Gaston Emergency Medical Services (GEMS)

Gaston Emergency Medical Services (GEMS) is Gaston County's EMS agency, providing Advanced Life Support ambulance coverage across 364.5 square miles of urban and rural communities with a population of approximately 242,010. The agency answers roughly 79,500 requests for EMS service a year, using System Status Management to move available units between strategic posts as calls come in.

Deployment consists of 9 paramedic ambulances, 4 dedicated quick-response vehicles, and 2 supervisory QRVs assigned to EMS stations throughout the county, backed by a Rescue Support Unit equipped for heavy rescue and special operations and staffed by paramedics with advanced technical rescue training. One volunteer rescue squad supplements the county EMS system.

The service began on January 20, 1982 as Gaston County Medical Transport, created to handle non-emergency transports; it reached paramedic-level care and took its current name on July 1, 1987. In July 1995 GEMS became the first EMS organization in North Carolina accredited by the Commission on Accreditation of Ambulance Services (CAAS), and in 2002 it received EMS magazine's Gold Standard EMS Service of the Year award.

Special operations teams include the S.T.A.R. team (trench, confined space, structural collapse, and high-angle rescue), dive rescue and recovery, swiftwater rescue, tactical medics who deploy with law enforcement, bomb medics, a bicycle emergency response team, a State Medical Assistance Team, and an honor guard.

GEMS hires through Gaston County's careers portal on GovernmentJobs.com, where EMT Basic, EMT Advanced, and Paramedic I–III positions are posted on a continuous basis. Applicants attach proof of certification and education to the application, and selected candidates complete a criminal background check and a pre-employment drug screening.

New employees are typically assigned to night shift at hire and take part in an annual shift-bid process. Experienced providers qualify for a lateral entry incentive: full-time EMTs or paramedics hired after July 1, 2026 with at least two years of full-time experience receive $3,000 (EMT) or $4,000 (paramedic), paid in two installments over the first 18 months of county service.