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Hello, From my point of view it seems like an awkward system to have the FD arrive start treatment and they had over transport to a 3rd party such as AMR. How dose this work? Dose the FD medic go with the AMR crew all the time, sometimes or never? I think a call could get congested. There could be a log jam of fire trucks and ambulances at each call. What dose the FD respond in? An ambulance? A Fire Truck? Chase Car? How many people? A full crew of four fire fighters? Also, the AMR crew may not agree with the treatment rendered. But, despite this you have to haul them to the ED. Or, catch flack if things went poorly. Lastly, I think, it would be sweet deal for the FD. Respond. Treat. Leave. While (for most calls I assume) the AMR crew drives to the ED, dealing with triage and possible sits and waits for a bed. IMHO. Cheers