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Disclaimer: all of this is personal opinion. Due to the cover-your-ass nature of today's society, professionally I have to say that if there's any doubt in your mind, call 911 immediately. That way, if you don't call and something bad happens, you can't blame me because I told you to call. Also, most of this applies to the units in my jurisdiction and may vary based on where you live. Most of this information applies only to the United States. However, IN MY PERSONAL OPINION:
One of the most common questions I'm asked is why fire trucks respond to calls for medics, and why ambulances respond to calls for fires. Simply put, most of us in the fire department are cross trained. A firefighter is also an EMT or Paramedic, and visa versa. They also usually carry some similar equipment. Our fire trucks carry a full compliment of EMS equipment, and our ambulances carry turnout gear (firefighting gear), some SCBA packs (air bottles, masks, etc), and some hand tools (fireman's axe, for example). If you're having a heart attack and 911 dispatch knows a fire truck is closer than the nearest available ambulance, the fire engine can arrive and provide care that much quicker (it's called being a "first responder"), and in many cases have the patient at least partially ready for transport by the time the ambulance arrives.
Terminology varies, but in general there is a difference between an EMT and a Paramedic. The National Registry of EMT's, (NREMT) recognizes approx 5 levels of care: FR, EMT-B, EMT-I/85, EMT-I/99, and EMT-P. First Responder is the basic life saving skills needed (CPR, spinal stabliziation, etc.) Training is approx 60 hours. Most police officers are trained to this level. Emergency Medical Technician - Basic is the minimum standard in most fire departments. It is usually between 120-160 hours of training, and includes basic drug administration through non-invasive means. Some are trained to give IVs, but no IV medications.
EMT-I/85 is the first level of ALS care available. It allows IVs and more drugs than and EMT-B, as well as more invasive skills. An EMT-I/99 is an even higher level, allowing more drugs and skills. An EMT-P is the highest level available, involving in some cases surgical skills.
EMT-B are usually referred to as EMT's, EMT-I's are usually referred to as "medics", and EMT-P's are usually referred to as "Paramedics". In some countries like Canada all responders are referred to as "paramedics", regardless of skill level.
Keep in mind that one of the most dangerous parts of our job is responding to calls. While a lot of drivers are responsible and get out of the way of emergency vehicles, some panic and do all sorts of crazy things (such as slamming on the brakes). When you call 911 screaming bloody murder "Oh my God! My baby! She's bleeding! There's blood everywhere! HELP!!!!!!", we respond differently than if someone calls and calmly says "I think my daughter hit her head... I think she's ok, there's a bit of bleeding that's pretty much stopped, but I'd like her checked out by the paramedics." Risk a little to save a little, risk a lot to save a lot, and risk nothing to save what is already gone. Dispatch in our area has a list they go down; this medical condition gets an ambulance, this condition gets an ambulance, engine, and supervisor, etc. Being calm and clearly stating what you need ensures you get what you need; not less or more.
As far as needing to call 911, when in doubt call us. Thats what we're here for. But think of this: if you call 911 for a papercut and your neighbor next door is having a heart attack and a farther away unit has to respond because we're busy giving you a bandaid, is that really in the best interests of the community? You'd be amazed the number of calls we get for people who could have safely gone by taxicab. I've run papercuts, nosebleeds, a runny nose, etc. To you (especially if you're a parent calling for a child) it might seem like an emergency at the time, but looking back was it really? To put it in perspective, think of it this way: if you knew we'd charge you (say, oh, $1000) for showing up, would you still call? Don't get me wrong, if you're having a heart attack or a stroke or think you might be having one please call, but if you're simply constipated and haven't pooped in two weeks, call a taxi cab (yes I've run that too).
I'll post more if there's interest. Thanks for reading, please rate/comment.
PS: Got a fire, got to run!
