Currently, in The 1st Battalion, there are six fire engines staffed 24 hours a day 7 days a week with four firefighters one of whom is a paramedic. These fire engines are housed at Downtown Silver Spring (1), Hillandale (12), Burtonsville (15), Four Corners (16), Montgomery Hills (19), and Colesville (24). Officially, they are named ALS First Response Apparatus (AFRA). On the radio, they are called Paramedic Engines.
As seen in this picture, the fire engines are equipped with a full complement of Advanced Life Support (ALS) equipment. This includes a cardiac monitor with 12-Lead capability with the ability to transmit said ECGs to the receiving hospitals. Also carried is a complete set of emergency medications and equipment with which to start IVs and place advanced airways in patients. For patients with trouble breathing, all of the paramedic engines carry a Continuous Positive Airway Pressure (CPAP) device. The AFRA carries everything a medic unit carries and complies with the minimum requirements for ALS units in the State of Maryland.
These four person paramedic engines serve multiple purposes. They can respond as the first paramedics to arrive on the scene while awaiting a medic unit, thus providing emergency medical aid minutes sooner (every second does count), or they can respond to satisfy the assembly of one or two paramedics and a transport unit on the scene of a medical emergency. If the paramedic is required to upgrade the ambulance, and help render aid to the patient enroute to the hospital, the fire engine will remain in service with a staffing of three firefighters.
The four person staffing is also instrumental in significantly reducing the amount of time to place an attack line (fire hose) operational to start to extinguish a fire sooner. This was proven in a National Instituteof Standards and Technology (NIST) study and in the recent battalion drills.