Captain explains how 911, police, BLS and ALS work together in Bernards Township

Captain Sarah Bonafoi, of the Basking Ridge Fire Company, told residents that the sequence after a 911 call usually begins with police arriving to secure the scene, followed by a Basic Life Support (BLS) ambulance and, when needed, an Advanced Life Support (ALS) unit. "You call 9101," Bonafoi said as she began describing the usual response, emphasizing the dispatcher's role in determining resources.

Why it matters: The township relies on a mix of volunteer BLS units owned by the township and hospital-operated ALS resources; residents who see multiple vehicles at a scene are often observing that layered response.

Bonafoi summarized on-scene roles: BLS crews are typically two EMTs who gather patient demographics, medical history and vitals while one clinician communicates with the patient and another manages equipment and movement. Paramedic-staffed ALS units carry more medications and advanced equipment, perform interventions such as IV placement and intubation, and sometimes ride in or follow the ambulance to the hospital.

Dispatch and automatic ALS triggers: Bonafoi said calls go through the Somerset County Communications Center, which uses triage questions and algorithms to auto-dispatch ALS for some conditions (altered mental status, chest pain, loss of consciousness, stroke, major trauma, burns to the face, falls over roughly 10 feet, rollovers and similar high-acuity events). BLS crews can also request ALS on scene or cancel an ALS unit if the situation does not require it.

Hospitals and transport: Morristown Medical Center and Robert Wood Johnson Somerset were listed among the hospitals commonly used for transports; Bonafoi noted that clinical needs or device capabilities can require transport to a specific facility.

Mutual aid and coverage: When township ambulances and Atlantic Health units are unavailable, mutual aid agreements bring neighboring agencies (for example Far Hills, Warren or Bernardsville) under direction from county dispatch. Bonafoi explained those lists are reviewed annually with dispatch.

Quote: "We are coming to your house as an ambulance crew with the expectation that you want to go to the hospital," Bonafoi said, underscoring the intent of EMS response and the handoff that occurs at hospital triage.

What residents can do: Bonafoi advised clear house numbering, turning on lights and, if possible, having someone stand outside to help crews locate the address. She also urged residents not to avoid calling 911 because of bill concerns.

Next steps: The session materials will be posted on the township website; Bonafoi and the fire company encouraged residents to consider volunteering or attending community demonstrations and training.