San Francisco Fire Department Marks 130-Year Milestone of Providing EMS

Earlier this year, San Franscico Mayor Daniel Lurie stood in front of city hall to commemorate 130 years of municipal ambulance service in the city.

San Francisco’s municipal ambulance service began in 1895, making it the country's first and longest continuously operating municipal ambulance service. The Department of Public Health previously administrated the service, and in 1997, the municipal ambulance service merged with the San Francisco Fire Department (SFFD), where it has continued to serve the citizens and visitors since.

Today, it is a fully integrated division of the SFFD, where the services continue to evolve and expand to meet and adapt to the community’s needs in the ever-changing landscape of EMS.

“Over the past century, many improvements and changes have been made. These include upgrading our dispatching software for better communication and accountability, transmitting pre-hospital EKGs from EMS providers to receiving facilities, and using data collection and analysis to drive improvements,” said SFFD Chief Dean Crispen. “What has not changed are the EMS providers' commitment to public service and dedication to providing the highest level of care to San Francisco's citizens and visitors.”

Timeline of emergency medical service to San Francisco residents:

• 1895: Began with a single horse-drawn ambulance donated to the city.
• 1906: Major earthquake and fire destroyed most of the city, but the hospital remained standing.
• 1912: The Emergency Hospital Service received its first automobile ambulance and first official uniforms.
• 1915: Nearly fully converted from horse-drawn carriages to motorized ambulances.
• 1936: San Francisco became the first municipality in the nation to place a police radio receiver in each of its ambulances.
• 1950: Two-way radios were installed in the ambulances.
• 1960’s: Pilot programs to upgrade the skill of ambulance and rescue squad personnel began to appear across the nation.
• 1973: Emergency Hospital Service received its own radio communications system.
• 1975: The service received its first set of Motorola radios.
• 1977: San Francisco General Hospital Emergency Department opened an expanded base station. Using new radio equipment, mobile intensive care nurses could now talk to and receive patient information and cardiac telemetry from paramedics while they were located anywhere in the city.
• 1978: Reorganization of the ambulance service under new management.
• 1979: The ambulance service began to charge patients a fee for its service.
• 1983: The city switched to the universal 9-1-1 emergency phone number.
• 1984: Ambulance dispatch center received automatic locating information equipment, which allowed the ambulance dispatch center to see the address of each caller.
• 1988: Installation and start-up of its CAD system.
• 1993: The Paramedic Division faced a financial crisis.
• 1995: The financial crisis resulted in longer response times and aging equipment.
• 1996: The Fire Commission and the Health Commission voted unanimously to merge the two organizations.
• 1997: The Paramedic Division was officially taken over by the fire department.

The growth doesn’t stop there. Over the last 28 years, there have been countless upgrades and additions to making the service run more efficiently. SFFD Rescue Captain Jennifer Warren has been with the department for nine years and shared with Firehouse key updates to the program she has seen.

• Dynamic deployment: Instead of responding from the firehouse, all ambulances are dynamically deployed in 10–12-hour shifts from one central station.
• EMS division expansion: Warren has seen the EMS division nearly double in size.
• Community Paramedicine Division: Street Crisis Response Teams assist unhoused individuals helping with the increased call volume.

“I grew up in the city, and so the history of the department is something that stands out for me, Warren told Firehouse.” “It’s such a great honor to be a civil servant for the city I grew up in, and to be a part of this department. That's something that's shared by all my coworkers here in the EMS division for the fire department,” said SFFD Rescue Captain Jennifer Warren.

SFFD paramedics continue to respond on fire apparatus, advanced life support (ALS) ambulances and Quick Response Vehicles with joint response with local law enforcement, tactical emergency medical services, also paired with law enforcement (TEMs), San Francisco International Airport as ALS bicycle medics and specialized response from multiple units from the Community Paramedic Division.

“The municipal ambulance service in San Francisco was established in 1895 to transport the sick and injured to hospitals. What began as a horse-drawn carriage staffed with hospital interns has developed into a fleet of fully equipped ambulances, with trained EMTs and paramedics running over 130,000 medical calls each year,” said Crispen.