Asking because (different country) when we had a person present with stroke symptoms and called 911, they sent both an ambulance and the helicopter. The heli came first but it had to land a ways off on a field and they had to walk over and basically arrived around the same time as the ambulance. A couple minutes earlier basically. No fire engine dispatched but that made sense too as it's volunteer based and while they would've been much closer, getting them to the station would've taken longer than the helicopter.
Driving time for the ambulance if it came from the same place as the helipad would've been about 15 min for the ambulance. Fire engine driving time from volunteer department: 2 min but no dedicated paramedic services, just volunteer firefighters. Heli time in air probably about 2 minutes given the "as the crow flies" distance I just checked, add whatever time is needed to get them in the air and such.
Now I can't really trust these numbers fully of course but according to "a quick AI analysis" :P Melbourne with millions of population has 0.08 helicopters and 8-10 ambulances per 100k population while the aforementioned location is at about 0.3 helicopters per 100k and 6-12 ambulances. Can it be true? It also says New York City has no emergency helicopters at all? Los Angeles has 0.18 per 100k? I know my current location definitely also has none at all. For millions of people.
Basic issues like overhead powerlines make life difficult for helicopters. They are used in rural Australia as an alternative to road, but only due to time saving. In a city, well you get a road ambulance/paramedic/medical team.
The (Melbourne) Victorian Ambulance Cardiac Arrest Registry claims third best in the world in out of hospital cardiac arrest.
Since 1998, in Melbourne for anything that might need a defibrillator a fire engine is sent at the same time as the ambulance (EMR Emergency Medical Response Program). https://www.mja.com.au/journal/2002/177/6/cardiac-arrests-tr... Medical Journal of Australia article. There is also GoodSAM https://www.ambulance.vic.gov.au/goodsam/ for individual helpers
Less of it about now but used for multilingual websites for the secondary language, particularly if non-latin alphabet. Will no-one think of Unicode!
The US always has failings, but this message is something we can be proud of.
At least they kept the stalks on the steering column ...
In my Australian State, South Australia, this a huge contrast with police who buy new from the manufacturer, get a three or maybe five year service contract from the manufacturer and then sell them when the warranty expires and they've done around 100,000 km (60,000 miles). So no servicing worries and they get some tax benefits so it works for them.
Ambulances have less mileage and my guess is retire after 10 years. Ambulances are very standardised so can swap metro and country vehicles to get value from the asset. There was a "twin life" ambulance (http://www.old-ambulance.com/Twin-Life.htm) that had a long life rear bit on a light truck chassis so swap out the motor bit two or three times every 200,000kms, but these days vans are used. There was much sadness in the ambulance fleet buying community when Ford discontinued the F150 type chassis in Australia.
But your average (fire/rescue) appliance in the city or country has low mileage. In the city plenty of use but never have to drive far. In the country not much use but do drive further but end up the same a very old vehicle without much mileage on the clock. Trailers can be even older 50 or 60 years before retirement. Another issue with a fire appliance is they carry water which is heavy, three tonnes is a pretty common load. And have other readers have mentioned a monopoly on manufacture wouldn't help.