Emergency Medical Services

Nowadays, one of the primary responsibilities of most fire departments in the United States is providing Emergency Medical Services to those in need.

Fire departments have been responding to accidents and medical emergencies for decades. Yet, some readers may be surprised to learn just how prominent this has become as part of modern fire services.

In fact, for many fire departments, the majority of their calls are for medical emergencies. In other words, many firefighters are providing more first responder medical service than firefighting service.


Emergency medical services (EMS) — also known as ambulance services or paramedic services — are emergency first responders that provide urgent pre-hospital treatment and stabilization for serious illness and injuries as well as transportation to definitive care.

Most communities (but not all) have both Fire Departments and EMS ambulances. These services work hand-in-hand to provide first-responder aid, including emergency medical care.

Yet, in many fire departments, Emergency Medical Technician (EMT) certifications are required for firefighters and some are also trained as paramedics, which means they have even higher medical response training.

In other words, in many communities, firefighters are cross-trained as EMTs and paramedics, which means they may have similar training to EMS specialists in the ambulance services.

So, to be real clear, in many cases, firefighters are also EMS. But in the majority of fire departments, they respond to medical emergencies in a fire truck(s). In which case, an ambulance would still be required for someone who needs to go to the hospital. (There are some fire departments that also have ambulances, but that is not common).

When a heart stops, or a serious injury occurs, every second is critical. Given the network of strategically located fire stations in many communities, the same fast response times that exist for fires can also benefit medical emergencies. This means that a fire unit can frequently get to an emergency first.

In brief, firefighters are called to medical emergencies because they may not only be trained as EMTs and paramedics but there are usually more fire engines in a given area than ambulances. This allows firefighters to respond first and stabilize the situation before the ambulance crews come to transport the patient.


More than 75% of calls that fire departments receive in the modern era are concerned with non-fire emergencies — and more often than not, these are medical emergencies.

However, firefighters have a broader skill set than EMS specialists. For example, ambulance crews aren’t particularly experienced with kicking down doors and getting into buildings. Firefighters, on the other hand, do this all the time.

The same is true at the scene of car accidents. Firefighters are trained and equipped to free victims trapped in cars and other situations. You may have heard some of these special tools referred to as the “Jaws of Life”. They can also help ensure that an accident scene doesn’t turn into a bigger crisis by helping to prevent vehicles from catching fire, as well as securing spills and leaks of chemicals and fuel, etc., which are things that ambulance paramedics don’t have the experience or training to offer.

One of the primary reasons fire departments are so valuable in terms of medical emergencies is that there are many more fire stations around the nation than ambulance stations. Fire departments, which depend on taxes, are required to be spread out with enough resources to handle a large fire when one breaks out. In addition to this, there are more fire engines than there are ambulances for much the same reasons. Each fire station requires a crew and the equipment to do the job and if they aren’t fighting a fire, they can provide EMS.

This means that in many places, the fire department is simply capable of reaching the scene of a medical emergency in a more timely fashion than an ambulance team can. This, of course, means that a firefighting crew may be better positioned to save lives.


Why haven’t firefighters simply replaced EMTs in ambulances? Since firefighters can often get to the scene faster and they also have medical training, why not just let fire departments replace ambulance services?

Well, one basic reason is that many fire departments don’t have ambulances. And fire trucks are not built for transporting patients to hospitals.

In other words, fire departments and ambulance services often work best when employed together in harmony.

That’s not to say things won’t change in the future. There are some fire departments that have ambulances, and maybe more will follow. In spite of the ongoing need to reduce costs in many communities, so far, having as many first responders as possible has been considered desirable for the well-being of many communities.


If firefighters are spending the majority of their time responding to medical emergencies and non-fire activities, what does that mean for their basic job of putting out fires?

Well, the fact is that the number of fires in the United States has fallen over the last few decades. In fact, there may be about 75% fewer fires than when compared to the 1980s. That means that while fire departments are still essential and that their first priority is, of course, to put out fires, there is quite a bit of time when there aren’t any fires.


No one knows how many fires will take place at the same time. Even though a firefighter may be trained to do a paramedic’s work, the same is not usually true in reverse. In other words, you can’t send an ambulance crew to extinguish a fire – they don’t have the right equipment and gear to even consider it. But you can send a fire truck and EMT-trained or paramedic-trained firefighters to a medical emergency.

Furthermore, across the United States, there are more fire departments, fire trucks and firefighters than there are ambulance resources. For that reason, firefighters are often the first to arrive at a medical emergency.

Firefighter Priority: Fight Fires or Provide Medical Response?
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