"Notartz" translates as "paramedic". Almost all the 104 German towns with full time fire brigades which provide EMS operate both ambulances as well as EMS tenders like this. They respond together or separately depending on the kind of incident. Often, the fire service EMS operations are performed jointly with other organizations, including (but not limited to) Red Cross, St John, Knights of Malta and Trade Unions. Volunteer fire companies very rarely have EMS capability, but a small number have ambulances and some cities are experimenting with EMS "first responder" cars.
Added by Rob Johnson on 27 October 2021.