See also : Certified First Responder and Emergency medical responder In France, the pre-hospital care is either performed by first responders from the fire department (sapeurs-pompiers, most emergency situations) or from a private ambulance company (relative emergency at home), or by a medical team that includes a physician, a nurse and an ambulance technician (called "smur"). The intermediate scale, the firefighter nurse (infirmier sapeur-pompier, ISP), is only a recent evolution and is performed by nurses specially trained acting with emergency protocols; these nurses are the French equivalent of the paramedics. The first responders are thus the most frequent answer to emergency calls.