Emergency Medical Services

Level of Care

Blowing Rock Fire and Rescue provides emergency medical care at the Paramedic level;  the highest level recognized in North Carolina. Paramedics with Blowing Rock Fire and Rescue undergo over 1000 hours of training. All full time staff work at the Paramedic level. Volunteers are certified as Emergency Medical Technicians (EMT), Intermediate EMT or Paramedic level. Certified as a Paramedic Service Provider, our medics are able to perform Advanced Cardiac techniques in the field, when minutes count. Visit the NC Department of Health and Human Services for more information about EMS in North Carolina

Tiered Response

Blowing Rock Fire and Rescue operates under a Tiered Response System. In a traditional EMS system, an ambulance is dispatched from a single source to provide emergency medical care. Under the Tiered Response System, multiple resources from multiple sources (tiers) respond to an emergency. Upon activation of the 911 system, resources dispatched include:

  • First Responders – medically trained personnel who may be in the area who can respond quickly
  • Firefighter / Medics that may respond as a Paramedic Level ALS Engine Company to initiate patient care
  • Quick Response Vehicles (QRV) –Smaller yet fully equipped vehicles that respond quickly to the scene
  • Ambulance – Traditional ambulances that provide continued patient care and transportation of the patient to the hospital.

This tiered response system provides the following benefits:

  • Allows for a faster response time to the patient
  • Maintains availability of Blowing Rock Fire & Rescue Personnel for simultaneous calls for service
  • Provides more flexibility to adapt to the type of call and location of the call
  • Uses resources efficiently

Blowing Rock Fire & Rescue serves as the primary ambulance provider for the Caldwell County portion of  our district. Blowing Rock Fire & Rescue also serves as a back-up ambulance provider for both Watauga and Caldwell Counties.


Obtaining certification as a Basic Emergency Medical Technician or a Paramedic is not an easy process. Staff and Volunteers at Blowing Rock Fire & Rescue collectively spend thousands of hours per year certifying or maintaining their knowledge, skills, and abilities in emergency medicine. Certification requirements are:

  • EMT – 169 hours initial training+ ongoing continuing education
  • EMT Intermediate – EMT + 256 hours of training
  • Paramedic – EMT + 1096 hours of training + 200 hours of clinical time (hospital and ambulance experience) + continuing education

Initial training programs are delivered through community colleges throughout the state under the supervision of NC Office of EMS. Following initial certification, 24 hours of continuing education is required each year. You can read more information about EMS training here.