This is the final installment of a multi-part article on the history
of NYC's emergency medical service.
the 1970s, changes in the delivery of pre-hospital emergency medical
care were taking place in New York City, as well as throughout the
country. In 1972, with call volumes reaching an all-time high, the
first-ever EMS Communications Center opened. It was tied into the
new "Dial 911 for emergency" system that had been established
in New York City.
Requests for ambulance service now were received by a Police Department
operator and routed to an EMS Call Receiving Operator (CRO). The
CRO would take the information and relay it to a dispatcher on a
handwritten card by means of a conveyor belt system. The CRO was
trained to and often would remain on the line with the caller, giving
first-aid instructions until the ambulance arrived.
Dispatch and control of all emergency ambulances, both municipal
and voluntary, now were being handled from one centralized location.
This greatly reduced the communications problems that had been prevalent
in the earlier years and significantly decreased ambulance response
times, as the annual call volume began to climb toward 500,000.
The 1970s brought many changes that affected the lives of all New
Yorkers. As America's role in the Southeast Asian conflict came
to an end, thousands of military-trained "Medics" returned
home to the United States, many of them to the New York City area.
These Medics were fresh from the battlefield and well-trained in
pre-hospital emergency medical care. They brought with them lifesaving
skills and equipment designs developed for use by soldiers in wartime,
such as Military Anti-Shock Trousers (MAST), reeves stretchers and
plastic IV containers.
These skills and training eventually were put to use on the streets
of New York City, as policymakers here and throughout the country
began to realize the benefits of having such expertise available
to the public in the pre-hospital setting. The scope of the Paramedics'
training became more defined and advanced as doctors and surgeons
who spent time on the battlefield began to develop programs and
protocols that eventually would bring new lifesaving skills to the
October 10, 1977, EMS moved out of the overcrowded office space
that it occupied in a Manhattan municipal building and established
its own headquarters in Maspeth, Queens. During this time, a new
communications system was developed and installed through federal
funding, which provided state-of-the-art, computerized, digital,
communications consoles and monitors. Six UHF radio frequencies
were dedicated for ambulance dispatch and Mobile Data Terminals
(MODATs) were installed in every ambulance to monitor unit availability.
In 1981, the MODAT system was replaced by a more modern Computer
Aided Dispatch system (CAD), which remains in use today. The new,
second-generation CAD system now in place allows for information
to be sent to and from an ambulance via computer, eliminating the
need for a large percentage of verbal communications between the
dispatcher and the crew.
By this time, EMS had become the largest provider of pre-hospital
emergency medical care in New York City and, on December 7, 1977,
then Mayor, Abraham Beame, issued executive order #96, designating
the Emergency Medical Service as the coordinating agency for emergency
medical care in the City of New York. Executive Order #96 recognized
EMS as the "primary provider of pre-hospital emergency medical
care" and charged it with the responsibility for establishing
an EMS system and coordinating all EMS activities within the city.
In 1978, with call volume and mortality rates on the rise, a hospital
categorization project, known as the "Manhattan Plan," was begun.
Its purpose was the designation of critical patient care categories
and the selection of hospitals within New York City with the necessary
facilities for handling such patients. The plan designated several
hospitals as "Specialty Referral Centers." These facilities specialize
in a particular area of expertise and include trauma, burn, snake
bite, replantation and hyperbaric centers. The plan has allowed
countless lives to be saved by eliminating a step in the treatment
Widely recognized as the largest and most sophisticated EMS system
in the world, the New York City Fire Department's EMS Command continues
to advance into the future with major strides. Our most important
goal continues to be the consistent provision of the finest, most
advanced, pre-hospital care. With the dedicated men and women of
the FDNY EMS Command continually offering their expertise to the
system, that goal will not be difficult to achieve.