I have worked on an ambulance for a few years, I have worked with people who have worked on an ambulance for decades, and from what I have gathered this is a tale as old as time. Abnormal lab work? 911. Toe pain for 4 years? 911. Haven't pooped yet today? 911. Altered mental status with rapid heart rate and low blood pressure? Let's wait 9 hours before telling anyone. These places are, fairly across the board, total garbage.