Rescue squads began as volunteer crews formed to give first aid and transport before formal EMS existed. The very first volunteer squad was the Roanoke Life Saving and First Aid Crew, organized in May 1928 in Virginia by Julian Wise. In the following years other early squads formed: for example, the Salem (VA) Volunteer Rescue Squad was established in 1932, and North Carolina’s first squads appeared in the late 1930s–1940s (e.g. Winston-Salem Rescue Squad in 1937, Elkin Rescue Squad in 1941, Davidson County Rescue Squad in 1941). Early squads included:

• Roanoke Life Saving & First Aid Crew (VA) – Founded May 1928 (often cited as the nation’s first independent rescue squad).
  
  

• Salem Volunteer Rescue Squad (VA) – Founded Nov. 15, 1932 (today the oldest continuously serving volunteer squad in the U.S.).
  
  

• Winston-Salem Rescue Squad (NC) – Formed 1937 (the first in North Carolina).
  
  

• Elkin Emergency Rescue Squad (NC) – Formed 1941 (second-oldest in NC and oldest active squad in NC).
  
  

• Davidson County Rescue Squad (NC) – Formed 1941
  
  

These and other early squads were created to fill gaps in emergency care. Prior to organized EMS, an accident victim might be carried away by the police or any bystander. In other words, no organized system or authority existed to provide care, so rescue squads evolved to address these deficiencies. Over time, the concept of a combined rescue and first-aid crew spread widely. By the 1960s thousands of volunteer rescue squads existed nationwide. Today’s squads are full-time (often volunteer) teams with trained members on call 24/7. They typically carry radios, medical gear, and rescue tools, and respond to a wide range of emergencies – auto crashes, heart attacks, falls, drownings, entrapments, and countless other emergency calls. In short, a rescue squad now operates much like an ambulance and rescue unit combined, providing on-scene lifesaving care and transport.

The term “rescue squad” can mean different things in different places. In general, it refers to an emergency service that provides technical rescue (rope, vehicle extrication, water rescue, etc.) and often also medical care. A rescue squad may be a standalone volunteer agency or part of a larger department. For example, the Mountain Park Rescue Squad (Surry Co., NC) describes itself as “an EMS and Technical Rescue Agency”, meaning it trains volunteers to perform high-angle, water, vehicle, and other specialized rescues and also runs ambulances. Many rescue squads operate BLS ambulances providing both first response and back-up transport capabilities and usually have their own ambulance to carry patients. In some cities, a “rescue squad” might simply be the name of a heavily equipped fire truck or an ambulance company. In other systems, “rescue squads” are dedicated teams within EMS or fire departments. Emergency Medical Services (EMS) agencies often maintain rescue squads for technical rescues or search-and-rescue missions. In all cases, though, rescue squads carry specialized gear (e.g. jaws-of-life, ropes, boats, shoring tools) and staff trained in rescue techniques as well as first aid. 

There is no one “right” model for delivering rescue services – it varies widely by region. In many rural areas (including North Carolina) local rescue squads are independent volunteer non-profits focusing on both EMS and technical rescue. For example, Burke County Rescue Squad in Morganton, NC is a volunteer squad specializing in wilderness search, water rescue, vehicle extrication, collapsed-structure rescue, and similar tasks, in addition to treating medical emergencies. In other jurisdictions, rescue teams are managed by fire departments: many city fire departments maintain heavy rescue apparatus (e.g. special rescue “squads” or “engines” equipped for entrapment and technical calls). Law enforcement also may field teams: for instance, the Hanover County (VA) Sheriff’s SAR team is a specialized volunteer unit trained to “search for persons who are lost, missing, stranded or injured” in any terrain. At larger scales, states organize regional USAR (Urban Search and Rescue) teams that can be mobilized for disasters.

Globally, models differ too. In the US, volunteer rescue squads and municipal EMS coexist, while in countries like the UK ambulance services are centrally run by the government and mountain or lifeboat rescues are done by separate volunteer organizations. The key point is that rescue service delivery depends on local needs and resources – some places rely on volunteers, others on paid staff, some on fire-based squads, and some on sheriff or state teams.

In Surry County (NC), rescue services are handled by five volunteer squads, each serving a different community. These are: Mountain Park Rescue Squad (State Road area, founded 1983), Elkin Emergency Rescue Squad (founded 1941), Mount Airy Rescue Squad (1961), Pilot Mountain Rescue & EMS (1965), and Dobson Rescue Squad (1981). 3 are medium rescue providers (Mountain Park, Dobson, and Pilot Mountain) and 2 are heavy rescue providers (Mount Airy and Elkin). All five are independent non-profits with the dual mission of technical rescue and ambulance service. Each squad maintains trained volunteer rescuers certified by the state and provides BLS ambulance transport for patients. 

Surry County Fire Departments also support rescue efforts in various ways (some have rescue equipment or trained personnel). Fire departments are increasingly supporting technical rescues with increased capacity. As of September 2025, there are 2 light rescue providers and 3 medium rescue providers that are fire departments. In addition, Surry County EMS has its own Technical Rescue Team of cross-trained paramedics for special incidents.

Pinnacle Fire & Rescue, Station 31, is a special mention. They are treated as a rescue squad in the sense of being a member of SCARS and that they hold primary rescue district in their special rescue jurisdiction.

The rescue squads in Surry focus on the specific needs of their districts – for instance, they train for mountain, water, or vehicle rescues as needed – but all maintain strong EMS skills. Importantly, the squads also back up the county’s EMS: during busy periods they put their ambulances into service to cover calls. In practice, this means when Surry EMS is short on units, the rescue squads’ rigs fill the gap.

In summary, the five Surry County rescue squads are volunteer agencies specialized in technical rescue and basic emergency medical care. They complement the municipal EMS system by focusing on local rescue expertise and lending their ambulances when call volumes spike.