History of Tri-Community South EMS

From the time the first settlers arrived in southwestern Pennsylvania until about 1970, no one heard the term "Emergency Medical Service."

In a medical emergency, a patient had two ways of getting care. First, the family physician could come to the patient. Second, the patient could call for an ambulance to take him or her to a hospital. Optimally, the physician would come first, provide immediate treatment and stabilization, then call for the ambulance for transport.

The ambulance, owned by the hospital, police department, fire department, or local funeral home, provided nothing more than a quick ride to the hospital. It would be staffed by a driver, and possibly an attendant, who may have had some first aid training.

In general, though, no care would be given to the patient by the ambulance crew. According to the wisdom of the day, only physicians and nurses were qualified to provide medical care.

EMS Concept Originated From Vietnam War Experience

The concept that providers other than physicians and nurses could provide this care came out of the Vietnam War experience.

In southeast Asia, critically wounded American military personnel were surviving injuries that would have been fatal at home. The difference was the medic: A specially trained provider who gave immediate care and stabilization on the battlefield and during transport to the field hospital.

Back at home, a few critical care physicians understood the implications. One of these was Dr. Peter Safar of the University of Pittsburgh. In 1967, he helped start Freedom House Ambulance Service, using "unemployable" black residents of Pittsburgh, some of them ex-Vietnam medics, to provide a new kind of ambulance service to city neighborhoods. Instead of rushing the patient to the hospital, the ambulance rushed the care to the patient. It worked. In Pittsburgh and other cities across the nation, emergency medical services were born.

Beginnings of EMS in the South Hills

For its first half-decade of existence, EMS was almost exclusively an urban experience. By the mid 1970s, however, the medical community and municipal officials banded together with citizens to institute EMS systems in suburban and rural communities.

In southern Allegheny County, the effort was led by the League of Women Voters in Bethel Park and Upper St. Clair, with the help of the Bethel Park Jaycees. The driving force from the medical community was Dr. Clara Jean Ersoz, director of the Critical Care program at St. Clair Memorial Hospital.

With the support and cooperation of the officials of Bethel Park, Upper St. Clair and South Park, a study commission was formed in 1976 to investigate options for providing EMS to these three communities. Medical guidance and research assistance came from Dr. Ersoz. After exploring several options, this advisory board determined that the best way to insure compliance with the standards which had been set was to have the communities themselves own, operate, and manage the ambulance service.

This recommendation was widely supported by the officials of the communities. An administrative compact was signed under the provisions of the Intergovernmental Cooperation Act of 1972, officially bringing Tri-Community South EMS into existence. The system was to be governed by an Administrative Committee comprised of the managers of the communities. Funding was to be provided by user fees, prepaid subscription plans and appropriations from municipal funds and federal and state grants.

Mary Ann Scott Sets Up Pilot Program

The first order of business for the system was to choose a leader. The committee chose Mary Ann Scott, RN, BSN, who had been associated with EMS since its inception. As a Head Nurse of Presbyterian University Hospital's Critical Care Unit, she assisted in the training of the first emergency medical technicians and paramedics for the Freedom House Ambulance Service.

Later as Patient Care Coordinator at Forbes Hospital System, she assisted in developing course content for the first Allegheny County paramedic classes at Columbia and North Hills Passavant Hospitals, and assisted in teaching these classes. This experience led to a position as the training coordinator at the Emergency Medical Service Institute of Southwestern Pennsylvania, then to a faculty position at the University of Pittsburgh, where she assisted in setting up the pilot program for the first Department of Transportation paramedic curriculum, which, though revised in the early 1990s, is still the foundation of paramedic training in the United States today.

In 1975, Mount Lebanon police chief David Varrelman called on her experience to help design and start operations for a multi-community EMS system in a pilot program which led to the creation of Medical Rescue Team South. With the success of the pilot program, and the establishment of MRTS, the officials of Bethel Park, South Park, and Upper St. Clair asked Mary Ann if she would lead the service which was envisioned for these communities.

