"The full life cycle of an EMS call begins at 0800 hours at each Monroe Fire Department fire station."

At this time, which coincides with the 8am beginning of shift, each person assigned to an apparatus reports to the truck and evaluates the readiness of the unit to which he or she is assigned. In addition to checking the fuel level, lights, and siren, they evaluate the equipment, specifically the EMS equipment, which includes the EMS bag (the "Thomas Pack™"), an oxygen bottle for delivery to patients, an AED or in some cases a combination AED and EKG unit, and a "drug bag" which contains drugs for delivery to patients in cardiac and respiratory compromise. Each bag is examined for completeness and readiness. This is the first phase of EMS response.

When a citizen recognizes the need for EMS, he or she should call 911. At the 911 center, the call is promptly answered and a few qualifying questions are asked of the caller regarding the nature of the emergency. Then, the call is transferred to the contracted private ambulance provider's dispatch center, where the more specific questions are asked regarding the symptoms, signs, and complaint the patient may have, or a description of the incident. Usually, the closest or only available ambulance is "pre-alerted" to the incident. Then, after gathering more information about the severity of the medical emergency and determining if the call falls within the city limits, the Monroe Fire Department dispatch is alerted by the private ambulance service by way of radio pager. At this point, the Monroe Fire dispatcher receives the call from the ambulance service, determines the closest fire apparatus, and depending on the nature of the call, selects additional units to send to the incident. The fire units are dispatched, including the local neighborhood Engine Company, and they begin their response.

Upon arrival at the incident address, the first fire unit assesses the incident, whether it is a medical-oriented incident related to a sick person, or a victim of trauma such as a fall or a motor vehicle accident. If care is needed, it is immediately offered at the appropriate level needed and according to the level-of-care of the responders. Vital signs are gathered, the patient is administered oxygen, or other interventions needed to evaluate and stabilize the patient. During this process, the ambulance service arrives, and a report is given to the paramedic on the ambulance regarding any findings by the fire personnel, and care of the patient is formally transferred to the ambulance personnel.

The Monroe Fire personnel continue to provide patient care and manpower in loading the patient onto the stretcher and into the ambulance, to help insure the comfort and safety of the patient and the proper care of the patient by the ambulance responders.

After the patient is loaded into the ambulance, the incident is not complete for the Monroe Fire responders. Any supplies used in care of the patient will be replenished, and any equipment used will be cleaned.

After returning to the station, the Company Officer insures the entire incident is documented both on paper and in the computerized EMS reporting system, including times related to the incident, what was seen and found, quantity and conditions of each patient, any treatment given, and how patient care was terminated, whether by transfer to an ambulance paramedic or another provider.