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First-In is a call where a patient or patient's family calls dispatch directly for a transport, usually BLS however some turn into ALS calls where the EMT crew will call for fire to respond.
This is not correct. First in means your are the first ambulance service to respond.
Example : Vernon Fire Dept is first in ambulance to Vernon. Bowers is second in.
Private dispatch centers are not supposed to field 911 calls. They are supposed to be EMD (Emergency Medical Dispatcher) so they can triage the call and transfer the call to the local 911 dispatch center.