Many of the patients treated by fire service EMTs and paramedics also represent the segments of the population at greatest risk of injury or death from fire. Just a couple of decades ago, many people questioned the fire service's role in emergency medical services (EMS). Today, the value of providing advanced prehospital care to improve the survival of victims of traumatic injury and acute health crises, such as cardiac ailments and respiratory distress, is almost universally accepted and acknowledged. As the stature of fire service EMS has risen and its role has become more secure, an awkward paradox has emerged: Many fire service agencies, burdened with burgeoning demand for their s...

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