On January 1, 2020, Putnam County EMS (PCEMS) became the designated agency responsible for the out-of-hospital care and transportation of persons who become acutely ill or are injured. Previously, emergency medical services for the County was provided by Putnam County Operation Life, a non-profit third service that existed between 1974-2019. An agreement between the Putnam County Commissioners, Putnam County Council and the Putnam County Operation Life Board of Directors led to the creation of a new municipal, county-run EMS agency. The men and women of Putnam County EMS provide service with respect, integrity, and compassion 24 hours a day, 365 days a year. Our agency responds to an average of 8 requests for service per day and more than 3,100 runs per year. PCEMS has three stations: a headquarters station in Greencastle, a northern district substation in Bainbridge and a southern district substation in Cloverdale. PCEMS runs three advanced life support units as standard daily staffing, each crew is comprised of an Indiana licensed paramedic (EMS-P) and an Indiana licensed emergency medical technician (EMT-B). Our field providers work a 24 hours on-duty / 72 hours off-duty rotation. All of our duty ambulances provide care at the paramedic advanced life support level. Medical Direction for PCEMS is provided by Indiana University Health Methodist Hospital in Indianapolis, which provides us with expanded scope protocols to meet the needs of our rural setting with extended transport times to definitive care.