Alpha Four is a 1999 Ford Explorer, with modifications done to allow it to work in a first response role. It has a strobe lightbar package, wig-wag headlights and strobes. It carries the same walk-in equipment that the ambulances carry, and some additional immobilization gear. These units stock some bulk amounts of drugs and supplies so they can stay out and work consecutive calls if necessary.

This vehicle has been removed from service. The paramedic staffing it is now stationed with Johnsonville Rescue Squad, and responds directly on their first-out ambulance during the hours of 0700-1700, weekdays.

Florence County EMS Alpha Four Crewchief is stationed at the Johnsonville Rescue Squad on Broadway Street in Johnsonville. The present Crew Chief is Sgt. Mattt Morris This is a 10 hour ALS first response unit, 7am-5pm. It responds to calls mainly in the Town of Johnsonville, and the rural areas in this lower southeastern side of the county. The assigned Crewchief responds onboard a Johnsonville Rescue ambulance. The Alpha Four Crewchief will accompany the patient to the hospital and provide primary patient care. This unit is responsible for a large section of Highway 378, which is a heavy corridor for beach traffic during the summer months. This unit also backs up Medic Six, Medic Five, Johnsonville Rescue, and Pamplico Rescue, as an additional ambulance provider in their respective service areas.

Quick Response Vehicle (QRV) -- An emergency response medical unit that is equivalent to a standard EMS response unit with only two differences: one paramedic staffs the vehicle, not two; and the QRV has no patient transport capability. This unit is dispatched to scenes where no transport is expected, or to assist a responding ambulance.