The third decade of the Tidewater EMS Council (1994‐2004) began and ended much the same – the
organization reorganized to address the changing landscape of EMS. In between, new medical devices,
preparedness, terrorism, quality improvement and ambulance diversion were major themes.

As the third decade began, under leadership of President Donald A. Haupt, Jr., the council modified and
added several new committees. Notably, the Mobile Intensive Care (MIC) Committee, that had served
the council since the 1970’s and fostered the development of advanced life support (ALS) in the region,
was changed to the Prehospital Care Committee. This change reflected the organization’s desire to
emphasize a greater range of system components such as resources, public education, disaster,
leadership, research and dispatch. That committee also began annual meetings with the emergency
department nurse managers from throughout the region.

The number of EMS agencies and ALS provision in the region jumped at the beginning of the third
decade. Between 1989 and 1994 the number of EMS agencies in the region increased from 49 to 61. At
the same time the number of agencies providing cardiac or paramedic level ALS care increased from 20
to 32. This increase in ALS was mainly in Western Tidewater and the Eastern Shore.
Trauma patient destination took on new meaning. What began as a general discussion of the best
destination for trauma patients during the early part of the council’s third decade gave way to a full
blown state legislative requirement for trauma triage, formal regional trauma triage plans and quality
improvement processes. The region’s first trauma triage QI committee met in 2001.

EMS Staffing and Support

Daytime staffing was the main topic for the new Western Tidewater EMS Council, chaired by Charles
Darden, which formed in 1994 as a subcouncil under TEMS using the Eastern Shore EMS Council model.
After several years of discussions and proposals to Southampton and Isle of Wight Counties, both
counties adopted strategies for staffing. In 2000 Isle of Wight County began hiring paid EMS workers to
support the county’s two EMS agencies. In 2001 Southampton County sought proposals for daytime
EMS coverage and awarded a contract to Medical Transport. The Western Tidewater EMS Council went
dormant soon after.

The council continued its annual EMS family picnic and awards program which grew to around 600
attendees at Chesapeake City Park. In 2001, the picnic moved to the Virginia Zoo in Norfolk where
attendance grew to around 900 in 2004. Other promotional activities during the decade included multi‐
agency EMS Week mall displays, wrecked car displays encouraging seat belt usage, mass CPR training,
Rotary Club and other community presentations, and EMS Night at Harbor Park.
Trying to address a concern that “too many people were calling 9‐1‐1” the council published 20,000
copies of a brochure called 5 steps to Manage Medical Emergencies and placed them in ER waiting
rooms.

An Emergency Medical Dispatch (EMD) committee developed a standard curriculum for the region’s 9‐1‐
1 communication centers and during the decade most localities adopted some version of EMD. The
committee helped teach EMD classes and also created a standard instructor‐trainer curriculum.
The Tidewater Regional Technical Rescue Team held annual heavy and technical rescue schools and
celebrated its 10th school in 1994. By the end of the decade, FEMA support enabled construction of a
much improved training site at the Virginia Beach Fire Training facility.

At the State Level

During the council’s third decade there was a proposal to incorporate EMS and fire into a Department of
Public Safety. After public hearings and outcries EMS was later withdrawn from the proposal. The 1994
Virginia EMS Symposium held in Norfolk was attended by 1300 registrants and staff and by 1997 the
number hit 1500 and continued to grow.

In 1995 Virginia rolled out the new assessment‐based national standard EMT‐Basic curriculum and the
EVOC requirement began. In 1996 long time state EMS director Susan McHenry retired and
consolidated EMS test sites began. In 1997 Gary R. Brown was appointed state EMS director. Numerous
attempts to increase the $2‐for‐life state EMS funding to either $3 or $4‐for‐life were tried and failed
before $4‐for‐life finally passed the General Assembly and signed by the Governor in 2003.

A large statewide study of regional EMS councils by EMSSTAR in 1998 reaffirmed the need for regional
councils but encouraged accountability and changes to promote sharing of best practices. Also in 1998
the state EMS for Children program began. In 1999 the state began to look at using the national EMT‐I in
place of the cardiac tech program, and the future of the shock trauma program was in question.

By 2000 EMS data reporting was required either by submission of paper reports or electronic data. In
2003 Virginia Office of EMS moved from its suburban Glen Allen location to the health department
building in downtown Richmond. The EMS community was concerned with parking and access. In 2004
the General Assembly’s JLARC completed a comprehensive statewide EMS study.
A process to regulate and re‐designate regional EMS councils started in 2004.

Sadness and Tragedy

The regional EMS system was saddened by the passing of two well‐known figures: Frank M. Yeiser, Jr.
MD died in 1995 and James M. Wagenbach died in 2003. Yeiser’s accomplishments were highlighted
during the council’s second decade.

