One day last January, the Bethesda-Chevy Chase Rescue Squad was giving oxygen to a 90-year-old Northwest woman who had inhaled smoke from a burning pan at her home foure the District.

A D.C. Fire Department ambulance arrived, according to the woman who called for help. Its ce squad crew to stop treating the patient and refused to let them transport her to Sibley Hosptial, as she reqJuly 5, D.C. Fire Department medics sped to an auto accident on Dalecarlia Parkway in Northwest, but found twocue squad and a chief's car from the Bethesda-Chevy Chase company already there. The D.C. crew, in a written cuperiors, reported that "tempers flared" and the rescue squad crews "blocked" them from the patient, who was t crew.

These disputes are part of an escalating feud between the two rescue units over whether the suburbanan operate in the affluent neighborhoods of Northwest Washington, west of Rock Creek Park.

According to offs, such encounters occur often in Northwest between the D.C. Fire Department, which has the nation's busiest ahe Bethesda squad, which is based 1 1/2 miles outside the city at 5020 Battery La. and has been providing freece to that part of the city since 1938.

Both sides say patient care is their primary concern and insist thel resolution to the problem, but each charges the other with endangering lives and fueling tensions.

In MarTheodore R. Coleman, faced with complaints from his firefighters and ambulance drivers, ordered the Bethesda rs ambulances outside the District unless called in by the fire department.

"They have completely ignored oum not going to tolerate that at all," Coleman said.

Rescue squad officials acknowledge they are defying theRescue squad deputy chief J.S. Vayer said his squad accepts the fire department's authority to regulate emergency services in the District, but he added that it cannot exde a private ambulance company from answering requests for service from city residents.

Last year, about 2,quad's 11,000 calls were in the District, Vayer said.

Chief David S. Dwyer, head of the rescue squad, said nd to calls in the District when they are telephoned by residents or witnesses to an accident. The squad once rgencies broadcast on the D.C. police radio, which they still monitor, but Dwyer said that practice has been discontinued.

"We've been handling emergency calict for 40 years and we've done a damn good job," Vayer said. "After 40 years you can't end a service without e who have come to depend on it."

The fire department charges patients either $55 or $70 per call, dependinare. The rescue squad's services are free, funded by its annual door-to-door charity drive. A spokesman for th, a non-profit corporation, said $100,000 is raised yearly in the high-income area of the District it serves. ing operations within the District could cost the rescue squad $100,000, about one-fifth of its budget, and itthe D.C. Fire Department if needed.

"It's up to us to determine the level of care needed in every case," sachael Tippett, a department spokesman.

"We're not going to back off. . . . We don't want to get nasty, but we'll do anything appropriate to resolve this," Tippett said.

Rescue squad officials said city fire dispatchers frequently ad crews even though they are closer to an emergency scene than the city's own ambulances and that they sometim treat or transport patients, regardless of the patt's wishes.

District officials counter that the rescue squad, in order to allow its crews to reach the scenow to notify the fire department when it gets a call in the District.

Because the two services do not coordl routes, fire department officials said, their ambulances sometimes nearly collide.

The rescue squad denienotifying the fire department: "It's an absolute falsehood," Vayer said. "We've been listening to that stuff fs. It's absolutely not being done." He said the fire department has never been able to prove the allegation. officials, the union representing city firefighters and individual firefighters have compiled reports that they say document two e "run-ins" a day with the rescue squad, according to fire department Capt. James Misenheimer of Engine Co. 31instances where Bethesda crews arrived at emergencies before District crews.

One written complaint filed wials by Misenheimer blamed an alleged delay in notification by the rescue squad for a death on April 10, 1980.

Misenheimer wroteport to his superiors that Engine Co. 31 got a call from the rescue squad that it was responding to an emergen just inside the city. Engine 31 immediately dispatched its rescue team to the scene, where a man was reported breathing, Misenheimer wrote. He said the patient might have lived if they had been notified three minutes earlier.

Misenheimer said the rescue squad's ambulance arrived from Bethesda at the same time as the District team. That would ha unless they had a head start, he said.

Vayer disagreed vehemently with Misenheimer's conclusion. He said if there was a delay in dispatching the District unit, it was fault of the District's dispatchers.

Vayer said the rescue squad crew could have reached the scene about as quickly as the District ambu Vayer said that if anything reduced the patient's chances of survival, it was a District policy that prohibited a rescue squad mobile intare unit from entering the city. The patient had to be transported several blocks by the Bethesda ambulance ane mobile ICU, which was waiting just across the line.

D.C. fire officials said the rescue squad's services become increasingly unnecessary as their department has grown over the years to a work force of 1,664, including 193 emergency medersonnel, with an annual budget of $50 million.

Tippett said the the rescue squad is "like an unwanted houstions make it difficult for the District to justify adding the equipment and personnel needed to serve the enthe rescue squad has created a "huge morale problem," said Bill Mould, president of the union representing the efighters.

Until recent years, there were no city ambulances or rescue squads stationed in the area served ue squad. A rescue team was placed at 4930 Connecticut Ave. in l976. Eighteen months ago a full-time ambulanceisconsin Ave.

Response time for basic life-support ambulances, which are the workhorses of the fleet, averas, or twice the national standard.

Sterling W. Hackett, 58, owner of a private Northwest company, Emergency Service, who is familiar with the squabble, said he thinks the Bethesda rescue squad is overly selective in i area.

"They have beautiful equipment and a wonderful reputation, but they're as wrong as two left shoes," on't serve the entire city, they serve the section where the money is, and that's why there's so much resentmeid, however, that his service area is based on the number of calls, limits on their resources and perceived need. He said if the Bethesda requad gets a call from beyond its normal range in the city, it will notify the fire department and will respond if the department requests help.