While all ambulances may look the same on the outside, there are actually two types of ambulances dispatched on calls in Montgomery County. A basic life support (BLS) ambulance, normally referred to simply as an “ambulance,” is staffed by at least two Emergency Medical Technicians (EMTs) and carries a number of pieces of equipment designed to handle most emergencies. Ambulances are all equipped with a stretcher, stair chair, oxygen, backboards, extrication kits, splints, automated external defibrillator (AED), and other medical equipment for handling both lifesaving emergencies and less critical injuries and illnesses.
An advanced life support (ALS) ambulance, often called a “medic unit,” is similar to a BLS unit but is always staffed with at least one paramedic, in addition to EMTs. Medic units are dispatched for more serious call types such as chest pain, trouble breathing, cardiac arrest, allergic reactions, and persons struck by vehicles. In addition to the equipment carried on a BLS ambulance, medic units carry other medications and diagnostic tools for paramedics to use in the assessment and treatment of people with these and other conditions.
Additionally, some fire engines and trucks are staffed with one or more paramedics and carry advanced life support equipment. These units can be sent to calls where a paramedic is needed but no medic unit is on the scene; firefighter-paramedics can use their equipment to treat and then transport patients on a BLS ambulance.
All 911 calls in Montgomery County are routed through the county’s Emergency Communications Center where emergency call-takers use standard questions and protocols to 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 BCCRS directly the information is passed from the BCCRS dispatcher to a DC emergency telecommunications specialist.
Dispatchers are trained to categorize emergency call types to ensure the proper response is sent depending on what the caller describes. Some calls automatically generate a response involving several units, such as a vehicle collision on a highway, while many only receive the response of a single ambulance. For more serious medical emergencies, the dispatcher will ensure that the closest EMTs respond to the scene, as well as the closest paramedics and BLS or ALS ambulance—that is why sometimes a fire engine or the heavy rescue squad and an ambulance all respond to one medical call. 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, trucks or squads.
There are several reasons why an ambulance may be sent from another station instead of BCCRS. 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 Boulevard near Montgomery Mall. If BCCRS units are already on another call, a different ambulance may be sent in order to ensure prompt response.
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.
In DC, BCCRS will always send an ambulance to calls for assistance in our service area if one is available. However, there are occasions where all BCCRS ambulances are busy treating and transporting other people and instead a DC Fire and EMS Department ambulance may be sent. Additionally, DC Fire and EMS will often respond with BCCRS ambulances to provide additional support, including advanced life support providers. This may come in the form of a fire engine or ladder truck, an ambulance, or both. BCCRS personnel work closely with the DC Fire and EMS personnel to ensure the most appropriate medical care is provided on scene and en route to a local hospital.
BCCS ambulance and medic units attempt to take patients to the hospital of their choice whenever possible; however, there are some occasions where the situation requires transport to an alternate facility in order to best meet the needs of the patient. Some of those situations include:
Montgomery County residents must call 911 for any medical emergencies. The 911 emergency dispatcher will dispatch the closest appropriate units. Residents are not able to request response from BCCRS or any of the stations in the county.
BCCRS does not bill for any services.
In 2013, the Montgomery County Council enacted a law allowing Montgomery County Fire & Rescue Service to seek reimbursement for ambulance transports from private health insurance companies, Medicare, or Medicaid. The law applies to all ambulance transports in Montgomery County, including those performed by BCCRS, using our ambulances and volunteers. Thus, a transport by a BCCRS ambulance in Maryland will result in a fee being charged to the patient’s insurance company. No Montgomery County resident should be personally charged. A portion of the ambulance transport fees collected by Montgomery County have been allocated to a grant program administered by the Montgomery County Volunteer Fire Rescue Association (MCVFRA), of which BCCRS is a member. Under that program, member departments of MCVFRA are entitled to apply for grants for: fire, rescue and EMS heavy apparatus purchases; facility infrastructure improvements and replacement; training for volunteers; administrative staff support; volunteer recruitment and retention; Personal Protective Equipment (PPE); fire, rescue and EMS equipment; volunteer stand-by support; and command, support and canteen vehicles.
