This is the second installment of a multi-part article on the history
of NYC's emergency medical service.
1969, New York City's ambulance service was part of the many changes
related to the delivery of pre-hospital patient care. However, none
of those changes would have as much impact on the citizens of the
city as what was about to happen. While the number of emergency
responses continued to climb past the 400,000 mark, the number of
hospitals participating in the EMS system had decreased, thus decreasing
the number of ambulances in service on the streets.
In 1970, the New York State Legislature chartered the New York
City Health and Hospitals Corporation (HHC) as a Public Benefit
Corporation to assume the responsibilities of the Department of
Hospitals. The Corporation's stated purpose was to provide high-quality,
dignified and comprehensive care to all-regardless of ability to
pay. The Ambulance and Transportation Division became the Division
of Emergency Medical Services, later shortened to the now familiar
Emergency Medical Service (EMS).
During this time, the United States Department of Transportation
(USDOT) developed guidelines for the training and certification
of ambulance personnel. As a result, all patient care personnel
were upgraded to New York State Certified Emergency Medical Technicians
(NYS EMT). Until that time, the levels of training varied among
New York City EMS ambulance crew consisted of Motor Vehicle Operator
(MVO) and an Emergency Medical Technician (EMT). The MVO did not
provide patient care and the EMT never drove the ambulance. This
severely limited the number of patient care resources available.
So, in 1973, a program was implemented to cross-train all ambulance
personnel. The resulting graduates of this program were called Ambulance
Corpsmen and they could provide quality patient care as well as
drive the ambulance.
For the MVO, this meant learning a new group of skills-bandaging,
oxygen therapy, patient assessment and the application of mechanical
equipment, such as the "Thomas Half-Ring Traction Splint,"
just to name a few. Many of the motor vehicle operators-rather than
face the prospect of additional responsibilities and training-opted
not to upgrade. During the next 10 years, they were phased out or
placed in other positions within the agency. Today, many of the
EMTs, Paramedics and officers who still are working within EMS are
proud to say they started as MVOs.
In 1974, a federally funded pilot program to train Paramedics was
begun in the Bronx, at the Albert Einstein College of Medicine.
A group, consisting of 21 emergency medical technicians, supervisors
and motor vehicle operators, was selected to participate. The graduates
of the program were New York State and Department of Health-certified
EMT-Paramedics. The program, which was hundreds of hours long, consisted
of many different "skill-based," "hands-on"
components. Due to the infancy of the program, the didactic portions
differed from what they are today.
Many of the skills were competency based with no testing procedures
in place. Apart from all this training, the students were required
to spend additional rotation time training in hospital emergency
and operating rooms, learning how to perform certain skills that
only could be practiced on real patients. Upon completion of the
program, the new Paramedics brought advanced medical skills, such
as endo-tracheal intubation, defibrillation and IV therapy into
the streets of New York City.
On July 7, 1975, the first two New York City Paramedic units went
into service at the Bronx Municipal Hospital Center. EMS Paramedics
now were performing skills in the field that once were reserved
for "doctors only." Instead of the patient being brought
to the emergency room, the emergency room was being brought to the
patient. This allowed Paramedics to perform 20-30 minutes of advanced
care prior to transport, greatly improving the patient's chances
The program was so successful in reducing pre-hospital mortality
and morbidity rates that in 1975, with federal grant money, the
Albert Einstein College of Medicine opened the Institute of Emergency
Medicine, designed specifically to enhance and improve the training
levels of pre-hospital care personnel in New York City. In the summer
of 1977, the second class of Paramedics began. This class graduated
the first female Paramedic-Helen Shanes.
The Institute continued training Paramedics until 1984. In 1978,
the NYC*EMS Academy opened (then located on the grounds of Queens
General Hospital Center) and began training, as well as re-certifying,
EMTs and Paramedics. Today, training and education of Fire Department
EMTs and Paramedics continues at the FDNY/EMS Bureau of Training,
located on the grounds of Fort Totten in Bayside, Queens. With some
of the most highly skilled and respected Paramedic instructors in
the EMS community, the New York City Fire Department continues to
produce the best trained pre-hospital care providers in the world.