National Run Survey: Busiest Hazmat, Ambulance Units of 2006

Kansas City, Mo. Hazmat 71 reported 1,938 runs in 2006.

When someone dials 9-1-1, an emergency communications dispatcher gives the caller pre-arrival instructions, while another person alerts the proper crew.

"Our dispatchers are trained to give medical instructions to the person so they can assist the patient until the ambulance arrives," said Ernest Hargett, deputy commissioner of operations.

Many without insurance and those living below the poverty level, call 9-1-1 for a myriad of issues.

"We are often their entry way into the health care system," Hargett said.

Fire department personnel staff 36 ALS and nine BLS ambulances. In addition, engines and ladders are manned by firefighter/EMTs.

Depending on the nature of the call and the location of the closest EMS unit, engines and ladder crews are often dispatched to provide care. "It's often important to get help to a person immediately."

During Eagles and Phillies games, the city has a certain number of dedicated units. However, the stadium or venues also are required to hire non-municipal providers to assist.

"There is just no way we can handle those events as well as the regular calls."

As in most jurisdictions, the insurance company of the patient is billed if the person is transported. But, Hargett said no one is ever denied service.

"We don't turn anyone down. We're here to help. It doesn't matter."

Philadelphia has a number of trauma centers which contract with various helicopter services. Should a patient need the services of a specialty center, medics can call for aviation.

Hargett said he doesn't foresee the number of EMS calls going down anytime soon, especially with the number of people who depend on emergency rooms for their everyday health care needs.