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Medical Control

Sylvia Fisher


Sylvia Fisher
EMS Manager
Phone: (828) 465-8234
Email Sylvia Fisher

Map of Bases

map 25 Government Drive
Newton, NC 28658

Office Hours
Monday - Friday
8:00 a.m. - 5:00 p.m

Medical control (also known as medical direction) provides a link between EMS providers and the licensed physician under whom they practice.  EMTs and Paramedics function as an "extension" of the physician while caring for patients in the field and are able to provide high level medical care in remote locations.  There are two types of Medical Control: on-line and off-line. 

On-line medical direction refers to immediate medical direction provided to prehospital personnel in outlying locations by a physician.  This direction occurs when EMS personnel contact an ED physician via telephone or radio for consult. 

Most often, EMS providers operate under off-line medical direction, relying on existing protocols and standing orders developed and approved by the EMS service, state, and local EMS Medical Director.  Due to the progressive nature of our protocols, and the extensive training we undergo regularly, CCEMS employees are rarely required to contact on-line medical control for direction, but are able to contact them any time they chose.

Protocols are guidelines that EMS personnel follow while evaluating and treating the most commonly encountered emergencies.  Protocols provide general information for dealing with problems and reflect the state and local standards of care for specific conditions.

Standing Orders are specific medical orders which permit paramedics to start IV lines, administer emergency medications, and perform advanced medical procedures for specific situations, under a pre-determined set of guidelines approved by the Medical Director.


Dr. Charles McKaraher is our Medical Director. He began his practice in the Unifour area in 1992 when he was offered a staff position in the emergency department at Frye Regional Medical Center. He served at FRMC for almost 8 years where he held various positions, including Chief of Service in the ED. He has also held several positions at Catawba County EMS, including ALS and BLS medical directorships.

Dr McKaraher

His interest in pre-hospital medicine started in the late 70’s when he obtained his EMT certification, and he was a member of a voluntary rescue squad prior to and during part of medical school.

His main practice interests include: pre-hospital/EMS medicine, operational medicine, (especially tactical medicine), and wilderness medicine. He has attended several tactical schools, including a CONTOMS course. He is also basic SWAT certified through the North Carolina Justice Academy). He holds several memberships: ACEP, NCCEP, AAFP, and National Association of EMS physicians, Special Operations Medical Association (SOMA), Wilderness Medical Society and the North Carolina Tactical Medic Association.

In his spare time he likes to spend time with his family and to get in the occasional deer hunt with his friends. He currently lives in Hickory with his wife and two children.