Ranks LMEMS is a subordinate entity of an umbrella organization called Emergency Services. LMEMS is headed by the director who serves as the agency head (much like a commissioner). This organization follows the structure of the United States Military. When wearing an<unk>  uniform the director of emergency services wears the silver eagle of a US army Colonel. Under the Director of Emergency Services is the top uniformed officer holding the job of 'Deputy Director', utilizing the title of 'Chief of Service' and the deputy director also holds the rank of Colonel (with gold eagle to indicate subordinate position to the director). This officer is the accepted chief of department. Traditionally, in the area, the chief of the emergency medical services is not addressed as "chief" but as "colonel" and styled "The Colonel." Under the assistant director are several officers with the assistant director of Operations wearing the silver oak leaves of a Lieutenant Colonel. The Operations Commander, wearing the gold oak leaves of a Major oversees all day-to-day operations including scheduling and may be drawn upon to provide additional manpower. Other personnel include the Operations Executive Officer who has the rank of Captain, Operations Field Officer-Paramedic who has the rank of Lieutenant and the Operations Field Supervisor-Technician who has the rank of Sergeant. The collar insignia of LMEMS is as follows: Title Insignia Director of Emergency Services (Colonel) 47px Deputy Director (Chief of Service) (Colonel) 47px Assistant Director of Operations (Lieutenant Colonel) 30px Operations Commander (Major) 30px Operations Executive Officer (Captain) 30px Operations Field Officer - Paramedic (Lieutenant) 10px Operations Field Supervisor - Technician (Sergeant) 25px * Regardless of collar rank an employee's skill level is denoted on the bottom edge of the right sleeve patch, either "Technician" or "Paramedic." A patch reading "Supervisor" was envisioned but never produced. Union LMEMS is a long-established "union shop" and all employees beneath the rank of lieutenant colonel can become members of the International Brotherhood of Teamsters (IBT) Local lodge #783, but all employees are required to pay a "Fair Share" contract support fee. Job assignments, shifts, and vacations are filled using a system based on seniority. However, an employee's tenure may be taken into account to determine suitability. Any employees' first twelve months of service with LMEMS is considered a probationary period where the new hire is subject to dismissal without union representation. Several separate bargaining contracts exist within the service. Street operations personnel, including the majority of EMTs and paramedics and operations officers are covered by one contract. Ancillary services personnel in supply and billing have their own contract suited to their unique duties. A chief and assistant chief steward are elected to oversee union matters for the entire service. Additional elected shop stewards are on duty at most times to assist members with concerns on a day-to-day basis.
Louisville Metro EMS
Alamo EMS
Transfer board
USNS Mercy 
Emergency medical dispatcher
Flight paramedic
Emergency medical responder
Trauma Team