We often get asked this very question.  First we need to mention that when a call for a medical emergency is received by our fire alarm operators they make the determination based on the information they receive as to whether or not the fire engine and its crew are needed in addition to the ambulance.  When any call is received for an unknown medical emergency, motor vehicle accident or any call requiring advanced life support the fire engine is dispatched along with the ambulance.  When we send the fire engine it allows us to provide the needed personnel to handle the emergency medical call.  By sending the fire engine in addition to the ambulance we achieve the most cost-efficient method of delivering multiple fire, rescue, and emergency medical services.  If the department were to use a smaller vehicle instead of a fire engine we would have to adequately staff these vehicles. In order to do that we would have to take people off the fire trucks or hire additional people for each of our four shifts to staff those vehicles.  Should there be a call for a fire or other emergency the fire engine and its crew can respond directly to that incident without having to return to the station and get the fire truck.  Additionally there are many times when the ambulances are committed to other incidents.  In these cases the closest fire engine will be sent as a first response unit.  Our fire engines are supplied with medical equipment that allows the firefighters to begin appropriate care while they wait for an ambulance.