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History and Heritage / EMS

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

EMS talking to patientThis is the final installment of a multi-part article on the history of NYC's emergency medical service.

Throughout 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 general public.

On 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 process.

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.


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