Wagenbach was the long time Franklin City fire chief who retired in 1998 after 33 years of city service.
He was an original EMS steering committee member which eventually became the TEMS Council, and
was a TEMS charter director who served for 28 years. He was recognized near and far as an EMS
instructor and for his contributions to the American Heart Association as a BLS instructor, instructor
trainer and affiliate faculty. In 1995 he was named to the AHA Hall of Fame. Following his death, the
TEMS board renamed its annual EMS instructor award in Wagenbach’s honor.

Sadly, in 1996 two firefighter line of duty deaths occurred in Chesapeake. There was an outpouring of
sympathy and support from the region’s public safety community and numerous interventions by the
critical incident stress debriefing team. The tragic event led to improvements to the city’s radio
communications and building inspection practices. That year also marked the 10th anniversary of the
regional CISM team and the Tidewater Regional Technical Rescue Team.
The council’s third decade was also the time our nation became all too familiar with terrorism and mass
shootings.

• The first World Trade Center bombing: 1993
• Oklahoma City bombing: 1995
• Columbine High School shooting: 1999
• 9/11 attacks on America: 2001.

The Virginia Task Force 2 Urban Search and Rescue Team, headquartered in the Virginia Beach Fire
Department and comprised of responders from throughout Hampton Roads, responded to OK City and
the Pentagon.

In 1999 the great Franklin Flood hit and challenged EMS and public safety response for several months.
The flood sparks steps to develop a statewide mutual aid agreement.

Preparedness Ramps Up

Perhaps with a bit of foresight, in 1994 the council obtained a state RSAF grant to purchase 10 mass
casualty trailers, one for each locality. The acquisition was rocky as the original vendor defaulted after
building 6 of the trailers and their quality was questionable. However, during 1995 a second vendor
completed the project. Chesapeake Fire Department led the way and designed the original interior
layout and stocking plan that was adopted by all. By 1997 five trailers were stocked and in service;
others followed.

The council formed its first disaster committee in 1995 which immediately published a regional MCI
plan, modeled after a similar plan from Virginia Beach EMS. During the next revision several years later,
a pocket size edition was also created and distributed to all EMS responders in the region. “Triage
Tuesday” was recommended by the committee.

In 1999 planning for the Hampton Roads Metropolitan Medical Response System (MMRS) began for the
16 jurisdictions of the Hampton Roads Planning District Commission (HRPDC). Hampton Roads was cited
by federal authorities as “cutting new ground” with a regional multijurisdictional MMRS program.
After the HRPDC created the original MMRS plan it sought a partner to implement and operationalize
the plan. In 2001 TEMS entered into an agreement with the HRPDC to manage the MMRS program in
close cooperation with the Peninsulas EMS Council. The HRPDC commissioners agree to an annual
sustainment contribution to the MMRS program of 20 cents per capita to help replenish expired
antidotes, provide program management and oversight, and implement the MMRS plan. William
Ginnow was hired by TEMS as the MMRS program manager in 2002. Probably as a result of the 9/11
attacks, federal funding for the MMRS program, originally anticipated for only one or two years,
continued throughout the third (and fourth) decade of TEMS.

The MMRS planning encouraged the TEMS and PEMS regions to combine their separate MCI plans to
facilitate multi‐region MCI response. The plans were combined in 2001 and a TEMS‐PEMS MCI
workgroup continues to the present.

WMD antidote kits were assembled and distributed in 2002 to EMS/fire departments and hospitals. A
strike team formed and trained for several years starting in 2002 and became operational in 2004. Early
on the MMRS program also purchased a considerable amount of strike team equipment, hospital
decontamination systems, and responder PPE.

Ambulance Diversion

In 2002, it appeared emergency department overcrowding and ambulance diversion was at its worst.
Attempting to address the issues, a “round robin” patient distribution concept was added to the existing
ambulance diversion policy and TEMS joined several other EMS councils in utilization of EMSystem, a
web‐based ambulance diversion/hospital bed status program. Into 2003 the diversion problems
continued but were better documented using the web‐based system and this enabled a certain amount
of “peer pressure” on the hospitals indicating highest amounts of diversions. EMS and ED leadership
were in unison that the issues needed to be addressed at hospital corporate levels. This eventually led
to a major regional fact‐based diversion meeting in 2004.

A new Governance Committee was added by the Board of Directors as a result of a consultant’s study
showing the need to improve governance, board diversity and board development. Also, a new main
EMS committee was formed: the EMS Medical Operations Committee representing the EMS leadership
throughout the region and other stakeholders such as hospital pharmacists, public health, ED nurses and
special operations.

Virginia‐1 Disaster Medical Assistance Team formed in 1974 as a partnership between Norfolk Fire‐
Rescue, York County Department of Life Safety and the Virginia Office of EMS, with TEMS providing a
home base and administrative support. Sentara Norfolk General and Riverside Regional Medical Center
were designated as Regional Healthcare Coordinating Centers (RHCC), as part of a new federal Hospital
Preparedness Program, with roles to be refined in the coming years.

