There are four District Chiefs on duty at all times in Wake County. The districts are divided geographically into the northeast, central, west and southwest areas of the County.
 
District Chiefs routinely respond to various emergency calls and carry out a host of administrative duties. They are generally responsible for:

- Supervision of field staff
- Support and coordination of multiple patient scenes
- QRV response support with full paramedic capability
- Oversight of general shift operations and scheduling
- Administrative duties

Each District Chief position is assigned a particular operational responsibility:

DC 1 – Central District, Vehicle Maintenance

DC 2 – Southwest District, Employee/Unit Scheduling

DC 3 – Northeast District, Station/Building Maintenance

DC 4 – Northwest District