in canada a "notarzt" who would arrive when an ambulance is called out , is an "unknown" .
"emergency doctors" (trauma specialists) are part of a hospital's emergency room team .
when "911" is called in a medical emergency an ambulance staffed by an emergency team is usually despatched . this team includes a "paramedic" who can make an on-the-spot assessment of the patient . often - in addition to the regular routine assesment - an EKG will be performed in the patient's home or on the way to the hospital and the emergency room will be informed of the patient's conditions prior to arrival .
in case of a suspected heart-attack the local fire department will also respond with the necessary equipment to assist the patient .
so we can sometimes see the ambulance chasing the firetruck - sometimes that's quite spectaclular .
since we live only about a mile from both a firestation and and ambulance depot , there is plenty of noise at times .
our hospital is a regional trauma centre whose service area extends all the way north to hudson bay and a fair number of patients arrive by helicopter ambulance on a regular basis .
btw ambulances and fire-trucks must obey the traffic signals . they are allowed to proceed on a red light if an intersection is clear , but they are not allowed to "bulldoze" . many traffic lights can now be changed remotely by the emergency vehicle crew as they come up to a traffic light .