For one of the fastest-growing cities in the country, Mount Pleasant, the fire department isn't fighting many fires.
So the department has reinvented itself, now buying something else to replace aging engines.
Mount Pleasant firefighters train to stay ready to battle fires. At a training exercises off Six Mile Road, they hone their skills at fighting fire several stories high and performing rescues from rooftops.
"We can put this right on the deck of the Yorktown and it creates its own standpipe system and waterway system up on the deck," Mount Pleasant Fire Capt. Greg Kent said.
But not many calls require the million dollar-plus ladder trucks.
"We don't have as many fires as in years gone by," Town Administrator Eric DeMoura said.
For a booming town of an estimated 76,000 people, there were 202 fires last year and those numbers are trending down from 229 just a few years ago.
But firefighters aren't sitting around. Instead they have responded to more than 4,700 emergency calls for medical help.
"So it begs a question: Should we be responding to these calls with million dollar fire trucks?" Demoura said.
They came up with a plan: Medical Response Vehicles. They are SUVs equipped to handle small fires, but primarily medical calls.
"We can handle heart attacks, overdoses," EMS Division Chief William Barnes, NREMT-P, said. "We work hand in hand with Charleston County so it's flawless coordination with EMS."
Mount Pleasant has two quick response teams. This one is stationed near a cluster of nursing homes.
"We just looked out ourselves like any other business. 'Am I giving the best service I can to the community?' And we had to re-invent ourselves," Mount Pleasant Fire Chief Herbert Williams said.
The new Medical Response Vehicle, they say, allows faster response time, but is also saving on fuel, manpower and wear and tear on the big engines.
"It saves millions to the taxpayer," Demoura said. But he says the public value is also measured by service. "Because we recreated ourselves in this direction, the public is receiving paramedic, quality care more quickly than they would have before."
Mount Pleasant and North Charleston are both using this model, two of only seven accredited fire departments in South Carolina who are. Williams said other cities are interested in the new concept.