Rural South Carolina EMS Agency Delivering Advanced Prehospital Care Recognized as State’s Small System of the Year
Source: South Carolina EMS Association
COLUMBIA, S.C.—In Marlboro County, where there is no hospital within county lines, EMS providers are responsible for delivering extended, advanced care during prolonged transport times. Marlboro County EMS has been named the 2025 Small System of the Year by the South Carolina EMS Association (SCEMSA), recognized during the Debbie Hession Awards Ceremony at the 2026 SCEMSA Symposium on March 27.
The agency serves approximately 25,500 residents and responds to more than 6,200 calls annually, averaging nearly one call every 90 minutes. In this environment, EMS functions as both an emergency response system and a critical access point to healthcare.
Patients requiring definitive care are often transported to regional trauma and cardiac centers, with transport times ranging from 45 minutes to an hour. During these transports, providers must manage critically ill and injured patients without immediate hospital access.
To meet this demand, Marlboro County EMS has implemented advanced clinical capabilities typically associated with higher-acuity systems. Crews are equipped with video laryngoscopy for airway management, point-of-care ultrasound to rapidly identify internal injuries, and single-channel infusion pumps to ensure accurate delivery of vasopressors and other critical medications.
Marlboro County EMS also carries and administers whole blood in the field, a capability available in only 1%–2% of EMS agencies nationwide. This allows providers to begin lifesaving transfusions for trauma patients before reaching the hospital, which is particularly critical in rural environments with extended transport times.
Additional interventions include mechanical respiratory support and evidence-based trauma care such as tranexamic acid and prehospital antibiotics, helping stabilize patients during prolonged transport.
These capabilities allow providers to initiate definitive interventions earlier in the care continuum, improving stabilization prior to hospital arrival.
The agency’s clinical performance is further reflected in recognition through the American Heart Association’s Mission: Lifeline program, which acknowledges EMS systems that meet established benchmarks in the treatment of heart attack and stroke patients.
Operationally, Marlboro County EMS has also implemented system improvements including body-worn cameras, soft ballistic armor, and modernization of quality assurance and documentation processes.
In addition to emergency response, the agency operates a Community Paramedic program focused on chronic disease management, home visits, and reducing repeat utilization of 9-1-1 services.
In rural systems where transport times are extended and resources are limited, the ability to deliver advanced prehospital care is critical. Marlboro County EMS demonstrates how targeted clinical investment and system design can expand access to care and improve patient outcomes in underserved areas.
About the South Carolina EMS Association (SCEMSA)
The South Carolina EMS Association is a nonprofit organization that serves as the unified voice for emergency medical services professionals across the state. SCEMSA strengthens the EMS profession through advocacy, education and collaboration, supporting providers and agencies in every sector of prehospital care. The association works with EMS leaders, policymakers, educators and community partners to advance the quality and sustainability of emergency medical services in South Carolina. More information is available at www.scemsa.org
