Nontransporting EMS vehicle

In the Swedish medical system, a non-transporting vehicle (akutbil) can be equipped with a nurse specialized in anesthesia who is specialized in pain management, paired together with a paramedic. These vehicles can be staffed around the clock or during the busiest hours of the day and week in order to augment the capacity of the prehospital care provider and can respond both independently and in conjunction with one or more ambulances, air ambulance(s) and other emergency services. As a result of new (circa 2013) legislation requiring all ambulances to be equipped with at least one trained nurse, non-transporting vehicles have become less common.

In the United States, several fire departments and private ambulance services have fly-car programs. The Fire Department of the City of New York (FDNY) added EMS capabilities to many of their fire engines, effectively adding dozens of EMS units to their fleet without having to purchase or staff additional ambulances. In 2016, the FDNY launched a formal EMS fly-car program to reduce EMS response times; this practice was suspended in March 2020 due to the COVID-19 pandemic. The program received criticism from the FDNY EMS union, which argued that the fly-car program siphoned personnel and resources from the regular EMS ambulance service. The New York City branch of Hatzalah, a Jewish volunteer EMS program, operates a two-tiered dispatch model where EMTs and paramedics respond to a call in their fully equipped private vehicles acting as fly-cars, while an ambulance is brought for transport if necessary.