History of Virginia Beach Emergency Medical Services

Since the mid-1940’s, Virginia Beach has been receiving pre-hospital emergency patient care services (EMS) from independently operated volunteer fire and rescue units.

Princess Anne County saw the arrival of its first ambulance in 1947. It was a World War II surplus Army field ambulance and was immediately placed into service as a mobile first aid station. It was used primarily for providing emergency care at the scene of fires, but its role quickly expanded as the local citizens began requesting the services of the ambulance to transport them to area hospitals.

At the time, the small resort town of Virginia Beach was carved out of Princess Anne County and incorporated on March 6, 1906. Its land area totaled 1,600 acres and had a population of 642. On February 12, 1952, Virginia Beach was designated as a city of the second class with a population of 42,277, and the first incorporated rescue squad was formed.

history-3The rescue squads’ missions were set forth to assist the general public by providing first aid and transportation to area hospitals. Princess Anne County Squads transported to hospitals in Norfolk, while the Virginia Beach Rescue Squad made most of their trips to the old Virginia Beach General Hospital located in the town. This was the beginning of what is now the only all volunteer rescue squad system among this nations’ 200 most populous cities. In 1963, at the merger of Princess Anne County and Virginia Beach, the City became a first class city with a total population of 125,000. At the time of the merger, a total of nine volunteer rescue squads served the City. Later that year, a new squad was formed in the Princess Anne Plaza area.

 

Beginning in the mid to late 1960’s, local physicians became more aware of the importance of the services provided by the rescue squads. Interested doctors began volunteering their time to advise the squads in medical techniques and procedures. A centralized training program in cardiopulmonary resuscitation, which began in the late 1960’s, strengthened the association between the physicians and the rescue squads.

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This advancement trend continued into the early 1970’s and culminated in 1972 with the formation of the nation’s first all-volunteer advanced life support program. The Emergency Coronary Care Program not only enhanced the provision of patient care, but also served as the catalyst that moved the squads from an era of simple first aid provision to that of providing sophisticated medical procedures. Medical techniques previously used only by physicians and certain allied professionals were successfully performed by specially trained volunteer rescue squad members known as cardiac technicians. The basic care level providers were also greatly affected when emergency medical technician training courses began in support of the cardiac technicians. These support skills and functions provided to the cardiac technicians were sophisticated, as well. The squads began to “practice medicine” within a system closely associated with physicians, nurses, and other health care providers.

During this developmental period, the administrative mechanism that evolved was a central coordinating and training office. This office was funded, initially, with a federal grant and was directed by two physicians who had served as advisors to the Virginia Beach Rescue Squad – Dr. James P. Charlton and Dr. William A. Dickinson. To maintain close relationships with the volunteer rescue squads, the physicians encouraged the formation of a Rescue Squad Captain Advisory Board in 1972. In 1975, support was gained from the city government to perpetuate the established central administrative and coordinating office. The organization continued to expand, receiving its direction from a formally established “Rescue Council” which formed in 1974 as an outgrowth of the original Rescue Squad Captain Advisory Board. That same year, the Sandbridge Volunteer Rescue Squad was formed, raising the total number of volunteer rescue squads to eleven. Collectively, the squads were answering 8,700 calls per year.

At the same time, a parallel development was occurring. In 1968, the General Assembly of Virginia charged its Board of Health with the overall regulation of emergency medical services. Later, the Board granted local governing bodies the powers to assure provision of adequate patient care services. In May 1979, six years after the initial development of advanced life support in Virginia Beach, the Board of Health required physician direction (medical control) of advanced life support programs.

After the institution of this requirement, the physicians who had become involved with these advanced life support programs, initially as advisors, realized their responsibilities changed. The mechanism for the proper discharge of these responsibilities was absent.

After much consideration and an empirical study, it was decided that the City government would intervene to protect the interest of the medical directors and, at the same time, insure the continuance of the all volunteer rescue concept that the City had supported over the years as a cost effective service. The course ultimately selected to insure these interests was that of the creation of an organization by municipal ordinance to bind these elements.

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The ordinance, passed by City Council on April 13, 1981, was originally seen as a formal means to stabilize and clarify the areas of responsibility for the physicians involved as medical directors, the volunteer rescue squads, who had traditionally provided pre-hospital care, and the City, who traditionally supported the efforts of both. The intent was to unify the service for directing and coordinating pre-hospital care, while allowing a certain amount of independence among the volunteer rescue squads to conduct their general administrative business (intended, to allow independent fund raising, funds expenditures, etc.), so as not to destroy the long standing traditionalism and enthusiasm which was present. The code was intended to provide authority to the medical directors to control the service, not only on their own behalf as the experts in the field of patient care, but on behalf of the City, for their liability and financial interests were also involved.

By this time, the population of Virginia Beach had grown to more than 260,000 and the squads were answering more than 13,000 calls per year. In late 1983, a series of events occurred, causing the medical directors, volunteer rescue squads and the City to make a thorough review of the organizational structure created by the ordinance of 1981. An issue involving medical director control, together with new information revealing unacceptable response times of rescue units, served to generate much concern as to the future of the all-volunteer rescue service. The solution was to centralize the management approach, to streamline the policy-making functions, and to combine manpower resources to staff ambulances to insure ambulance response. After several months of reviewing the alternatives, the staff, medical directors and Rescue Council decided to recommend to the City Manager the establishment of a revised ordinance, which would centralize management of the rescue services under a unified organization. In 1984, an independent division of emergency medical services (under the executive department) was created which combined a single medical director and all the volunteer rescue squad members within one organization headed by a director.

In March of 1988, the volunteer rescue squads launched the first-ever volunteer recruitment campaign. Full-page ads were displayed in The Beacon and five donated billboards urged prospective members to join – to experience the excitement and compassion found in volunteer rescue work. The campaign was a huge success. The squads received 372 inquiries – nearly double the number from the previous year. City-wide, squad membership increased from 410 in 1987 to 650 in May of 1989.

In 1990, the division had grown in numbers, equipment and visibility and in July, the agency was elevated to the status of Department by the City Council. Throughout the 1990s, the department strengthened its membership through constant recruitment and its capabilities by state of the art equipment acquisition. Specialty teams were created (SAR, Bike and others) and the responsibility of lifeguard contract oversight was assumed.

In early 2000, in partnership with the Fire Department, the Emergency Response System (ERS) was formed. This initiative is aimed at fully utilizing all of the combined resources of advanced life support providers in both departments to provide increased services. In 2004, to further strengthen response capabilities in the face of the steady rise in the demand for services, career paramedics were added to augment the volunteer rescue squad efforts.

Today, the department serves a population of some 440,000 residents. It boasts 33 ambulances, 5 squad trucks, 6 boats, 10 zone cars, support & command vehicles, a state-of-the-art dive truck and locating equipment (side scan sonar). The volunteers continue to contribute their time, which is valued at some $6 million each year; have assets valued at $5 million; and fund raise $2.1 million each year. They respond to over 34,000 calls each year. Virginia Beach EMS still does not charge patients for services and the customer satisfaction rating is around 97%. With over 700 volunteers, augmented by over 20 career paramedics and supervisors, Virginia Beach EMS remains the largest volunteer-based EMS system in the country.

Contact Information:
Virginia Beach EMS Headquarters and Training Center
4160 Virginia Beach Blvd.
Virginia Beach, VA 23452
Phone: (757) 385-1999
Fax: (757) 431-3019