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Any time BCCRS EMTs or paramedics assess, treat or transport a patient, they complete a patient care report using the county’s electronic EMS records system. In addition, all fire and rescue responses, including those for fires and other non-medical emergencies, require reports to be completed in the county’s fire records management system.
In order to protect your privacy, access to those records must be requested through Montgomery County Fire & Rescue. For more information, visit them here.
A fire engine is a heavy vehicle equipped with specialized systems supporting fire suppression efforts. Examples of these systems include water tanks, pumps, and hoselines. A “truck” is the term used in the fire service for a vehicle with an aerial ladder or platform capable of performing rescues or applying water to a fire several stories in the air.
A heavy rescue truck, or what is often simply called a “rescue squad” is a specialty unit equipped with high power electric generators, winch systems and hydraulic rescue tools. The unit also has basic firefighting hand tools, such as axes and fire extinguishers, and is staffed by fully qualified firefighters capable of performing any firefighting or medical duties required on scene.
BCCRS and the other local volunteer organizations are fully integrated with the county’s fire and rescue department as one seamless system. BCCRS personnel are trained to the same medical, firefighting and rescue standards as other paramedics, EMTs and firefighters-EMTs certified to serve in Montgomery County. When 911 operators in Montgomery County receive a call for help, a central computerized dispatch system helps the dispatcher select the closest resources needed to respond to and mitigate the emergency.
At an emergency incident, BCCRS units and units from other departments operate in the same command structure, meaning chiefs from BCCRS sometimes supervise personnel from other departments on the scene, and vice versa. BCCRS members follow the same state and county medical protocols and standard operating procedures that apply to all firefighters and EMS providers serving in Montgomery County.
Maryland law requires patient transport be performed by approved basic life support (BLS) or advanced life support (ALS) transport units equipped with safely mounted cots. Fire trucks have transported patients in extreme circumstances, such as during a blizzard when no other units were available and roads were blocked; however, the safest and most effective way to transport medical patients is in an ambulance designed for that service.
Typically, BCCRS staffs the rescue squad with three to six firefighters.
Being a volunteer at the rescue squad requires extensive training. At a minimum, members must become state-certified emergency medical technicians and pass a rigorous department training process. Members who go on to become emergency drivers, firefighter or paramedics receive several hundred hours of additional education and training. For more information, visit our recruitment section.
Do not turn any electric light or appliance on. Immediately leave the house and, once you are out of the house, call 911 to report the problem.
Carbon monoxide alarms are very important early warning systems that save lives. However, these systems have expiration dates and can malfunction. Systems operated on battery power may fail when battery power becomes low. Replace the units when they become obsolete and replace batteries when you replace the smoke detector batteries (at least twice each year). However, carbon monoxide poisoning can be extremely dangerous, even fatal, so do not assume the alarm is malfunctioning. If the alarm goes off for an unknown reason, leave the house, call 911 and report the problem. Be sure to inform the 911 center if someone is feeling ill with headaches or not behaving with normal mental alertness. The closest firefighters will be sent to investigate. All fire apparatus, including the rescue squad, carry specialized meters to test for gases and carbon monoxide. The crew will use this meter to carefully check for a problem. If a problem is found, the crew will ensure the problem is corrected safely.
The majority of incidents that urban fire departments respond are medical emergencies or fire/rescue incidents that also have a medical component. All BCCRS firefighters, as well as all personnel in the Montgomery County Fire and Rescue Service, must complete and maintain Emergency Medical Technician (or higher) status during their affiliation with the fire and rescue system. All types of apparatus respond to medical incidents, however, the role they after arriving differs and is often minimal for fire/rescue vehicles. On pure medical calls, fire/rescue units are normally limited to initial assessment and assisting EMS crews with patient care on serious emergencies. Firefighter/paramedics may also supplement an ambulance’s staff during transport of a critical patient. On the other hand, ambulances start and carry-on patient care until transferring at patient at the hospital. Firefighter personnel spend a majority of the training hours on fire and rescue topics.