What is the highest rank mentioned in this hierarchy?

The highest rank mentioned in the hierarchy is EMS Captain. This rank typically represents a leadership position that oversees emergency medical services within the fire department. The EMS Captain is responsible for managing EMS personnel, coordinating emergency responses, and ensuring that medical protocols and practices are adhered to during operations.

In many fire department structures, the ranking order often places the EMS Captain above the Lieutenant and Captain roles, which may focus primarily on firefighting and operations rather than specialized emergency medical services. The role of Firefighter, being an entry-level position, is generally the most foundational and does not carry the supervisory responsibilities that the EMS Captain does. Thus, the designation of EMS Captain signifies a higher level of authority and responsibility within the structure of emergency services.