Fire departments and ambulances

[perpetua]

As a spin off from the 'what do firefighters do' thread, but something that I've been wondering about ever since Michael Jackson died and the fire department sent the ambulance: Do you not have a separate ambulance service in America?

Here in the UK ambulances are provided by the Ambulance Service and staffed by paramedics. We have three separate emergency services: Police, Fire Brigade and Ambulance (four if you count the Coastguard). When you dial 999, you're asked which service you require. Ambulances do not come from the fire brigade here.

Who provides emergency services where you live?

[RingTailedLemur]

As a spin off from the 'what do firefighters do' thread, but something that I've been wondering about ever since Michael Jackson died and the fire department sent the ambulance: Do you not have a separate ambulance service in America?

Here in the UK ambulances are provided by the Ambulance Service and staffed by paramedics. We have three separate emergency services: Police, Fire Brigade and Ambulance (four if you count the Coastguard). When you dial 999, you're asked which service you require. Ambulances do not come from the fire brigade here.

Who provides emergency services where you live?

Six.  You forgot mountain rescue and cave rescue.

Where I live, the ambulance station and the fire station are at the same place.  Regional difference?  Or maybe where I am us unusual.

[PastryGoddess]

Here if you dial 911 the ambulance is sent out from the fire dept. 

There are private ambulance services, but typically they are for transportation only.  For example if a person needs to get from Point A to Point B and will need medical support, a private ambulance is called for the transportation.  They have local or toll-free numbers

[perpetua]

Six.  You forgot mountain rescue and cave rescue.

Probably because I'm not a mountainy or cavey type of person But yes, good point.

And also the AA   

[Just Lori]

To add to the confusion, firefighters are trained in basic lifesaving techniques and are also dispatched for medical emergencies. Look at it this way- if each fire house has two or three firetrucks and one ambulance, and the ambulance is already out on a run, you're better off with a trained firefighter at your house now than an ambulance from a nearby station showing up 10 minutes later.  That's why you might see a firetruck when your neighbor has taken a spill on the ice or whatever.

My brother is a firefigher, and he and his colleagues do an awesome job.  However, he can absolutely boggle our minds with stories of silly calls for help, which is why there's not always an ambulance available for the legitimate calls.

[RingTailedLemur]

Six.  You forgot mountain rescue and cave rescue.

Probably because I'm not a mountainy or cavey type of person But yes, good point.

And also the AA   

IIRC the AA got into trouble for referring to themselves as "the 4th emergency service" because they forgot them too!

[PastryGoddess]

What's AA?  I've heard of Triple A...not Double A

[perpetua]

What's AA?  I've heard of Triple A...not Double A

The Automobile Association.

There's no 3rd A here, because, well, we're not American 

[camlan]

In the US, there are a few different systems, depending on what state you live in.

In general, in an emergency, you dial 911 and state your emergency. The dispatcher will contact the appropriate people--you don't have to state which emergency service you want. You can ask for an ambulance, but the dispatcher will know who to call for that. Depending on where you live, ambulances may be free, or you may have to pay for your ambulance ride. Some insurance companies cover ambulances in an emergency; some do not.

EMS (Emergency Medical Services) vary widely from state to state--there is no Federal EMS. Some EMS departments are separate entities, some are made up of police and firefighters, some are completely volunteer, as are some fire departments.

Even within the same state, you will have cities with a police force, paid firefighters and a separate EMS with its own ambulances, and then smaller towns with no police force of their own who rely on county or state police/sheriff services, volunteer firefighters and volunteer EMS personnel who rely either on a paid ambulance service or, with an agreement with a larger city, the ambulances from that city.

[Thipu1]

In NYC there are four different kinds of ambulance service.

The Fire Department ambulances respond to 911 calls.

Hospitals have their own ambulances.  These may be contacted instead of the FDNY if the emergency is near the hospital. They are also used to transfer patients from one facility to another.

There are private ambulances for the particular.  These are very pricy.

