| An ambulance is a vehicle designated for
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| | airport and college public safety
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| transporting people to or from a place of
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| | offices. Some smaller towns and cities
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| treatment for an illness or injury. An
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| | may also have them. Generally all
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| ambulance may travel from the site of an
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| | personnel are cross-trained as EMT's
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| accident or injury to a hospital, from a
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| | Firefighter/peace officer.
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| hospital to a patient's home, or between
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| | 6. Hospital Based - Ambulance service
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| two points of treatment (such as between
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| | such as ALS, BLS and CCT are offered by
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| a doctor's surgery and a hospital with
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| | profit and non profit hospitals as a
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| specialist facilities).
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| | service to the community. Often these
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| The term ambulance is most commonly
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| | services do not support themselves and
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| associated with the emergency vehicles
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| | are funded by the hospital.
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| seen throughout the world administering
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| | Service Level
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| emergency care to those with acute
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| | The lines between one level of care and
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| illnesses or injuries, hereafter known as
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| | the next are becoming increasingly
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| emergency ambulances. These are usually
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| | blurred. Skills that were once reserved
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| fitted with flashing warning lights and
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| | for physicians are now routinely done by
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| sirens in order to facilitiate their
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| | paramedics, and skills once reserved for
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| movement through heavy traffic. It is
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| | paramedics, such as defibrillation, are
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| these emergency ambulances that are most
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| | now routinely done by Basic Emergency
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| likely to display the Star of Life, shown
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| | medical technicians (EMTs). There is also
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| on the right, which represents the six
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| | wide country-to-country, state-to-state
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| stages of prehospital medical care.
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| | (or province-to-province), and even
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| There are also several other types of
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| | county-to-county variation of what types
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| ambulance used throughout the world.
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| | of care providers at different levels are
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| Probably the most common is the patient
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| | allowed to provide. That said:
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| transport ambulance. These vehicles are
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| | Certified first responder (CFR, or
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| not usually (although there are
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| | sometimes just FR) - usually consist of
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| exceptions) equipped with a high level of
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| | personnel in a rural setting in which
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| equipment, and are usually crewed by
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| | ambulance transport is delayed due to
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| staff with a lower qualification than
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| | distance. In these cases, many of whom
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| those working on emergency ambulances.
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| | are volunteers, render very basic first
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| Their purpose is simply to collect
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| | aid to include oxygen administration to
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| patients from, or drop them off at, their
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| | patients until a more definitive
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| place of medical treatment. In most
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| | transport unit arrives.
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| countries, these are not equipped with
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| | Basic Life Support (BLS) - usually
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| flashing lights or sirens.
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| | consists of two EMT-Basics. Provides
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| Throughout the world, the look of
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| | oxygen therapy, Splint (medicine),
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| emergency and patient transport
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| | bleeding control, defibrillation with an
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| ambulances varies, although trucks, vans
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| | AED, and light extrication (eg: removing
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| and station wagons are most commonly
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| | a victim from a car, but not using the
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| used. Other vehicles used as ambulances
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| | jaws of life.)
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| include busses, helicopters, or even
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| | Intermediate Life Support (ILS) - usually
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| hospital ships.
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| | consists of an EMT-Basic and an
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| Ambulances in the United States are
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| | EMT-Intermediate. EMT-Intermediates
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| defined by KKK-1822E requirements which
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| | provide BLS care with the addition of IV
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| defines several categories of ambulances,
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| | therapy, and often intubation.
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| althought most states have additional
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| | Advanced Life Support (ALS) - usually
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| requirements that are added to meet their
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| | consists of an EMT-Basic or
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| individual meeds. In Canada, each
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| | EMT-Intermediate and an EMT-paramedic.
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| Province and the Canadian Military has
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| | EMT-paramedics provide BLS care and ILS
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| its own Ambulance Specifications.
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| | care with the addition of manual
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| Type I Ambulances are based on the
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| | defibrillation and advanced electrical
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| chassis-cabs of light duty pickup-trucks,
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| | therapy including transcutaneous pacing
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|
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| | (fitting a temporary pacemaker to the
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| Type II Ambulances are based on modern
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| | patient's chest) and synchronized
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| passenger/cargo vans, also referred to as
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| | cardioversion (an advanced form of
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| Vanbulances,
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| | defibrillation), intubation, medication
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| Type III Ambulances are based on
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| | administration, pleural (chest)
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| chassis-cabs of light duty vans,
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| | decompression, and more.
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| Extreme Duty versions of both Type I and
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| | Mobile Intensive Care Unit (MICU) - Some
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| Type III are also now authorized based on
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| | services divide ALS, as described above,
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| the chassis-cabs of medium duty truck
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| | into units staffed by Intermediates,
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| chassis.
