The Phoenix Valley is the only place I know of that sends Fire Trucks instead of Ambulances for medical calls. Phoenix Fire And Rural Metro (PMT/SW) are how it all started. Fire no longer has as many calls as they use to, so in order to maintain funding, they started taking over medical calls. In order to be like "The Big Dogs", (Phoenix Fire} the rest of the valley FD's followed. R/M EMS in order to keep contracts just followed along with it. After AMR bought everything and said "No, EMS should be lead", they started losing contracts to Maricopa Ambulance. Maricopa Ambulance is owned by the previous CFO of Old R/M, which left after the first bankruptcy filing. He left Arizona for five years after that. I'll let you all make that connection. This concept is called Fire Based EMS, which is very rare. Most systems are EMS based, being Fire supports EMS when needed. It's very hard to transport a patient on an Engine.