Whats the difference between private ambulances and fire dept. ambulance crews (aside from who handles their payroll)?
In my area, the firefighters are trained as first responders, but are not EMTs. They tend to be closer than the actual ambulance people, since there are firehouses more uniformly distributed throughout the city. Thus, if you call for an ambulance, the fire department will show up first and hopefully be able to stabilize you enough to keep you from dying immediately, followed shortly thereafter by the ambulance service, who can do more intensive lifesaving operations while transporting you to the hospital. The private ambulances here are only for non-emergency transport. Like if a person on a ventilator needs to be taken from the hospital to a nursing home or whatever. The semi-government ambulances also do that, but they’re more expensive. I also used to live in a city where the firefighters were also EMTs and thus had ambulances and acted as the sole ambulance service. Before that, I lived in a city with private ambulance service, where firefighters would only respond to fires or othe
Where I live there are a few fire department ambulances, a bunch of volunteer ambulance corps and two commercial ambulance services. On top of that most fire departments have EMTs and other trained staff who act as first responders. The rescue trucks most fire departments have are not intended to transport patients (and often too large to enter the emergency department’s facilities anyway). When you call 911 with a medical emergency, the dispatchers will send whatever ambulance is first on the list for where you live. For me, that means the local volunteer ambulance corps. If they don’t have a crew available or all their ambulances are out, the call will go to a neighboring ambulance corps or one of the commercial ambulances. If the call is severe enough and the fire department has the appropriate first responders, they will be also be sent. All of the emergency services can talk directly to the 911 center. Fire and EMS services, whether volunteer, paid or commercial, can talk directly
Some while back, I was told that (in that area, at least), fire stations were more prevalent, so some fire department was most likely to be the first unit on the scene. I’d assume that the ambulance would only come if necessary, for taking someone somewhere else, or for more complex medical equipment, but that’s all guessing.
You have three different questions, first, the question about who responds when you call 911: This varies by municipality and is basically an issue of who the municipality contracts with to provide emergency services. Typically, EMS services fall into three categories: (1) “fire based” i.e. the fire department also does EMS service; (2) “hospital based” where the ambulances live at the hospital or are administratively controlled by a hospital; (3) totally private services, the biggest of which is American Medical Response (AMR). The most common system in the US is fire-based EMS. Ambulances / medic units live at the firehouse, and (depending on staffing arrangements) the same people might jump on either a fire engine or an ambulance-type unit depending on the call. I’ve also worked in hospital-based EMS systems, and personally I rather like them (as a non-firefighter EMS provider) although they’re not practical for large swaths of the country that don’t have local hospitals, or a high