Tri-Community South's First Director

As the director of what was now named Tri-Community South EMS, Mary Ann undertook the task of forming a budget, developing operating procedures, securing equipment and hiring personnel. The original personnel costs of the system were provided by a grant under the Comprehensive Employment Training Act. CETA grant money provided for 19 full time employees. Volunteers from the community filled out the staff. Federal grant money provided funds for equipment. Medical control was provided by St. Clair Hospital, under the direction of Dr. Ersoz. By late December of 1977, everything was in place.

Tri-Community South Begins Operations

On December 31, 1977 at 11:00 p.m. Tri-Community South EMS went into service with two vehicles, providing Basic and Advanced Life Support services 24 hours a day, seven days a week, with a staff of the director, one supervisor, 18 full-time employees and 30 volunteers.

In its first year of operation, Tri-Community South EMS answered 2,779 calls. Continuing evaluation of call volume and changes in the health care environment has altered the staffing pattern over the years.

In 1985, Tri-Community South EMS began to provide non-emergency transport service. By 1988, this service accounted for about 20 percent of the total call volume.

In 1988, the system was operating with the director, four supervisors, 11 full-time employees, three part-time employees, and 30 volunteers.

In 1988 Tri-Community South EMS answered 3,373 emergency calls. By 1994, four full-time supervisors, one part-time supervisor, 11 full-time employees, 12 part-time employees, and 21 volunteers would be handling 4,013 emergencies and 1,337 non-emergency transports.

In 1994, Tri-Community South EMS began to provide wheelchair van transport service.

In 1996, Tri-Community South EMS joined with Baldwin EMS, Brentwood EMS and Peters Township Ambulance Service in a joint operation named South Suburban EMS. South Suburban provided shared supervision, scheduling duties, staffing, equipment, and vehicles to cover the area in a more economical and effective way. Coverage was adjusted to meet normal call volumes during the 24-hour cycle. Wheelchair van transport services for all SSEMS members operated under the South Suburban banner.

By the end of 1997, the Tri-Community South EMS staff consisted of the director, five full-time supervisors (one as a supervisor of support services), one part-time supervisor, 12 full-time employees, nine part-time employees, 24 volunteers and an office staff of seven. In 1997, Tri-Community South covered approximately 33.5 square miles and 70,000 residents, and answered 4,813 emergency and 1,048 non-emergency calls.

In its first two decades of service, Tri-Community South EMS has responded to 72,671 emergencies, and has done 15,255 non-emergency transports.

Headquarters, Bases and Business Office Locations

The "home" of Tri-Community South operations has moved several times over the years.

The first ambulance base was in the Bethel Park Public Works complex on Slater Road. Tri-Community South EMS shared space in this building with the Bethel Park sewer department and the Teen Job Bank. The building had originally been built as temporary quarters for the police department during the 1967 construction of the Bethel Park Municipal Building. When this construction was completed, the building was reassembled at the public works site, and had a variety of uses until occupied fully by Tri-Community South EMS in 1979. Garage space was provided in the public works garage, with the garages about 50 yards from the base. Though far from optimal, this arrangement would continue in Bethel Park for the next 19 years.

Bases were also provided in South Park and Upper St. Clair.

The South Park base was first occupied on February 26, 1978. It was a garage bay in the police department garages which had been carpeted and furnished. This base would be renovated in 1992 as part of the overall renovations to the municipal complex.

In Upper St. Clair, crews were consigned to various locations in the municipal offices for the first several months, until the relocation of the public works department made an office available. In 1982, space was allocated in a renovated former police department garage. This base was moved in 1985 as part of the renovation of the municipal building. The current base, with completely up-to-date facilities, is located in the area formerly occupied by the police department administration office.

The Tri-Community South EMS business office was originally located in the Upper St. Clair municipal building in an office shared with the director of public works and the township forester. In 1979, space was found in the County Park on Buffalo Drive. Two large but poorly insulated, poorly heated, and non-air-conditioned rooms on the second floor provided sufficient space, but little comfort, and no access for the disabled. With the additions to the Bethel Park Municipal building in 1982, the office moved to better quarters in this new space. Still, the growing volume of business necessitated yet another move.

