Prehospital Care

The Department of Emergency Medicine at Eastern Virginia Medical School (EVMS) offers a broad range of prehospital care opportunities.  Exposure to Emergency Medical Services (EMS) begins during your internship orientation month with an EMS base-station course.  This course provides an overview of local / state EMS rules and regulations and the essentials of radio communications.


In the Emergency Department, our residents are responsible for providing medical command (with attending oversight) for the multitude of agencies that transport to our facilities.  This experience fosters interest and understanding of the capabilities and limitations of our prehospital providers.  Our residents also provide medical oversight for the Sentara Nightingale Air Ambulance that provides critical care and trauma transports from the eastern portion of Virginia and North Carolina.


Our Emergency Medicine residents are required to complete a one-month EMS rotation during their third year.  This intense experience places the resident in the prehospital setting riding side-by-side with experienced paramedics.  The resident learns to interact with patients in their home environment and prehospital providers in the field, reinforcing the core curriculum objectives of professionalism and systems-based practices.  


Residents have the opportunity to fly with Sentara Nightingale Air Ambulance.  Though not required, this experience provides added exposure (from 3,000 ft.) to the complex balance between ground and regional air ambulance assets.  It is the only air ambulance for the area.


For those with an advanced interest in prehospital care, EM faculty can provide additional educational opportunities.  Emergency Medicine faculty serve as Operation Medical Director for the majority of the Tidewater area EMS agencies, including Norfolk, Virginia Beach, Suffolk, Portsmouth and Sentara Nightingale.  As Operational Medical Directors are responsible for ensuring that all aspects of prehospital care are functioning at a high level, opportunities exist for the residents to be involved in  lecturing, oral boards assessment, quality assurance, on-scene response and providing feedback to prehospital providers.


Emergency preparedness and disaster response are a strong focus of the region.   EVMS Emergency Medicine faculty serve as leaders in the development and implementation of emergency preparedness plans with the hospital, region and the state.


Our faculty have both national and international experience on Urban Search & Rescue Teams (USAR) and Disaster Medical Assistance Teams (DMAT).  Faculty have responded to, and provided medical care for, victims of the Haitian earthquake, Hurricane Katrina and numerous other national disasters.  Opportunities exist for the resident physician to learn more about these agencies and even participate in training exercises.


If tactical emergency medicine is of interest, our faculty serve as lead physicians on local SWAT and police response teams.  Opportunities exist to learn more about the medical components of these tactile response teams.


Our faculty has been recognized on multiple occasions for their outstanding contributions to Emergency Medical Services at the local and state level.  In 1987, the state established the “Governors Award for Outstanding Operational Medical Director of the Commonwealth of Virginia”.  The first recipient of this award was Dr. Frank M. Yeiser, one of our beloved clinical faculty.  Since it was established, a member of our faculty has received this prestigious award six times, more than any other single institution in Virginia.  In addition, the local Tidewater Emergency Medical Services (TEMS) Outstanding Operational Medical Director Award, given annually, is named the “Frank M. Yeiser, M.D. Award”, to honor Frank’s many contributions to EMS.


In order to provide prehospital care in an organized, effective and efficient manner, the Tidewater Emergency Medical Services (TEMS) Council was formed in 1974.  The TEMS Council integrates and coordinates resources to ensure rapid response and expert patient care, as well as coordination between more than 70 local EMS agencies and 12 hospitals.  Several of our faculty serve on the Council.  To learn more, go to:  www.tidewaterems.org.

Sentara Nightingale Air Ambulance

Nightingale Regional Air Ambulance began operations in 1982 and is based at Sentara Norfolk General Hospital, the only Level I Trauma Center in Southeastern Virginia. Nightingale was Virginia's first hospital-based air ambulance and the nation's 38th air medical program. To date, Nightingale has safely and successfully transported over 16,000 patients. Nightingale flights consist of scene and the interfacility transfers. Approximately half of all flights involve trauma patients and the remaining transports consist of medical patients with neurological, cardiac or multisystem issues. Nightingale Regional Air Ambulance serves a dual benefit to such critically ill patients: the flight team provides rapid transport to a tertiary care center while at the same time administering advanced critical care support.

The Operational Medical Director (OMD) for Sentara Nightingale is a faculty member of the EVMS Department of Emergency Medicine. Currently, Lori Givonetti, M.D., FACEP, Assistant Professor of Clinical Emergency Medicine, serves as the OMD for Nightingale. Attending Emergency Medicine physicians in the Emergency Department at Sentara Norfolk General Hospital provide on-line medical control for all flights.

The medical flight crew consists of a flight nurse and a flight paramedic, combining both hospital and pre-hospital experience. Nightingale flight nurses are registered nurses with a critical care background and are certified as Emergency Medical Technicians. Nightingale flight paramedics are nationally registered EMT-paramedics with additional training in pediatrics. Medical flight crew members are required to maintain specialty certifications to enhance their knowledge and skill levels.

 An independent helicopter agency supplies the Nightingale pilots, mechanics, and aviation services. The Nightingale pilots are all military trained and have a minimum of 2000 hours of flight time. The Nightingale twin-engine helicopter cruises at approximately 145 mph and assists surrounding hospitals and EMS agencies in an approximate 125-mile radius from its base in Norfolk.

Emergency Medicine residents have the opportunity to serve as observers on Nightingale flights during their one month Emergency Medical Services (EMS) rotation. Flying on the helicopter is optional and strictly the decision of the Emergency Medicine resident.

For more information on Nightingale, call (757) 388-2500 or visit www.Sentara.com/Nightingale .

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Group Governance