http://armstrongambulance.com/our-services/emergency-medical-dispatch/

Explanation - in my words - corrections appreciated

The first person who says hello when you dial 911 is the primary PSAP.
If that person then connects you to a 2nd party, usually after getting
the basic info about the incident, then the 2nd party is the secondary
PSAP. In this case, I believe that Armstrong is being used as the EMD
provider. The EMD provider provides medical screening and advice to
the caller. I dont think that Armstrong actually dispatches anyone in
the 7 communities - they just provide advice to the callers. The
dispatching is done by the dispatchers in the primary PSAP.

Other types of PSAPs might be - overflow PSAP - backup PSAP (in case
the primary PSAP gets nuked) - tertiary PSAP (I think that is very
much frowned upon)

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