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Funding stability, education transition and Frank Yeiser were hallmarks of the Tidewater EMS
Council’s second decade.

In 1989 Joseph T. Mullen, MD, Professor and vice chair of the EVMS Department of Surgery, and
former council president, said “once the Council organized EMS, other services such as surgery and
trauma care organized to provide a true systematic approach to patient care.”
During the second decade the TEMS region continued to organize and refine. Nightingale had
successfully proves itself during a two-year pilot program and purchased its second, larger helicopter.
The universal 9-1-1 number was implemented. The Virginia Beach-Norfolk cardiac and paramedic
training courses became a regional training program, and were transitioned to the Tidewater
Community College. Regional CISD team and technical rescue teams were formed. A statewide mutual
aid frequency was installed in all ambulances across the region. Triage tags were purchased for all
ambulances. The Shock Trauma training program was widespread and helped fill advanced life support
needs on the Eastern Shore and Western Tidewater. Hospital “overload” became a problem. The idea of
“free-standing” emergency departments prompted the first ambulance patient destination policy. The
regional poison center expanded and computerized its services, only to cease operations towards the
end of the decade. The third and fourth editions of regional medical protocols were implemented. A
regional mass casualty plan was implemented. Emergency nurse managers and emergency medical
dispatch committees were formed. An annual regional EMS awards program began and when combined
with a family picnic, attendance grew steadily to more than 500. Personal computers and electronic
communications are added to the TEMS office. Phillip G. Leavy, Jr., MD succeeded Joseph T. Mullen, MD
as council president and presided over the council for most of its second decade.

Funding Stabilizes

The most significant event of the early 1980’s to impact the council and statewide EMS system
was passage of the “One-for-Life” program. At the urging of EMS stakeholders, and especially regional
EMS representatives, the General Assembly in 1993 passed an appropriations bill adding $1 to the
motor vehicle registration. The funding provided a grant program for EMS agencies, a return to
localities, training support, and state and regional program support. One-for-Life provided a stable and
ongoing source of funding for TEMS and other regional EMS councils, originally established using federal
grants which had ended. EMS stakeholders successfully lobbied for an increase to $2 for life in 1990.
During the second decade the council obtained funding from other sources as well: the
Tidewater Hospital Council supported printing of protocols, communications manuals and mass casualty
tags. Various grants from the Norfolk Foundation and others funded training equipment and
communications upgrades. The Eastern Shore EMS Council held annual radiothons which raised money
for training and equipment.

Educational Transition

Virginia’s advanced life support training originally began in Virginia Beach as the Emergency
Coronary Care Program in the 1970’s. By the late 70’s regional ALS training had grown into a regional
cooperative effort of Virginia Beach EMS and Norfolk Paramedical Rescue Service who jointly conducted
annual Cardiac Technician and Paramedic (bridge) courses held at EVMS. Substantial credit for these
programs goes to coordinators Doris Foster, Virginia Beach EMS and David Palmer, Norfolk PRS. The
council’s Mobile Intensive Care Committee provided oversight.
Citing the need to better support regional training the council added an EMS training
coordinator in 1983. In 1984 the council assumed coordination of the two annual courses in cooperation
with Virginia Beach and Norfolk. Now including students from throughout the region, the limited
capacity of the courses and insuring mentored clinical experiences for students was becoming a
concern. In 1985 a training advisory committee investigated alternatives to improve ALS education
including an EMS degree option. Discussions with EVMS, ODU, TCC and a site visit to the Northern
Virginia Community College eventually lead to transition of the regional cardiac and paramedic courses
to the Tidewater Community College.
The TCC EMS Technology program began in late 1985 under the direction of program head
Clinton Franklin. In early 1986 the first 40 students enrolled in Introduction to Cardiology, the first
segment of the cardiac tech program. Not without some transition pain, the TCC program eventually
took off when the EMS program was transferred from industrial and public service technologies to the
health science technologies program. In 1991, the college awarded its first Associate in Applied Science
in EMS degree. Substantial credit for the growth and stability of the EMS program at TCC goes to Lorna
Ramsey, the second and current program director.

The Yeiser Decade

The second decade of Tidewater EMS could be described as the Yeiser decade. Frank Marx
Yeiser, Jr. was the founder of Physicians and Surgeons Ambulance Service in Norfolk and first
superintendent of Norfolk Paramedical Rescue Service. In 1977 he exited EMS to attend medical school
and emergency medicine residency. He returned in 1993 and EMS in Tidewater changed forever.
Described by then Norfolk city manager Jim Oliver, Yeiser was “brilliant, compassionate and
always in touch with the human condition.” Everyone around Yeiser knew his mantra: always do what’s
best for the patient.

Among Yeiser’s Accomplishments:

  • Attending ED physician, Emergency Physicians of Tidewater
  • Operational medical director for Virginia Beach EMS, Norfolk and Nightingale. Built a
    full-scale helicopter cabin model for training.
  • Oversaw the merger of Norfolk Fire Department and Norfolk Paramedical Rescue.
  • Chaired the regional OMD committee.
  • Led an effort between the Tidewater and Peninsulas EMS regions to standardize drug
    boxes and protocols.
  • Instrumental in regional protocol revisions.
  • First state EMS medical director.
  • Operational Smile.
  • Accomplished woodworker.

