coordinate activities in the event of a major emergency. deployment lmems transport ambulance ambulances may be staffed by two emergency medical technicians, one emergency medical technician and one paramedic or, rarely, two paramedics. there is also at least one "chase car" staffed with a paramedic at any given time. additional chase-cars are staffed as need dictates. 2010 policy revisions state there must always be one supervisor per operations division but currently no more than two are ever on duty simultaneously. this leaves at least one division without a supervisor on a recurring basis. ground transportation lmems utilizes a fleet of modular ambulances manufactured by lifeline emergency vehicles from sumner, iowa and ford explorer response vehicles called chase-cars. currently three styles of ambulances are in use. specimens of the former lfd and jcems (slant-sided) ambulance types remain in use until retirement with new paint and striping. the newest (post-merger) ambulances retain the straight-side feature of the former lfd type and are taller, longer, and heavier. in 2012, ford motor company announced they would no longer manufacture the econoline van ambulance prep package and subsequently lmems has opted to begin procuring type i vehicles based on the f-450 pickup truck chassis. the first delivery of type i ambulances occurred in 2013. most lmems response vehicles, including all ambulances, are fitted with satellite transponders that constantly track the exact location of the vehicle, map the potential route to a call, and determine which unit is closest to the emergency. the ambulances have emergency lights and sirens along with air horns to help them warn motorists to move over. they also have radios to communicate with other units as well as the dispatcher. all ambulances are stocked with a full complement of advanced life support equipment including lifepak 15 cardiac monitor–defibrillators, lucas ii mechanical chest compressors, and oral and intravenous medications and fluids. each ambulance can transport up to three fully immobilized patients. all crew members are trained and equipped with protective gear to treat patients potentially contaminated with hazardous materials. all charting and patient care information is collected and distributed electronically, eliminating paperwork and reducing the possibility of patient privacy compromise. electrocardiographs (ekg) can be transmitted wirelessly from the cardiac monitor to the receiving hospital in the advance of the patient's arrival. area of responsibility and divisions louisville metro ems has the largest area of geographical responsibility of any louisville metro public safety agency. it is the sole provider of emergency medical services to 96.5% of the 399 square miles (1,000 km2) of louisville-jefferson county. the cities of anchorage, jeffersontown, and st. matthews maintain their own ems providers, however, lmems is required to ensure a response if these providers are unable. divisions of louisville metro ems division two st. matthews (medic 211), middletown (medic 112), lyndon and graymoor-devondale (medic 113), berrytown-english station (medic 119), downtown (medic 151), camp taylor and germantown-schnitzelburg (medic 161), clifton-crescent hill (medic 162), buchertown and the highlands (medic 277), and douglass, western hikes point and bowman field (medic 175), okolona (medic 121), highview (medic 123), newburg, watterson park (medic 225), buechel (medic 127), and fern creek (medic 126). division four beechmont(medic 163), iroquois and auburndale (medic 267), university of louisville (medic 274), smoketown (medic 255), pleasure ridge park (medic 131), valley station (medic 132), fairdale (medic 135), shively (medic 137), shawnee (medic 141). russell (medic 243), portland (medic 145), and california (medic 147). continuity of coverage not all locations have ambulances on station at all times. alternatively, response cars may be placed with a single paramedic or technician instead of an ambulance. communications all lmems resources are dispatched and tracked by metrosafe, a unit of metro government that coexists within the emergency services that handles all public safety communications. previously many separate dispatch centers existed staffed by the individual agencies they served. metrosafe puts, for the first time in area history, all emergency call-taking and radio dispatching under one roof. in addition to radio telecommunications metrosafe is the primary answering point for all 911 calls placed inside louisville-jefferson county. two-way radio the current louisville metro public safety radio system is a motorola project 25-compliant trunking system. voice encryption is used for many channels including all those used by lmems, thus radio traffic cannot be received using a scanner. by using voice encryption the chances of protected health information (phi) being compromised by unauthorized monitoring is greatly reduced. response by department procedure, response requests are assigned to lmems resources based on their proximity to the incident and the skill level anticipated by using information gathered from the caller. when a bls unit is closer to an incident believed to require advanced care an additional ambulance (or, if available, a chase-car) containing a paramedic is also dispatched. using information gathered from the call, assigned resources are also instructed response with red lights and siren (termed code-3) or without lights and siren (termed code-1). if the bls ambulance crew first arrives and determines that advanced care is not needed the als resource may be canceled and ready to respond elsewhere. patients are transported to any of the area hospitals either code-1 or code-3. the decision to use, or not to use, lights and siren en route to the hospital is at the sole discretion of the crew. area hospitals current hospitals served by louisville metro ems include: the five hospitals and a pediatric outpatient medical center owned by norton healthcare norton children's hospital (downtown louisville) norton children's medical center (springhurst, louisville) norton women's and children's hospital (st matthews, louisville) norton hospital (downtown louisville) norton brownsboro hospital (springhurst, louisville) norton audubon hospital (city of audubon, louisville) the hospitals of uofl health university of louisville hospital, the region's level 1 trauma center. saints mary and elizabeth hospital (beechmont, louisville) jewish hospital (downtown louisville) jewish medical center-east (st matthews, louisville) jewish medical center-southwest (valley station, louisville) jewish medical center-south (brooks, ky) jewish hospital-shelbyville (shelbyville, ky) the hospitals of baptist healthcare baptist health - louisville (st matthews, louisville) baptist health - lagrange (lagrange, ky) baptist health - floyd (new albany, indiana) the u.s. department of veterans affairs louisville medical center (clifton, louisville).