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| | which they call "ALS units" and units
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| Note that Type I's and Type III's are
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| | staffed by paramedics, frequently called
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| often called boxes by their crews with
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| | "MICUs" or "paramedic units." These
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| Type II's being called vanbulances (or
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| | usually consist of either an EMT and a
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| jokingly Trauma Twinkies); ambulances are
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| | paramedic or multiple paramedics, and
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| also referred to as buses (common
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| | provide the full range of advanced
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| nomenclature in the New York City area,
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| | services to include IV therapy, Cardiac
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| which some EMTs and paramedics from other
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| | monitoring and drugs, pain killers. etc.
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| areas consider to be derogatory), mods or
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| | In some locations, physicians may ride
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| modulars (if type I or III), rigs etc.
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| | MICUs for special calls or as a matter of
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| Type III ambulances with single-wheel
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| | course.
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| rear axles are sometimes referred to as
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| | Critical Care Units - consist of a
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| mini-mods, since the "full-size" mods
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| | combination of EMTs/Paramedics/Nurses
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| have dual-wheel rear axles.
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| | Physicians depending on the need and
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| There are also fly-cars (which go by
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| | service. They may provide special
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| several names; see the fly-car page for
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| | transports for premature babies, cardiac
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| details), which are large cars or SUVs.
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| | transfers, etc, although in some
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| These units cannot provide patient
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| | services, these are standard ALS units.
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| transport, but are used variously by
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| | Need for Flexibility
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| supervisors or as a source of additional
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| | There is a continuous flux in terms of
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| personnel. In some communities the
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| | types of services due to constant efforts
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| paramedics respond to emergency calls in
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| | to improve efficiency and effectiveness.
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| their fly-car, while a BLS ambulance
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| | Indeed, many fire departments are
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| responds as well to transport the
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| | fire-oriented only in name and are
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| patient.
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| | becoming all-purpose emergency services
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| Many companies who specialize in
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| | organizations.
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| non-emergency patient transfers are
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| | Ambulances in the United States are often
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| creating their own vehicles, which are
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| | staffed by at least two crewmembers. Many
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| similar to ambulances and carry ambulance
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| | areas require that at least one crew
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| type equipment, but lack emergency lights
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| | member be a certified or licensed EMT,
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| and sirens.
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| | enabling this person to continue to
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| Ambulance Providers
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| | provide medical care while the other
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| Ambulance service providers come in
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| | crewmember drives the ambulance to
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| several types in the USA:
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| | transport the patient to the hospital.
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| 1. Volunteer Ambulance Corps (VAC) or
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| | Ambulance crews called to an emergency
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| services - function similar to Volunteer
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| | will identify and treat anyone needing
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| Fire Companies. VACs may be community
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| | medical assistance, calling for
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| owned or privately owned, but are
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| | additional assistance in the field (e.g.
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| typically organised as non-profit
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| | additional ambulances, paramedic
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| organizations. VACs may also be part of
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| | assistance, police or fire department
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| Volunteer Fire Companies; in some of
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| | intervention) as needed.
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| these cases, EMTs and drivers are also
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| | Large American cities like New York and
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| firefighters.
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| | Los Angeles tend to have many distinct
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| 2. Private Ambulance Service - Normal
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| | ambulance services representing all of
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| commercial companies with paid employees,
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| | the types mentioned above, so pedestrians
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| but often still have ties to
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| | and drivers must be alert for ambulances
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| municipalities. The two largest private
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| | of many shapes, sizes, and colors. Most
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| companies in the United States are AMR
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| | ambulances certified for emergency
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| (American Medical Response) and Rural
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| | response in the U.S. are marked with the
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| Metro. While many private companies
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| | Star of Life for ready identification by
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| provide inter-facility patient transfer,
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| | the public.
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| many communities' emergency medical needs
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| | American ambulances usually are fitted
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| are served by private services.
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| | with red (and sometimes white, amber and
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| 3. Municipal Third Service - Operate as a
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| | or blue, depending on local law) flashing
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| third service alongside fire and police
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| | lights and a siren that continuously
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| departments. These are more likely to be
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| | rises and falls, as opposed to the two or
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| found in areas with a high population
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| | three-tone sirens heard in other
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| density, such as a city or metropolitan
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| | countries. Air-horns, such as those found
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| area. Municipal third services may be
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| | on a fire engine, are also becoming more
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| operated directly by the municipality, or
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| | prevalent. When an ambulance turns on its
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| by private companies such as AMR or Rural
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| | lights and siren, all other drivers are
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| Metro).
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| | required by law to yield the right of
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| 4. Municipal - Usually fire department
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| | way. In some states, like California,
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| owned and operated, though some systems
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| | there is an affirmative requirement that
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| are police department owned and operated.
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| | all vehicles and pedestrians must also
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| 5. Combined - these are full service
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| | move to the side of the road as much as
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| emergency service agencies such as
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| | possible and stop.
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