Forty Years of Change for Pennsylvania Chief

Like so many things, it started with a girl.

Designs on the chief’s daughter led high-school junior Fred Trasatti, Jr., to join his local rescue squad in 1965. The courtship didn’t end with a happily-ever-after, but the rescue work did: Today, 4½ decades later, Trasatti is chief of Pennsylvania’s well-regarded Second Alarmer’s Association and Rescue Squad (SARS), a position he’s held since the mid 1970s.

Anyone who got in the game before the seminal “white paper” of 1966 has surely seen a lot change. It wasn’t called EMS back then, and there were no EMTs and paramedics. The job took a first aid card. The local responders were all volunteers. Even as the system matured over the next decade, its early EMTs and paramedics were kept on tight leashes by the ER docs who called their shots.

“We couldn’t do much without calling the hospital,” Trasatti recalls. “We could initiate BLS skills, but we couldn’t do any ALS without permission. It was very ‘Mother, may I?’ With the cardiac patients, we’d just hope to get an order to start an IV, so if something happened on the way in, we’d have a drug route. We didn’t have some of the narcotics they use now, but we had lidocaine, we had sodium bicarb, we had Narcan for overdoses and Valium, which I don’t think ever came out of the box. But for the time, we were really doing it!”

In subsequent years EMS continued to accelerate, locally and everywhere. Second Alarmer’s took over service for Abington Township, tripling its call volume, and added paid crews. Tools and training and protocols advanced, letting providers do more. As chief, Trasatti helped speed progress, requiring CPR training and implementing overnight coverage.

Those cutting-edge efforts continue. More recently Second Alarmer’s partnered with Abington Memorial Hospital to improve systemic care of time-sensitive conditions like STEMI and stroke. Its STEMI alerts have helped slice door-to-balloon times by a quarter to a third. Now the service is involved in a tablet-based telemedicine trial that will let docs see and communicate with patients in transit or even the field. It’s also worked with the hospital to train field providers on LVADs and helped validate a new, faster stroke scale developed by late AMH neurologist B. Franklin Diamond.

That’s all pretty progressive stuff, good for patients and providers too. But a 40-plus-year EMS career doesn’t come without some lows as well, and for Trasatti and SARS that was the 2008 death of their colleague Michael “Boz” Garvin, who died at home after concluding a shift. “That crushed us,” Trasatti says. “He was 39—you never expect something like that to happen.”

Even that tragedy, however, ultimately became a positive for SARS. Upon discovering after Garvin’s death that nearly all his coworkers lacked wills, SARS contacted a group called Wills for Heroes, which helped them all get key legal documents executed.

“That was important, because we’re in a bad business,” Trasatti says. “We all think we’re indestructible, but we’re not. We all get sick, and we all get hurt. So it was an eye-opener, and it felt good because somewhere in the back of my mind I recognized there was a real need for us, not just the public we serve. The squad was good enough to sponsor it. And it wasn’t just for our guys; we offered it to the police and firefighters in the area as well. We got capacity crowds every time.”

That, perhaps, is the best way to sum up a 40-year EMS career: If you do it right, you’re going to help a lot of people—those who deliver it with you as well as those who call 9-1-1.

“I don’t know about other chiefs, but I consider myself lucky,” Trasatti says. “As old as I am, I’m still chief of a very innovative department. My team works hard to make sure things go the right way, and they deserve the credit for the good things that happen. There have been a lot of calls I’m sure would have ended up tragically if not for our intervention. But that’s just what we were trained to do.”