"Technical rescue" refers to the aspects of saving life or property that employ the use of tools and skills that exceed those normally reserved for fire fighting, medical emergency, and rescue. These disciplines include rope rescue, swiftwater rescue, confined space rescue, ski rescue, cave rescue, trench/excavation rescue, and building collapse rescue, among others. In the United States, technical rescues will often have multiple jurisdictions operating together to effect the rescue, and will often use the Incident Command System to manage the incident and resources at scene.
NFPA standards 1006 and 1670 state that all rescuers must have medical training to perform any technical rescue operation, including cutting the vehicle itself during an extrication. Therefore, in most all rescue environments, whether it is an EMS department or fire department that runs the rescue, the actual rescuers who cut the vehicle and run the extrication scene or perform any rescue such as rope, low angle, etc., are medical first responders, emergency medical technicians, or paramedics, as almost every rescue has a patient involved.