A friend of mine who was a paramedic told me that getting people out of a building is actually heavy, dangerous work. "They always die on the crapper, up 3 flights of stairs."
Also, in my town, the firefighters are also paramedics. The first people who showed up in my Moment of Need came in a fire truck. The ambulance came a couple minutes later.
For particularly heavy patients, on occasion the only way is to knock down a wall.