Emergency Medical Services

North County Fire was the first fire department in the State of California to operate an ambulance service. In 1990 the District initiated a paramedic program which now serves as a model for much of San Diego County. The challenge emergency medical service ( EMS ) providers face is to make important, sometimes critical decisions with a limited amount of information. Below you will find a summary concerning your EMS system.  

Personnel Staffing

The EMS program is integrated into and administered through the Fire Department.  Each full-time fire engine company and each ambulance is staffed with at least one paramedic, providing at least two paramedics on every call for medical service.   This ensures rapid arrival of advanced life support (ALS) trained personnel to each medical emergency.   This standard of care is largely uniform throughout the metropolitan portions of San Diego County and for this reason, it is common for a fire engine and an ambulance to respond to a medical emergency.

Ambulance Placement

To properly serve the community, paramedic ambulances are located in a manner that best services all the residents of the community. The location of ambulances is based on meeting County mandated response time criteria, which is for a paramedic ambulance to arrive on the scene of all medical aid calls within 10 minutes, 90% of the time.

In an effort to minimize the response time to citizen's emergency calls, we have implemented a "boundary drop" program which allows for sharing of surrounding agencies' fire and paramedic ambulance resources.  

The Demand for Emergency Medical Service

The public's demand for emergency medical services has steadily increased over the years and represents approximately 75% of all calls for service (6,394 total calls in 2017).   Approximately 70% of all EMS calls result in an ambulance transport to the hospital or transport by a helicopter to a hospital providing specialized services.

Given this increased demand for services, in 2016 North County Fire entered into a Joint Powers Agreement (JPA) with the Fallbrook Regional Health District to develop collaborative partnerships to improve access to healthcare, reducing hospital readmissions, and address the impacts associated with the closure of Fallbrook Hospital in 2014.


The County of San Diego Medical Director is responsible for all medical aspects of pre-hospital patient care. The Medical Director has the authority to approve the level of pre-hospital care which may be rendered by EMTs and Paramedics within the County of San Diego, as well as establish and monitor compliance with field performance guidelines and training standards.   Paramedics receive direct medical control from an assigned Base Hospital , which assists in making treatment and transport destination decisions.

The Operations Chief heads the EMS Division with the direct assistance of the Medical Services Officer (MSO). These two individuals provide direct day-to-day oversight of the EMS delivery system for the North County Fire Protection District and are responsible for the operations and maintenance of EMS , quality assurance, emergency medical training, complaint disposition, fiscal management, and compliance with all polices, orders, and procedures.

Community Outreach

Ideal provision of emergency medical services relies upon total community involvement.   As such each member of the community represents a link in the "chain of survival." To that end the Fire Department  has implemented a Public Access Defibrillation (PAD) program, which encompasses placement of 40 Automatic External Defibrillators (AED's) throughout the community.

In order to maximize customer service, the Fire Department also sends customer satisfaction surveys to persons that utilize our ambulance services.   Should you or a member of our family require these services please provide us feedback so that we can continue to improve our quality of service. We are proud to maintain a 95% "excellent" overall customer service satisfaction rating.

The Future of EMS

The scope and complexity of medical services provided by paramedics continues to evolve, with paramedics providing many critical interventions that were once only available in the hospital setting.   In 2018 North County Fire will commence transition of its ambulances to single-role paramedics so that we may better help patients successfully navigate the healthcare system, ensuring they get to the right place the first time.  This ensures our ambulances remain available locally, eases Emergency Room overcrowding, reduces hospital wait times, and ultimately reduces system operating costs.