The problem was that the Londonderry Fire Department responded to all emergency medical services (EMS) calls utilizing red lights and siren (RLS) regardless of the nature of the call. This exposed employees and the public to a greater risk of being involved in a collision involving an ambulance. The purpose of this action research was to devise a method for the Londonderry Fire Department to reduce the number of RLS responses to EMS calls without adversely affecting patient outcome. This research explored several key areas including: how other departments to determined response modes; the risks were associated with RLS use; impact on patient outcome and response times; and legal and cultural concerns.This research was carried out by performing a literature review, conducting a state-wide and internal surveys; analyzing data from the Londonderry Fire Department's computer aided dispatch and electronic patient care reporting systems, performing time comparison studies, and reviewing hospital charts. The results indicted that the use of RLS presented additional risk; that many departments utilize some form of emergency medical dispatching to determine response modes for ambulances; these prioritizations are generally accurate; and study patients coded as a more severe (delta) received more EMS procedures than patients coded as less severe (alpha). Results also found that although there were no legal hurdles to implement triaged response modes there were significant cultural hurdles to overcome.Recommendations were made to the Londonderry Fire Department to implement a procedure of utilizing call determinant coding information provided by New Hampshire E-911. This information would allow the Department to be more selective on which EMS calls require the use of RLS when responding.