In 1987 the state EMS symposium was held in Norfolk and Yeiser chaired the steering
committee. He personally oversaw the selection of topics and faculty, and training for local “hosts”. The
logo which he pushed showed various components of the EMS system but highlighted the “patient” as
the priority. During the symposium that year Yeiser received the annual Governor’s Outstanding OMD

Following two years as the first state EMS director, the Governor’s OMD award was named in
Yeiser’s honor in 1991. That same year, during a regional legislative breakfast, Yeiser explained to
members of the General Assembly how EMS must transcend political boundaries, must be consistently
available throughout the Commonwealth, and must, above all, hold the patient as the number one

Yeiser died of a heart condition in 1995 at the age of 48. In addition to a private family service, a
memorial was held at Town Point Park in Norfolk attended by more than 1000 family, friends and

Trauma System Development

C. William Schwab, MD was the first trauma service director at Norfolk General. He served on
state committees and helped guide the early development of criteria and designation of several trauma
centers in the Commonwealth. Under his guidance, the trauma service provided the first of what would
become annual trauma symposiums, initiated the prehospital Trauma Score, and established an
outreach program to provide patient outcome feedback to referring physicians. Schwab was also
medical director for the region’s earliest Advanced Trauma Life Support courses for physicians. Although
he set the wheels in motion for the designation of the Tidewater region’s own trauma center, he
relocated to New Jersey before it would happen.

In late 1985 Norfolk General Hospital was designated as a level I trauma center. R Adams
Cowley, father of “the Golden Hour” concept, was keynote. Wendy J. Marshall, MD, the center’s new
director of trauma, spoke about individuals who were instrumental in its formation. It reads like a who’s
who of the Tidewater EMS Council: former council president and surgeon Robert Brickman, MD,
Nightingale project director and council director Ed Holmes, former TEMS director and multiple trauma
service director C. William Schwab, MD, EVMS surgery chair James F. Lind, MD, former council president
and surgeon Joe Mullen, MD, executive director Kent Weber and Frank M. Yeiser, MD.
From 1985 through 1989 the council and trauma center sponsored ongoing PreHospital Trauma
Life Support Courses. Seventy-two ALS providers were PHTLS trained in 1995.
L. D. Britt, MD, MPH succeeded Dr. Marshall as trauma director in 1987.

Mass Casualties Test System

In 1987, the region’s mass casualty response was put to the test when a Norfolk Southern
excursion train derailed in the Dismal Swamp in a remote location near the Chesapeake/Suffolk line.
Over 175 patients were transported to six hospitals by 10 EMS agencies using 29 ambulances and five
helicopters. Then Chesapeake EMS Director, Kenneth R. Murphy, credited “years of planning and
regionalization of Tidewater EMS agencies a key to the successful management of the incident.”

Another noteworthy mass casualty event during this decade occurred during the Greekfest riots
in Virginia Beach in 1989. That Labor Day weekend saw surges of revelers jamming the oceanfront
streets on Saturday night. Rioting and looting broke out. Virginia Beach EMS declared a “STAR Team”
alert (Special Trauma and Rescue) and evacuated Rescue 14, the oceanfront rescue station, two nights
in a row. EMS set up triage and treatment areas at the Dome and Pavilion. Twenty-one ambulances,
two squad trucks and five zone cars were assigned. Eighty EMS personnel staffed the Pavilion site.
Nightingale staged at the Pavilion. Injuries poured into triage areas as rioting continued through the
night. By 6 am the streets had been secured by police and National Guard. Similar rioting occurred again
on Sunday night, though contained quicker, and again injured patients poured into the triage areas.

A month later a third major regional MCI response was needed. In October 1989 a fire at the
Hillhaven Convalescent and Nursing Center in Norfolk killed twelve Hillhaven residents and 141 others
were transported to seven area hospitals and 8 nursing homes. The MCI response included 26
ambulances from seven localities, plus the Navy and Tidewater Regional Transit. Donald A. Haupt, Jr.,
then Superintendent of Norfolk Paramedical Rescue Services, attributed quick mutual aid response and
the close working relationships of EMS leadership throughout the region as key to the operation’s

Response Newsletter Begins

Perhaps one of the more visible aspects of the TEMS Council, starting in the second decade, was
creation of the newsletter Response. In 1983 both Nightingale and the council were investigating a
newsletter. The two organizations merged efforts and in 1994 began what has become the longest
continually published EMS newsletter in Virginia if not the US. (In 2008 Medical Transport, LLC became
the council’s Response partner.)

As the council’s second decade came to an end, Donald A. Haupt, Jr. succeeded Philip G. Leavy,
Jr., MD as council president, Medical Transport introduced STAT-1, blood borne pathogen training
became standard, Norfolk added 3 new units, Portsmouth transitioned to a paramedic on every
ambulance, Chesapeake added SWAT medics, EMS leaders in Western Tidewater formed an EMS subcouncil, red lights and sirens were debated, a new EMT curriculum was published, Tangier got an
ambulance, and the council initiated mass casualty trailer project.

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