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AMBULANCE SERVICES

AMBULANCE SERVICES began in Cleveland, as in most other U.S. cities, following the Civil War. City Hospital, Lakeside Hospital, HURON RD. HOSPITAL, and ST. ALEXIS HOSPITAL all operated ambulances in the late 19th century. Beginning in the 1880s, the wealthy preferred private ambulances. For non-emergency conveyance, many
funeral homes operated invalid carriages. Early ambulances were horse-drawn vehicles with box-shaped bodies and, later, hard rubber tires and spring suspensions. The rudimentary equipment usually consisted of a stretcher, blankets, and a bottle of brandy. In 1903 Lakeside Hospital introduced the first electric ambulance in Cleveland, which, although it had problems climbing steep hills, answered 750 calls its first year. By 1912 Cleveland benefited from gas-powered ambulances, offered by the local PEERLESS MOTOR CAR CO. and WHITE MOTOR CORP. Styles varied from trucklike vans to luxury limousines. After World War I, only City Hospital provided ambulance service, but of its 3 ambulances, 2 were usually broken down. At a time when municipal funding of hospital ambulances was becoming common in other cities, Cleveland's emergency services were left largely to the CLEVELAND POLICE DEPARTMENT and the CLEVELAND FIRE DEPARTMENT, and by 1920 to over 100 funeral homes. Funeral homes, in particular, were often criticized for not disinfecting their vehicles (usually with formaldehyde) after conveying a person with a contagious disease. In police emergency vehicles, basic equipment was little more than a tourniquet and rubber gloves. Until the 1970s, despite occasional outcries from medical groups, very little was done to improve the training of ambulance attendants, largely because of the lack of state regulations. Vehicle improvements included the electric siren (replacing bells and gongs), colored roof lights (1940s), and, after World War II, 2-way radios. Many ambulances began to carry oxygen. Some even carried trained nurses (see NURSING), although they were not required to by city ordinance.

In the 1960s, when Medicare guaranteed 80% payment of the ambulance fee, private firms began to compete with funeral homes for emergency service. By the 1970s funeral homes, unable to afford compliance with new state regulations and federal wage laws, dropped completely out of the market. By the 1980s most Cleveland SUBURBS were served by private companies; sometimes several communities shared a contract. Compared to other major cities, Cleveland was late in setting up its own ambulance service. In 1968 a study by the METROPOLITAN HEALTH PLANNING CORP. (MHPC) concluded that medical-emergency calls overwhelmed police and fire departments. In 1974, the MHPC implemented a countywide 1-telephone-number service. Working with Mayor Ralph Perk (see MAYORAL ADMINISTRATION OF RALPH PERK), the following year MHPC helped set up the Emergency Medical Service System (EMSS), a division of the public safety department. Using federal and state funds, the EMSS began with 15 modern ambulances, 11 stationed at Cleveland hospitals (see HOSPITALS AND HEALTH PLANNING), and one at CLEVELAND HOPKINS INTL. AIRPORT. All EMSS personnel were required to undergo paramedic training at CUYAHOGA COMMUNITY COLLEGE. In Nov. 1987, using federal, county and local funds, Cuyahoga County established a 911 emergency dialing system for medical, police, and fire services.

In the early 1980s, helicopters became a major component of ambulance services in Cleveland as Metro General Hospital, later renamed MetroHealth Center (see CUYAHOGA COUNTY HOSPITAL SYSTEM) began to operate its Life Flight program. Each Life Flight helicopter carried a nurse and a doctor, which distinguished it from most other air-ambulance systems in the nation, which used nurses and paramedics only. Life Flight was also unusual in that it was designed to serve many area hospitals rather than one. Life Flight began with one helicopter in 1982 and transported 15 patients in its first month of operation; by 1992 four medically equipped Sikorsky S-76 choppers were in use, and Life Flight had transported more than 16,000 patients to 65 receiving hospitals in northeast Ohio.


See also MEDICINE, NURSING.