also since I am trying to go for realism with my departments I have a few questions with ems rescues. What reason would an EMS agency have to have a rescue role (traditionally a fire department task) and how do they define response jurisdiction with fire departments with a rescue truck close by, are there turf wars over this issue?)
In New South Wales Australia the NSW Ambulance had a full rescue capability for years. It was downgraded a bit but they still have Special Operations and Special Casualty Access Teams who do extrication, plus rope, water, etc. SCAT also provide the paramedics to the rescue helicopters.