WE’VE COME A LONG WAY BABY!
“On June 4, 1869, America’s first ambulance service went into operation from Bellevue Hospital with a driver, a surgeon, a horse and equipment including a stretcher, a stomach pump, bandages and sponges, handcuffs, a straight-jacket, and a quart of brandy.” (borrowed from TheBoweryBoysHistory.com https://bit.ly/4gabgr2) Mid 20th century ambulances were often morticians and their hearses which offered no room for medical treatment enroute to the hospital.
New York has a solid history with ambulances. Today there are more than three hundred (paid) ambulance organizations in the state; there are over 6,000 employed EMTs and Paramedics. In many areas of the state, volunteer (non-profit) crews also answer the call for help. The training to be an EMT, whether paid or volunteer, is the same – just as the responsibility for saving lives is the same. There may be a marked difference in hours and commitment, but the service provided still saves lives and reduces pain and suffering. Several “volunteers” do this to help their communities; many go on to professional (paid) jobs in the field.
The training for each EMS level is the same whether you plan to do the job as a volunteer or as a paid professional. Times have changed from the days of first aiders to professionally trained Emergency Medical Technicians and Paramedics. Several volunteer organizations sponsor youth squads who learn first aid and often progress to become Certified First Responders. Volunteer ambulance corps often help to meet the needs of a community as well as foster the love of helping neighbors in their times of need.
NYS Article 30 of the Public Health Law makes very distinctive rules about the scope of practice, education, and medical intervention for each category of provider. Todays’ EMT must take a minimum of 150 to 180 hours of instruction in basic life support and transport; Paramedics study up to 1,800 hours of Advanced Life Support and other procedures. There is a core mandate for physician oversight (Medical Directors) to help guide EMS practitioners with oversight and compliance. Professional nurses are rare on the ambulance and often used only in certain critical cases.
EMT candidates must be 17 by the last day of the month of the scheduled exam. Certified First Responders, popular in volunteer squads, must be at least 16 before the certification exam. There is no set maximum age for EMT or Paramedic so long as the ability to perform all duties is proven. The State Emergency Medical services code requires that there have been no criminal convictions that could be harmful to a patient and the public.
At minimum, EMTs are responsible for assessing the patient during transport, doing CPR, supporting airway management, administering bleeding control, and how to manage certain critical medications. ALS Paramedics (Advanced Life Support) often treat the more critical patients with intubation, cardiac monitoring, defibrillation, emergency drugs, and IVs. The ambulance rolls with a minimum of at least one EMT in the back to treat the patient, while paramedics address the more critical cases.
Today’s EMS system works more like a portable emergency room than the original horse and buggy or hearse. Kudos to the training of our EMS personnel and the oversight of the NYS Department of Health.
I'm a former NYS EMT and still part of an EMS & FD family. I like to think I can write ;)