Other Notable Events

During the council’s third decade, EMS equipment and medications changes improve assessment and
treatment choices which continue to the present such as (1995) pulse oximetry, (1997) aspirin and
(2002) CPAP, needle‐safe devices and bi‐phasic defibrillation.
Also, during the council’s third decade:

1994: Rose 1, a converted golf cart, is used for special event patient movement. “Rusty” Blow is named
as operations manager for Medical Transport. Multiple volunteer fire departments in Suffolk license as
first responders to improve EMS response times. 2300 attend the annual VAVRS convention in Virginia
Beach.

1995: FLSA issues emerge. Accomack County tells its fire/EMS employees to stop volunteering in the
county. TRTRT suspends training due to FLSA issues.

1996: TEMS obtains regional CLIA waiver for glucose monitoring devices for 9‐1‐1 EMS agencies. Norfolk
purchases the Tabernacle Church on Granby Street and will convert it into a fire/EMS training center
(dedicated in 1998). Norfolk Southern donates $12,000 to help equip MCI trailers.

1997: Stewart Martin, MD succeeds Donald Haupt as council president. Rob Glover is hired as the first
public safety director for Accomack County. Federal anti‐kickback issues arise related to ambulance
restocking by hospitals. Northampton‐Accomack Memorial Hospital opens a new emergency
department. Don Haupt is named fire chief for Norfolk. Long time Virginia Beach fire chief Harry Diesel
and Chesapeake Fire Chief Michael Bolac both retire. DePaul Hospital installs hyperbaric chambers.
Steve Cover succeeds Chase Sargent at the commander of the Tidewater Regional Technical Rescue
Team.

1998: Sentara Leigh Hospital installs hyperbaric chambers. TEMS publishes a Bereavement booklet
modeled after a similar publication at Sentara. Eastern Shore EMS Council establishes an areawide
infection control committee. Chincoteague separates 9‐1‐1 from the rest of the Eastern Shore and
establishes its own communication center. Region begins development of a template ambulance
restocking agreement in cooperation with other EMS regions, the Virginia Hospital Association and the
Attorney Generals office. That effort concludes in 1999 and all TEMS hospitals and EMS agencies sign
the agreement. Year 2000 (Y2K) concerns develop: is EMS medical equipment going to be impacted?
The Internet domain vaems.org is secured for use by the EMS councils.

1999: TEMS celebrates its 25th anniversary. Atlantic Communications awarded a contract to replace all
HEAR base stations and antennas at the region’s hospitals. Several North Carolina EMS agencies adopt
TEMS protocols. Philip G. Leavy, Jr., MD, a TEMS charter director, steps down after serving 25 years on
the TEMS board. Portsmouth Naval opens a new hospital. The two rescue squads in Suffolk obtain
funding to purchase Andy the Ambulance for public education. Sentara adopts a new logo. Operation
Measured Response Hampton Roads tests some 700 respon

2000: As the new millennium rolls past, the epic Y2K computer meltdown fizzles. The Tidewater EMS
council once again looks at its structure and services. Over the next several years the large number of
EMS committees put in place around 1994 is consolidated over concerns of fragmented decisions.
Kenneth R. Murphy, long time EMS director in Chesapeake, retires. A regional ALS preceptor program is
developed. Norfolk Fire Chief Don Haupt relocates to Coral Springs, Florida. Network Medical Systems
graduates its first paramedic class. Nansemond‐Suffolk VRS celebrates its 40th anniversary

2001: Nansemond‐Suffolk places an ambulance and crew at the Chuckatuck fire station to improve
response times to that part of the city. The Eastern Shore EMS Council holds an art auction. Norfolk
unveils a GIS system linked to fire and EMS calls, zoning, census information, inspections, photography
and maps. Child safety seats are required in ambulances.

2002: Sentara Obici opened a replacement hospital in Suffolk. On move day, 63 patients are transported
using 27 ambulances and 104 EMS providers. Maryann Fitchett succeeds Scott R. Chandler who
completes 21 years as president of the Eastern Shore EMS Council. The new www.tidewaterems.org
website is implemented. Norfolk Fire‐Rescue adopts its new name. A regional EMS Quality Improvement
committee is started, mirroring the success of the Trauma Triage QI committee.

2003: EMS Pioneer James O. Page is guest speaker at the Virginia Beach Emergency Coronary Care
Program’s 30th Anniversary. Hurricane Isabel causes substantial damage throughout Hampton Roads and
elsewhere.

2004: The council’s program and staff are outgrowing the donated offices at the Eastern Virginia
Medical School and a space search began.
Originally published in the Tidewater EMS Council RESPONSE newsletter, March/April 2014