In the United States, emergency medical services (EMS) are handled through a decentralized network managed by local municipal governments, private ambulance companies, hospital-affiliated transport divisions, fire departments, and volunteer rescue squads. At the federal level, agencies like the National Highway Traffic Safety Administration's Office of EMS provide national coordination, guidelines, and funding support. Meanwhile, in the technology manufacturing sector, American EMS operations are managed by domestic contract manufacturers like Sanmina and Benchmark Electronics.