Emergency medical services are delivered in a layered or tiered response. The first units to respond are fire engines, ladder trucks, or aid units staffed with firefighter/EMT's from the fire stations.
Depending on the nature of the emergency, the paramedics (Bellevue Fire Department Medic One Unit staffed with firefighter/paramedics) are either requested by the fire apparatus/aid unit, or are dispatched at the same time. Medic Units, with paramedics, perform Advanced Life Support (ALS), in addition to Basic Life Support (BLS) emergency medicine that the firefighters provide. ALS includes physician level procedures such as endotrachial intubation, intravenous fluid and drug therapy, cardiac defibrillation and advanced emergency trauma treatment.
The Bellevue Fire Department facilitates all transportation for the sick and injured to local hospitals on the "Eastside". On some occasions, we utilize private ambulances (American Medical Response - AMR, and Rural Metro) for transporting patients to facilities outside of the City. These are not fire department resources, but private companies. If a BLS patient requests to be transported to a hospital facility outside of the local area, a Seattle hospital for example, then utilizing private ambulances allows for fire department resources to be available for other fire/medical emergencies.