While all ambulances may look the same on the outside, there are two distinct types of units based on the equipment they carry and the personnel onboard. A BLS ambulance, normally simply referred to as an ambulance, is staffed by at least two Emergency Medical Technician’s (EMT) and carries a number of pieces of equipment designed to handle most emergencies. Ambulances are all equipped with a cot (or stretcher), stair chair, oxygen, backboards, extrication kits, splints, AED’s, and aid kits.
An ALS ambulance, or medic unit, is staffed by at least one EMT and one Paramedic, and is often staffed by two paramedics. Medic units are dispatched for more serious call types such as chest pain, trouble breathing, cardiac arrest, allergic reactions, and persons struck by vehicles. Medic units carry all the same equipment as an ambulance, and in addition carry a number of other items used for advanced care. These include cardiac monitors, drug and IV kits, CPAP devices, and IO drills.
Additionally, some fire engines and trucks are staffed with a paramedic and carry advanced life support equipment. They can be sent with an ambulance and upgrade it to a medic unit.
All 911 calls in Montgomery County are routed through the Emergency Communications Center where emergency call-takers gather the necessary information and then dispatch units to an emergency. The same is true in the District of Columbia, however when those residents call B-CCRS directly the information is passed from the B-CCRS dispatcher to a DC Fire Department dispatcher.
Dispatchers are trained to categorize emergency call types to ensure the proper response is sent. This varies depending on the complaint that is reported by the caller. Some calls automatically generate a number of units, such as vehicle collisions, while many only receive the response of a single ambulance.
In general, non-life threatening emergencies will have a single ambulance dispatched to the call. In some cases, if another unit is much closer it will be sent in addition. This is why you may see both a fire engine and an ambulance sent to a medical emergency call.
Life threatening emergencies such as chest pain, trouble breathing and allergic reactions receive an advanced life support response. This will almost always result in multiple units being sent to the scene. Normally, it will be a medic unit and a fire engine or truck, however in some cases multiple units may respond. The standard response will send the closest unit, whether it is an ambulance, medic unit, fire engine or truck, or even rescue squad, as well as the closest ambulance, and the closest paramedic (which may be on the ambulance or instead on a fire engine). Some very serious calls including cardiac arrest, an unconscious person, or a person choking require two paramedics respond. This may send even more units to the scene, sometimes including two, or on rare occasions, three fire engines.
There are several reasons why an ambulance may be sent from another station instead of B-CCRS. The Rescue squad normally has two ambulances and one medic unit staffed at our main station on Battery Lane, and an additional ambulance or medic unit at Station 26 on Democracy Blvd. If the B-CCRS unit is already on another call, a different ambulance may be sent. Additionally, normal dispatch procedure is to send the closest unit to a call, and many times another unit may be closer to an address than a B-CCRS unit. As a result, you may have an ambulance from the National Institutes of Health (NIH), Walter Reed National Military Medical Center (WRNNMC), or one of the surrounding stations including Glen Echo, Cabin John, Kensington, or Rockville.
For DC residents, B-CCRS will send an ambulance to any calls requested, however there are occasions where one is not available and instead a DC Fire Department ambulance may be sent instead. Additionally, for calls requiring Advanced Life Support, often both a B-CCRS ambulance and a DC Fire Department medic unit will respond to the call.
Rescue Squad ambulance and medic units attempt to take patients to the hospital of their choice whenever possible, however there are some occasions where that is not possible. There are a number of reasons that may be the case, however some of the most common are listed below.
- The hospital is closed to ambulances. Often time, hospital ER’s become overwhelmed with more patients than they can safely treat and they will request that ambulances transport a patient to a different emergency room that is less crowded
- The patient’s symptoms require them to be transported to the closest hospital. Depending on the nature of a patient’s symptoms, EMT’s and paramedics may elect the patient go to the closest ER to receive immediate care from hospital staff that cannot be done in the field.
- The hospital is not capable of handling certain types of injuries/illnesses. Not all hospitals are equipped to handle the same conditions. Very few hospitals are trauma centers, capable of handling serious injuries. Additionally, some hospitals are designated as cardiac care centers, stroke centers, and obstetric/neonatal centers.
Montgomery County residents must call 911 for any medical emergencies. The 911 dispatcher will dispatch the closest units. Residents are not able to request specific units be sent.
All of our services are provided free of charge. B-CCRS does not receive any direct tax support, nor do we charge for any services we provide.
Patients who are transported in Montgomery County will have their insurance billed by Montgomery County for the ambulance transport. Non-county residents may also be billed for a deductible. Residents of DC transported in DC will not receive any sort of bill. It is important to note that B-CCRS does not receive any money from this billing; it is collected by Montgomery County and does not support the Rescue Squad.
More information on the EMS Transport fee may be obtained at http://www.montgomerycountymd.gov/emts/
Common Features of EMS Units
- Ferno Ambulance Stretchers which can support up to 700 lbs
- Seating for four belted passengers in the ambulance box, in addition to a patient on the stretcher.
- Two car seats, to allow for transport of pediatric patients or children with their family members
- Onboard oxygen and suction systems
- The "stair chair", a modified wheel chair which allows EMS providers to easily take patients up or down stairs
- The Reeves Stretcher, which allows EMS providers to take patients unable to sit from their home out to the ambulance
- The Scoop Stretcher, which allows us to move patients with possible hip injuries