Volunteer ambulance corps often serve ethnic and religious groups which prefer to be treated by people who share their beliefs.  In NYC, the Orthodox Jewish Community is a good example.  Neighborhoods may also choose to have a Volunteer corps. Park Slope has one.  All responders in these groups need to have  the proper training and be certified.

There are also ambulettes.  These don't respond to emergencies.  They're privately operated and are car services equipped to get people with mobility issues to and from medical appointments.  When a person needs a ride they call the service and ask for a pick-up. 

[rashea]

This is a complicated question, and it depends on where you live.

In many areas, there is an ambulance connected with the fire station. This tends to happen in areas with a large enough population to sustain the need for that service. The EMTs can be paid, or volunteer (just like the firefighters).

In more rural areas, a town might contract with a private service that provides for a small region. These are paid employees of a particular service. They are also used to transport patients between facilities.

[CLE_Girl]

I'll POD the "It depends were you live."

I live in a suburb of Cleveland.  Cleveland is a smallish major city. 

The City of Cleveland has firefighters and paremedics.  Both are part of the Fire Department and the ambulances will be housed at a fire house, but a firefighter doesn't need to know more then basic life saving techniques and a Paremedic doesn't need to know how to put our a fire. 

In the inner suburbs, were I live, the situation is the similar to the city except most (if not all) firefighers are also EMTs (emergency medical technicians).  EMT have more medical training then just a firefighter but not as much as a paremedic.  Some city's don't have any paremedics because it's too expensive or it's a small department. 

When you get out to the far suburbs and rural areas, some city's fire departments are mostly volunteers (2-4 paid firefighter EMT's, the rest community volunteers). 

This information comes from a friend that was in firefighter training but couldn't pass the EMT exam and didn't want to work in the city, thus he couldn't become a firefighter. 

[Thipu1]

I grew up in a small town.  The police officers were paid professionals.  The fire departments ( for some unknown reason, our tiny village had five) and the ambulance corps were staffed by volunteers.   

Every family had a small poster by the phone.  When the town siren went off, the  code of long and short blasts told everyone exactly where the emergency was.  Two longs and a short might mean that the problem was at New Main Street and Broadway. Two shorts and three longs might mean that Cosgriff Avenue was in trouble.  That was how small the town was. 

There were always a few people on duty at the fire houses to get the trucks and ambulance out.  Others would report directly to the spot and pick up their gear there. 

People were intensely proud of their Volunteer Fire Departments. Because no town in the county had a professional fire-fighting force,  the major events of the year were the Firemen's parades. The parades always featured a few horse-drawn pumpers from the 19th century.  The town with a new America-La France truck had bragging rights for the year. 

Ah, small-town America. 

   

[Judah]

In my county, all firefighters are EMTs and all EMTs are firefighters. The ambulance lives at the firehouse and is dispatched any time the station is called to an emergency. When the firetrucks roll, so does the ambulance, and vice versa.

In other areas I've lived, the ambulance service is owned by a private company that contracts to the local emergency services. They are directed by the 911 operator, but aren't housed with either the firefighters or police.

[Bottlecaps]

POD to "it depends on where you live." Back in my home state (West Virginia), in my very small home town, we had the county police, the city police, a volunteer fire department, and an emergency squad (ambulance service). Of course they were all in communication with each other and often all three or four would respond to an accident or a house fire, but if you had a medical emergency, only the emergency squad would show up. Another difference is that while you weren't charged (to my knowledge) for the services of the police and the fire department, as they were payed for with tax money, your insurance/Medicare/Medicaid/you if you had none of the above would be charged if you had to ride in the ambulance. The emergency squad was subsidized with tax money, but they still had to do a lot of fundraising and still had to charge people if they needed their services. (Of course, they would give you the ride and services you needed, and then bill you later - it's not like they made you pay before you could ride.)

I'm not sure how it works down here in Alabama, where I live now. Luckily I haven't yet needed the services of first responders here. This may be a good question to ask the boyfriend tonight, as he's native to Alabama and would most likely have better knowledge of this matter in our area.