Part II of III - View Part I - View Part III

This is the second installment of a multi-part article on the history of NYC's emergency medical service.

By 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 most agencies.

A 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 for recovery.

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.