Emergency Medical Services

Jason Weber, Chief, Fire Department

Marin County Fire Department first provided Emergency Medical Services (EMS) to the residents of Marin in 1965, when a Cadillac ambulance was stationed in Point Reyes. The community of Point Reyes, led by Waldo Giacomini, provided the funding for the first ambulance and its equipment. The American Red Cross trained personnel assigned to the ambulance in advanced first aid. 

In 1977, nine firefighters from the department were sent to Stanford University for paramedic training.  In April of 1978, Rescue 90 was placed in service in Point Reyes, becoming the first paramedic rescue ambulance in Marin County. This "emergency room on wheels" brought advanced life support services to West Marin. Paramedics received over 1200 hours of training in anatomy, physiology, cardiac care, advanced airway procedures and over fifty medications that they could administer. To support the Paramedic Program, in 1982 all Marin County Fire Department firefighters became Emergency Medical Technicians (EMT).


Heart Attack and Stroke Symptoms

Act in Time

The American Heart Association and the National Heart, Lung, and Blood Institute have launched a new "Act in Time" campaign to increase people's awareness of heart attack and the importance of calling 9-1-1 immediately at the onset of heart attack symptoms.

Heart attack and stroke are life-and-death emergencies -- every second counts. If you see or have any of the listed symptoms, immediately call 9-1-1. Not all these signs occur in every heart attack or stroke. Sometimes they go away and return. If some occur, get help fast!

Today heart attack and stroke victims can benefit from new medications and treatments unavailable to patients in years past. For example, clot-busting drugs can stop some heart attacks and strokes in progress, reducing disability and saving lives. But to be effective, these drugs must be given relatively quickly after heart attack or stroke symptoms first appear. So again, don't delay -- get help right away!

Heart Attack Warning Signs

Some heart attacks are sudden and intense -- the "movie heart attack," where no one doubts what's happening. But most heart attacks start slowly, with mild pain or discomfort. Often people affected aren't sure what's wrong and wait too long before getting help. Here are signs that can mean a heart attack is happening:

  • Chest discomfort
    • Chest discomfort. Most heart attacks involve discomfort in the center of the chest that lasts more than a few minutes, or that goes away and comes back. It can feel like uncomfortable pressure, squeezing, fullness or pain.
  • Discomfort in other areas of the upper body
    • Symptoms can include pain or discomfort in one or both arms, the back, neck, jaw or stomach.
  • Shortness of breath
    • This feeling often comes along with chest discomfort. But it can occur before the chest discomfort.
  • Cold sweat, nausea or lightheadedness
    • These may include breaking out in a cold sweat, nausea or lightheadedness.

If you or someone you're with has chest discomfort, especially with one or more of the other signs, don't wait longer than a few minutes (no more than 5) before calling for help. Call 9-1-1.

Early CPR

  • "Pump and Blow"
  • Early Defibrillation: Use the AED!
  • Early Advanced Care

Stroke Warning Signs

The American Stroke Association says these are the warning signs of stroke:

  • Sudden numbness or weakness of the face, arm or leg, especially on one side of the body
  • Sudden confusion, trouble speaking or understanding
  • Sudden trouble seeing in one or both eyes
  • Sudden trouble walking, dizziness, loss of balance or coordination
  • Sudden, severe headache with no known cause

If you or someone with you has one or more of these signs, don't delay! Immediately call 9-1-1 or the emergency medical services (EMS) number so an ambulance (ideally with advanced life support) can be sent for you. Also, check the time so you'll know when the first symptoms appeared. It's very important to take immediate action. If given within three hours of the start of symptoms, a clot-busting drug can reduce long-term disability for the most common type of stroke.

Cardiac Arrest

Cardiac arrest strikes immediately and without warning. Here are the signs:

  • Sudden loss of responsiveness. No response to gentle shaking.
  • No normal breathing. The victim does not take a normal breath when you check for several seconds.
  • No signs of circulation. No movement or coughing.

