“Seriously, I just have a little asthma flare up and you send the ambulance and fire truck.” “Do you really need all those people just for a fender-bender?” “I’m so embarrassed did you have to send everybody?” Or, my personal favorite, “I’m having pain in my chest, what are Firefighters gonna do?” These are but a few of the questions asked on a daily basis to Paramedics everywhere. I have a few answers to those questions and a bit of information that will clarify the rhyme and reason for our decisions. Let’s start at the beginning. When a citizen of the Creve Coeur Fire Protection District calls 911, the call is routed to Central County Emergency 911 Dispatch. This is the emergency dispatching agency for a bulk of the West St. Louis County area. The operators answering the phones are trained Emergency Medical Dispatchers as well as some being certified EMT’s and Paramedics. This means that they are qualified and experienced in being the first person to categorize your emergency, make the decision on what and how much equipment and personnel to send your way, and also begin any pre-arrival instructions to help your situation until emergency services arrive. The type and amount of equipment is based on the known severity or probable severity of the particular event. “So what dictates whether I’ll get just an ambulance or whether I’ll get an ambulance, fire truck, police, National Guard, and Batman as well?” It’s what you told us when you called. There are categories that may be absolute life threats. These would include but are not limited to cardiac arrest, chest pain, difficulty breathing, any loss of consciousness, choking, seizures, and overdoses. These are the calls where the person in need of help may have a different perspective on the situation than the emergency services professional. Difficulty breathing may be a mild asthma attack or someone ready to stop breathing. Choking may be someone who has cleared a piece of food that they were choking on when you called, or it could be someone who now has full airway obstruction and can no longer breath. Chest pain may be indigestion, or it may be the onset of a heart attack. The bottom line is that we don’t know on which end of the spectrum the emergency sits, and for that reason, we will error on the side of caution and supply ample manpower in the best interest of our citizens. Other emergencies that may or may not be life threatening, but could require more manpower than just two paramedics include pregnancy with impending delivery, and motor vehicle collisions. “Well I need an ambulance, why did only a fire truck show up?” That’s a good question and I have a good answer. If the fire truck, which is staffed with the same trained Paramedics as an ambulance, is closer than that ambulance, then it will arrive first to render the same care while awaiting arrival of the transporting ambulance. How’s that for continuity of care? The Creve Coeur Fire Protection District employs professionals cross-trained in fire- fighting and rescue, as well as in emergency medicine to provide citizens the best possible service in their time of need. Which apparatus the Paramedic/Firefighter will be assigned to on a particular day depends primarily on staffing levels, but rest assured knowing that the men and women arriving on the fire truck, were probably on the ambulance a few days ago. This keeps our personnel proficient in all phases of the profession. So when you hear someone say, “I didn’t need that fire truck”, always remember the reasoning. Time is of the essence in many emergencies and early treatment with sufficient qualified professionals may make the difference between life and death. Don’t forget our thinking when it comes to the amount of people and apparatus we send to your emergency. It’s better to have more and not need them, than it is to need more and not have them.