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South Lake Tahoe Dispatch provides the first contact with the patient utilizing a Emergency Medical Dispatching System (EMD) to determine chief complaint, Location, units to respond and pre-arrival Instructions if needed. The fire department provides the first two tiers of emergency medical treatment through Paramedic staffed Advanced Life Support (ALS) Ambulances and Basic Life Support (BLS) Staffed Fire Engines. All non-Paramedic units are staffed with a minimum of Emergency Medical Technician (EMT) Basic Level personnel and defibrillation capability. The fire department is the exclusive provider of extrication and disentanglement for trapped victims. South Lake Tahoe Fire and Lake Valley Fire provide ambulance service through the Cal-Tahoe JPA as the next tier of the system. They provide advance drug therapy and some invasive procedures, as well as transport patients to the hospital. Medical Air Ambulance is provided by Cal-Star as a primary County Franchise and Care-Flight as back-up.
Together, the tiers provide a network for the patient regardless of who arrives on scene first. Often times the patient has the best chance of survival when all of the responders work together on the scene. Often times, patients require more than two personnel for care. This is particularly true when families or others are present creating another facet for the responders to deal with. In these and the more complex calls, a Company Officer is required to buffer the actions and develop and maintain command of the scene. The more complex incidents may require more manpower to deliver care with timeliness a critical aspect. Responding the first tier with the next as a baseline ensures this delivery of critical care. When the engine companies arrive first, care will be transferred immediately upon arrival of the upper tier (ambulance) from the EMTs to the Paramedics. On incidents where the Engine Companies are on scene first and the ambulance has an extended response time, the patient is stabilized by the EMTs and packaged to minimize the on scene time when the next tier (ambulance) arrives. This aspect is critical in some patients and a minimal scene time with rapid transport is critical for survival.