If cardiac arrest occurs, call 9-1-1 and begin CPR immediately. If an automated external defibrillator (AED) is available and someone trained to use it is nearby, involve them.

Vial of Life

The “Vial of L.I.F.E.” program is a collaborative effort supported by Marin General Hospital and Sutter Health (Novato Community Hospital), Kaiser Permanente, the County of Marin, the Marin Fire Chiefs Association and the Marin County Fire Department. The program is intended to provide community members with a method to store medical information in the home. The “Vial of LIFE” kit enables emergency responders (firefighters, police officers and paramedics) to obtain helpful information regarding a patient’s medical history. This is especially important if the patient is unconscious or is unable to speak to the caregivers. The kit includes a small plastic vial (it resembles a medium size medication container), a magnet for the refrigerator door, a sticker for the front door, a medical information form and a small piece of Velcro®. By completing the medical information form and storing the vial correctly, you can provide vital life-saving information to the emergency responders.

A free Vial of L.I.F.E. can be picked up at any fire station in Marin County during normal business hours. Follow the instructions that are included with the Vial. Your medical information on the form should be updated whenever the information changes. It’s a good idea to review the information at least twice per year (do it at the same time you change your smoke detector batteries – when we change to and from daylight savings time). Additional medical information forms may also be downloaded.

How to use the Vial of L.I.F.E.

  1. Complete the medical information form in English. The form must be legible to be beneficial to medical personnel. Be sure to keep the information up-to-date and accurate. Be sure to sign and date the form.
  2. If available, attach a recent photograph (or photocopy of your drivers license) to the form.
  3. Place the vial on a shelf in the door of your refrigerator.
  4. Place the magnet on the outside of the refrigerator in a prominent location. If the magnet does not stick to the door, use the self adhesive Velcro strip. Place one piece on the magnet and the other on the door.
  5. Place the Vial of LIFE sticker on or near your front door where it is clearly visible to emergency responders.
  6. Update the form whenever your medical history or medications change. Review the form at least twice per year when you change your smoke detector batteries.

Contact your physician or local fire station if you have any questions.

EMT Education Program

The Marin County Fire Department EMS Division administers an Emergency Medical Technician (EMT) education program. This program allows firefighters to maintain their certification in-house, at a lower cost than sending personnel to outside training. The department offers EMT training to the Stinson Beach, Bolinas, Inverness, and Tomales Volunteer Fire Departments. Personnel from the Marin Municipal Water District, Pt. Reyes National Seashore, National Park Service, Skywalker Ranch, and Muir Woods National Monument, also attend this monthly training.

CQI Program

Marin County Fire Department recently implemented a Continuous Quality Improvement (CQI) program, which provides peer review of the ALS system. New protocols, in conjunction with the CQI program, allow paramedics to provide more advanced care for patients, without base hospital direction. This program provides continuous monitoring, improvement, and systems analysis of the paramedic service.

History of the EMS Division

In 1985, in response to a request by the Ross Valley Paramedic Authority, Marin County Fire Department assumed administration and staffing of Rescue 40, a paramedic unit stationed at the Ross Fire Station. This Joint Powers Authority provides paramedic services to residents and visitors within the communities of Corte Madera, Larkspur, Kentfield, Ross, San Anselmo, Sleepy Hollow, Fairfax, and County Service Area 27. Now known as Medic 18, it responds to approximately 1500 calls per year. The addition of Medic 18 benefits the department by providing a unit with a higher call volume, allowing paramedics an opportunity to maintain their vital skills.

Following the founding of our EMS team in 1985, we have continued to build a comprehensive and countywide system of emergency medical services.  With ALS transport ambulances and fully trained paramedics, we also cover the County's more outlying areas of Tomales and Stinson Beach.

We now offer our residents paramedics trained in cutting edge life saving technologies kept current by ongoing training.  Our fleet of vehicles, including all fire engines are equipped with the most up-to-date equipment enabling all fire personnel to assist in medical emergency calls.