On June 30, 1997, Tri-Community South EMS celebrated the opening of its new business office and Bethel Park ambulance base in the public works complex, about 100 feet from the former base. Garage space was reassigned to provide for quicker access to the vehicles. Modest, but adequate space has been provided for a billing office, reception area, conference room, offices, staff work space, kitchen, and equipment storage and cleaning areas.

Community Involvement

Tri-Community South EMS has always provided more than ambulance transportation. From its earliest days, the system has been involved in community health care and education.

Cardiopulmonary Resuscitation training to the community began in 1978 with classes for police and fire personnel, scheduled community classes, all day marathon classes, private classes for businesses and CPR "house parties", where instructors teach CPR to small groups in the resident's own home.

Tri-Community South EMS personnel also taught the First Responder course for area fire fighters and citizens. TCS remains a motivating participant in training and support of the Automated External Defibrillator-Police Provider study of the University of Pittsburgh and the Center for Emergency Medicine, and actively supports the current initiative to extend AED training to the public at large.

Community Education and Events

Educational programs include those directed to public and private school students. In 1978, Tri-Community South EMS sponsored an elementary school EMS awareness poster contest. Employees and volunteers visited every school in the three communities in order to introduce the students to the concept of EMS. Middle school students received CPR training from TCS instructors until 1982, when school teachers were taught by Tri-Community South EMS instructor trainers to take over this function. High school students have been able to participate in community leaning programs.

In 1983 Tri-Community South EMS launched the Junior Paramedic program, giving kindergarten children the opportunity to earn a certificate and patch for completing simple emergency awareness and safety projects. Tri-Community South EMS has also conducted EMS awareness programs for local scout and church youth groups as well as many local adult groups.

The system has produced its own video presentation, and is a regular participant at community days, fire department open houses and the annual South Hills Village Health Fair. Tri-Community South EMS has sponsored several community health care events, including blood drives, multiphasic heart screening, the "Jail Bail for Heart", and community blood pressure screening.

In 1978 TCS developed the "Envelope of Life", a complete family medical history form that is kept in the resident's refrigerator to aid emergency personnel in making a rapid and appropriate assessment of an ill or injured family member. The success of this program led to its adoption county-wide in 1980.

Staff Education

The system also maintains a high standard of continuing education for its staff. Virtually all employees and many volunteers are CPR instructors. Some are instructor trainers. ALS personnel must maintain certification in Advanced Cardiac Life Support, Pre-Hospital Trauma Life Support, and Pediatric Advanced Life Support. All personnel must maintain certification in Basic Vehicle Rescue and Hazardous Materials Operations. Employees and many volunteers are trained in trench rescue, high-angle rescue, water rescue, protective breathing apparatus use and aircraft landing zone site safety. Continuing education is required for all personnel.

Tri-Community South EMS was one of the first EMS services in the state to receive the Certificate of Excellence under the Voluntary Ambulance Service Certification Program and maintained VASC until that program was superseded by state licensure. Tri-Community South EMS was an early and vocal supporter of minimum standards legislation, which was finally enacted in 1985 as Act 45 and provided for the licensing of EMS services.

Medical Community Alliances

Tri-Community South EMS works closely with other public service agencies such as local police and fire departments, with shared training, communications and emergency planning. The system has also fostered a close working relationship with other EMS providers. Tri-Community South EMS is a member of the SouthWest Ambulance Alliance, which includes many EMS providers from southwestern Pennsylvania. The system's closest partners are the members of South Suburban EMS. Tri-Community South also works regularly with the two local aeromedical services, Life Flight and STAT MedEvac. Within the medical community, St. Clair Hospital has been instrumental in providing medical control since the very beginning of the system. TCS paramedics function under protocols and procedures provided by St. Clair. The hospital also provides training and continuing education for Tri-Community South EMS staff, and has provided some of the equipment necessary to carry out advanced procedures. St. Clair was the first hospital in Allegheny County to provide direct medical command by dedicated UHF radio channels with EKG telemetry capabilities. St. Clair has also provided community recognition for Tri-Community South EMS.

Twenty years ago, Tri-Community South EMS was established to meet a need for an emergency medical service which adhered to high standards. It has been and will continue to be dedicated to "Service... Dedication... Professionalism."