The Evolution of Emergency Medical Services in Tidewater Virginia

The Early Development of EMS in Tidewater Virginia

Experiences in managing casualties in Korea and Vietnam demonstrated that effective medical treatment in the field followed by prompt on-going care in a hospital emergency room and appropriate follow-on treatment (ICU, CCU, OR) could significantly reduce morbidity and mortality of critically ill or injured patients. In the early 1970s, federal and local interest focused on developing a systematic emergency medical services (EMS) system for civilians. In 1970, Virginia Beach physicians and rescue squad personnel began planning a program to train prehospital EMS personnel to treat heart attack victims on-site. With funding from the Virginia Regional Medical Program and local contributors, the Emergency Coronary Care Program was launched in 1972.

Federal Funding and the Formation of the TEMS Council

In July 1972, the Tidewater Regional Health Planning Council (TRHPC) convened a meeting of medical, civil defense, public safety, and health officials to discuss EMS planning and development. A steering committee was appointed to establish policies and guidelines. The 1973 Emergency Medical Services Systems (EMSS) Act (PL 93-154) provided funding opportunities, leading to the formation of the TEMS Council as an independent corporate entity in November 1974. The initial Board of Directors included EMS providers and consumer representatives from eight jurisdictions in State Planning District 20 and two counties on the Eastern Shore (Planning District 22).

Building a Regional EMS Communication System

In early 1975, the TEMS Council secured $30,000 in federal funding through TRHPC, which was matched by local hospitals. These funds were used to purchase VHF radio communication equipment linking 14 Tidewater hospitals on a dedicated 155.400 MHz frequency. The Tidewater Hospital Council assumed net control, and the system became operational on April 1, 1975. This marked a significant milestone in establishing a regional EMS communication network.

Expansion of EMS Services Through Federal Grants

In April 1975, the TEMS Council applied for funding from the federal Department of Health, Education, and Welfare to develop a coordinated EMS system in eastern Virginia. By June 1975, the Council received a one-year federal grant of $323,782, which primarily funded the completion of the regional EMS communications system. Additional funds supported the purchase of emergency vehicles and training equipment. Between 1975 and 1980, the TEMS Council successfully applied for and received annual federal EMS grants to enhance the regional EMS system further.

Enhancing Prehospital Care and Rescue Operations

These federal funds enabled the installation of four-channel VHF radios with EMS accessory groups in 78 ambulances, as well as biomedical telemetry mobile and base station radios for advanced life support (ALS) systems in the five-city area. Pager units were also purchased for rescue squads, and funds assisted in acquiring ambulances. On the Eastern Shore, a new antenna tower was erected, significantly improving EMS, fire, and law enforcement communications. Medical Anti-Shock Trousers (MAST) were distributed to each ambulance, enhancing patient stabilization during transport.

The Introduction of Nightingale: Virginia’s First Medical Helicopter

In 1982, the TEMS Council introduced Nightingale, the first hospital-based helicopter ambulance in Virginia. This high-visibility ALS transport unit provided rapid medical transportation, complementing the regional ground and water-based EMS infrastructure.

The Impact of 9-1-1 on Regional Emergency Response

The introduction of the universal 9-1-1 emergency number by the region’s three largest cities significantly improved access to EMS. While facilities, vehicles, and personnel were crucial components, the success of the EMS system relied on the effective integration and coordination of these resources to ensure a seamless continuum of patient care, ultimately reducing morbidity and mortality.

Standardizing EMS Care: Protocols, Training, and Medical Control

During its first decade, the TEMS Council developed and implemented regional standards, including medical protocols, patient record forms, a drug box exchange system, and physician-directed medical control. Regional training programs for cardiac technicians and paramedics reinforced these uniform EMS care standards.

National Recognition and the Future of TEMS Council

Under the leadership of Dr. Robert D. Brickman, who served as Council President and Medical Director for six years, the TEMS Council gained national recognition as a model EMS program. His successor, Dr. Joseph T. Mullen, continued expanding on these foundational achievements. As the first decade of the Tidewater EMS Council came to a close, significant progress had been made, but ongoing advancements were necessary to meet the evolving demands of EMS in the region.