[GWN7]

The reason why most areas have a payed fire response instead of a volunteer department is simple, it all has to do with costs. Your home and business insurance is determined by the insurance underwriters association. They determine what the level of fire resonce is for your area and charge you a premimun accordingly. They also set out what the minumim type of equipment is that your department has to use or the insurance preminums goes up. They look at population density, home types, water supply, mutial aid and a whole bunch of other factors when determining what you pay.

It has been determined that a initial attack responce of 5 min or less is needed from the detection of a fire to when the first hose lines are brought into play or a resulting total loss can occur.

So if you live in a city where most homes are 5-10' apart and you have a fire in one of the homes without a payed fire service you could loose the whole city block of homes. (think Great Fire of Chicago)

If you live in a semi rual area with a volunteer fire department and you have a fire in your home most of the time your house will be a total loss and the volunteer department will be there to prevent the expansion of the fire so your fire dosen't cause your neibours homes to burn down.

So either you pay via taxes for a professional fire department or you write a cheque to your insurance provider.

Now on to paramedics:

All paramedics opperate under a doctors licence. The medical director of a paramedic program sets out the guidelines of what medical procedures can be done and how they are to be done and all paramedics that opperate under his licence have to follow those rules. The medical director sets standards for paramedics based on their medical association recomendations.

So if the Dr. says X, Y & Z have to be done before a transport arrives at a hospital then they better be done or their licence will be suspended because those are the rules they have to follow.

Now understanding these facts, if a patients complaint, their history and the basic vitals determine that certain procedures need to be done such as a 12 leed EKG or a starting a IV or even the simple task of taking a blood preassure they can't be done while bouncing down the road with lights and sirens on and that's why a ambulance may sit outside a home for 5 or 10 minutes after a patient is loaded.

Captain WFD, 28 yrs EMR