> I've never understood why the fire department doesn't acquire and dispatch small vehicles for all those medical calls instead of a giant fire truck. Staffing

> I've never understood why the fire department doesn't acquire and dispatch small vehicles for all those medical calls instead of a giant fire truck. Staffing. Almost every call requires more than two people and ambulances are typically only staffed with two people. If there is a second call (fire, rescue, or anything that requires the larger apparatus) while the fire engine is out assisting the EMS crew and the crew has taken a smaller vehicle, they have to drive back to the station, get on the engine, and then respond to the second call. This is not uncommon-- for my department I'd say it's routine. In smaller volunteer departments like mine, there aren't enough people to go around. In larger paid career departments, the cost of the extra personnel needed to staff smaller vehicles very quickly exceeds the cost of the wear and tear on the larger apparatus. You have to account for more than just their salaries, but also insurance, training costs, any equipment issued, and retirement contributions. There's also the matter of equipment. Larger apparatus carry tools and equipment that smaller vehicles can't or don't. Many jurisdictions do have a mix of resources where EMS crews can get the additional resources they need on a call without an engine or truck responding, and it does work for the most part. Most jurisdictions can't afford that. It seems common in Europe to not send fire apparatus, but I'm willing to bet they deal with many fewer bariatric patients so most calls don't need six guys.