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EMS History

Old EMS vehicleBoston has one of the oldest public health agencies in the nation, tracing its history to 1799. In addition, Boston has one of the oldest ambulance delivery services in the nation. The City Hospital Ambulance Service was created and transported its first patient to Boston City Hospital in the 1890s.

Originally, the Ambulance Service consisted of 11 horses and two​ ambulance carriages. The stables were located on Albany Street in an old wooden building that had once served as a smallpox hospital. Twelve men lived at the facility and worked as “horsekeepers, chore men, and porters.”  In general, the patients who were transported by the city ambulances received no medical care until they reached the hospital, because the men who operated the carriages received no medical training. Surgical cases were the exception to this rule. Occasionally, a surgeon was dispatched along with the ambulance so that an injured extremity could be amputated at the scene. Fires were extremely common during this period, and because the mortality rate for fire-related injuries was so high, an ambulance was always dispatched whenever a second alarm sounded.

By the turn of the century, a simple communications system had been installed at the City Hospital’s front gate. When an ambulance bearing an injured patient approached the hospital, a gatekeeper would phone the Administrator’s Office and the surgical division would be notified. Stretchers would be brought to the front door, and a “surgical house officer would be summoned without delay for immediate attendance.”

The first ambulance satellite was established in 1900 at the Boston City Hospital Relief Station in Haymarket Square. The City Council considered this arrangement to be a success, and in the coming years, a number of additional ambulance stations were constructed throughout Boston. After the turn of the century, horse-drawn ambulances were gradually replaced by mechanized ones. Police department ambulances eventually took over much of the City’s emergency work, but the City Hospital Ambulance Service would remain a fixture in Boston until well into the twentieth century.

Over the years, as Boston became more populated and more hospitals were built, ambulance service workers became more involved in pre-hospital medical care. Today, our EMTs and Paramedics are some of the best trained emergency medical workers in the nation.

Sources: City of Boston: Report of the Committee on the Will of Elisha Goodnow (1860), Report of the Committee on a Free City Hospital (1861), A History of the BCH from its Foundation until 1904 (1906).

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