by a doctor (Medical Control). You can reaad ECG strips, push all sorts of fun drugs, and shock people. Class time: a few years of experience as an EMT plus like 600 hours of classes (or some obscenely high number)
EMS isn’t my thing, but I do know a bit about it. I’m sure someone who knows it a bit better than I can fill you in more.
I can think of no more stirring symbol of man’s humanity to man than a fire engine - Kurt Vonnegut