Emergecy Response

Recently in my place of business, a young woman collapsed to the floor with no warning. Her mother was there, screaming that her daughter was dying, so I called
9-1-1. The Fire engine was on the scene in a matter of minutes. By the time they arrived, though, the young woman had come to, and refused medical service.

Why is it that, more often than not, the first response in a medical-related 9-1-1 call is a fire truck, and not an ambulance with paramedics?

Maybe the ambulance was on the other side of town at the time and the fire truck was the closest emergency personell available. I had to call 911 once, and I got an ambulance. No fire trucks.

Don’t know about there, but here, ambulances are owned by private companies and don’t respond to 911.
Paramedics are part of the FD and ride on the FD trucks.

Probably, the fire station closest to your work has a fire truck, but doesn’t have an ambulance. I assume that they want to get someone there quick; the supplies can come a few minutes later.

pmh has it pretty much right. Many jurisdictions have a private ambulance company providing EMS transport. The contracts for these private companies generally say something like “thou shalt have 2 ambulances in town waiting for calls.” The ambulance company skirts this by having a contract with the next town saying the same thing. So, they put 2 ambulances on the town line. See, both towns are covered with 2 ambulances. Can’t get mad about that, can ya? Well, yes, you can. A certain EMS provider in Connecticut is being run out of town because of this practice. When it takes 15-20 minutes to get an ambulance, a fire engine is generally closer.

Another aspect is those towns which the EMS is done by the fire department. When this is done, most of the time there are 2 EMTs on the ambulance and at least 3 firefighters (hopefully more, but thats another story) on the engine. Two EMTs can just about package a patient and get them into the ambulance. It seems that the 350lb people only live on the 3rd floor or higher. So, to help share the work, they send an engine for manpower.

Then we have a situation such as Boston. The fire department and EMS are two seperate city agencies. The fire stations were positioned in the 1800s, when there was plenty of room in the city to properly space the buildings. BEMS didn’t start until (I beleive) the 1960s (I could be wrong on that, don’t quote me). Now, you’ve got 65 pieces of fire apparatus, spaced evenly throughout a city of 600,000. You also have 7 to 10 ambulances, not evenly spaced. If you call the fire department, 98% of the time you’ll have someone there in 3 minutes. The ambulance is almost always going to take longer. So, send the fire engine that has most of the needed equipment on it, and start treatment for when the ambulance arrives.

We only send an engine if its a mutual aid ambulance (one from out of town) coming in. Our own ambulance can get to the scene fast enough otherwise.


Nobody ever calls me after they’ve done something smart.

I’ve always wondered about this. Wouldn’t it be more efficient, and save money, to have a small ambulance located at each fire station, instead of bringing out the huge fire truck?

Quand les talons claquent, l’esprit se vide.
Maréchal Lyautey

Well the fire trucks will need to have basic medical equipment in any event. So is it more efficient to purchase and maintain a little smaller vehicle to use when there is no fire? Maybe, but probably not.

Especially when the ambulance would take one of maybe only two stalls away from a fire truck.

The Fire Dept is only three blocks away & they are trained & have paramedics. Ambulance? Why they are at least 7 miles…

Time is of the essence…BTW ambulance costs about $2400 just for a ride to the hospital [5 miles or so] ugh.

It probably depends on the city because in some, the Crash or Paramedic fire truck runs first to a report of an injury complete with all of the medical supplies and fully trained paramedics. The ambulance follows for transport and their medics.

In other cities the ambulance goes alone to non-automobile accident related injuries but is accompanied by the fire department to any car wrecks.

My city has a volunteer ambulance department, though we almost lost it once because public donations were low and good, skilled medics did not want to volunteer plus there were a couple of pay-transport ambulance companies bribing the city council members to get into the business. Since we were one of the very first, years ago, to have a volunteer department, we all kept it, and the city underwrites it and it has grown. They bill you for services under the title of donations but don’t get all bent out of shape if you can’t pay. Our fire department doesn’t run with the ambulance unless called. The police do, however.

That started when it became a ‘fun thing’ to call out an ambulance and then rob it for drugs or shoot the rescuing crews because they were white and in the wrong neighborhood like happened in some cities. Here, at night, the police have to accompany any wrecker calls also, even if your car just has a dead battery.

I had a roomer who liked to drink himself into oblivion every chance he got, which was daily, and twice, fearing that he was in the throes of alcohol poisoning, had him shipped to the hospital via ambulance and the cops showed up first. (The guy even drank my mouthwash, any alcohol based cooking flavorings I had, plus a bottle of rubbing alcohol. I think he was getting ready to start working on the paint thinner when I booted him out.)

The last engine we bought was about $265,000.
The last ambulance the town bought was $130,000. I should add that the town does not own the ambulance service, it is a private company that does our EMS, and they buy their own equipment. We have to have fire apparatus, and we have to have ambulances. I think it would be more inefficient to let the really expensive truck sit in the station when it could be put to some good use, even if it can’t actually bring you to the hospital.

We have four stations, and 12 pieces of apparatus.
Station 1: room for 4, has 5
Station 2: room for 4, has 4
Station 3: room for 1, has 2
Station 4: room for 1, has 1

Where was the ambulance supposed to fit again? In all seriousness, most towns and cities have their trucks sqeezed into their stations like sardines. Plus, there is (in some places) some serious animosity between the fire department and the EMS providers. Kind of a “no way you’re parking that in my fire station” mentality. I know its not in the public’s benefit, and I personally don’t agree with it, but I don’t make political policy for the nation’s emergency services. Thank god my department isn’t like that.


Nobody ever calls me after they’ve done something smart.

My wife was involved in a lifesaving situation when an elderly woman collapsed at our local elementary school. The school was having a costume parade and had invited residents of a local nursing home as guests to see the parade. One of the guests collapsed and stopped breathing.

My wife and another mother and the school nurse started CPR, while others went for help. Since the school is right across the street from a fire station with paramedics, they ran across the street instead of calling 911. That was wrong. The firemen were out on another call. They had to run back and then call 911.

The paramedics arrived after what seemed like an eternity to my wife, but it was really only ten minutes or so. She was amazed at how vigorously they worked on the victim when they took over, so much so that she was afraid they hadn’t been doing it right and had been no help at all. The paramedics assured her later that they had performed a vital service in maintaining some air and blood flow, sufficient to keep her going till they got there.

The end of the story is a happy one – the woman who collapsed not only survived, but the attack led her doctors to an unsuspected condition which been troubling her for some time and which was easily corrected. So afterward she was healthier than she had been before!

“If ignorance were corn flakes, you’d be General Mills.”
Cecil Adams
The Straight Dope

Where I live the emergency wagon is sent out with two people which is not enough to take care of some medical emergencies so it is followed by a fire truck with whatever its correct number of staff is.

The fire crew helps the emergency crew if needed, if not it goes back to the station.

This means that if there is a fire every truck is staffed even if it is out on a medical emergency and when no longer needed, it goes from the emergency to fire, doesn’t have to stop to get the rest of its firepersons.

The end result is that we don’t have that third person in the emergency wagon humming a song when not needed but in a fire truck. Which seemed okay when I started this.

Oh, I’m gonna keep using these #%@&* codes 'til I get 'em right.