History of Emergency Public Ambulance Service in Washington DC

Emergency public ambulance service or as termed today emergency medical service for Washington D.C. has followed a convoluted and at times troubled path. Its beginnings in our nation’s capital are rooted in the various hospitals and their evolution in service and care. The Civil War is a likely beginning as at the height of the conflict as many as 85 hospitals exist in Washington. A military ambulance corps with dedicated wagons moves the array of injured soldiers from trains and boats to the many facilities most as camps or warehouses of suffering with little in the way of sanitation or proper medical treatment. After the war, Washington D.C. begins to develop as the once river bottom city expands into the hinterlands adding new public facilities and services. This includes new hospitals models for the improved understanding and practice of medicine.

In 1880, Central Dispensary Hospital opens its emergency department becoming Central Dispensary and Emergency Hospital. In 1888, telephone service founder Alexander Graham Bell donates an ambulance to Garfield Memorial Hospital another model of medical modernity. An ambulance is added to Central Dispensary and Emergency Hospital by 1892 about the same period the city’s Metropolitan Police Department has several ambulances. Most ambulances of this period are like horse-drawn delivery wagons or hearses used mostly for those less able to pay for a doctor to come to their home.

After 1910, the horse-drawn wagons and modified hearses are replaced by motorized vehicles still operated by just a few city hospitals. Not all hospitals have emergency departments with most open part-time. Central Dispensary and Emergency Hospital near the White House as well as Eastern Dispensary and Casualty Hospital near the Capitol become the mainstay of emergency medical care and public ambulance service. In 1918 an influenza pandemic brings various Red Cross ambulance stations to parts of the city. More like garages, these have nurses and motorized ambulances for handling the array of flu cases already overwhelming the hospitals.

By 1924, five hospitals have ambulances with a sixth run by the Health Department for the indigent and mentally ill. The concept of emergency medicine is as yet to be realized with no dedicated professionals just whoever is on duty to handle an emergency case. Ambulances are staffed by interns, an occasional doctor or nurse on board depending on the type of call. Still, abuse of service in the way of needless calls are a problem and at times no ambulance is available. There is no coordination or dispatching and no way to communicate with units once they are on the street. In early 1925, the District of Columbia Fire Department adds an ambulance as part of its newly formed rescue company. This responds on rescues and fires initially intended for injured firefighters. Over time as service demands rise, the fire department ambulance is used to cover for busy hospital ambulances.

In 1937 a group of citizens in the Chevy Chase section of Upper Northwest form the Chevy Chase First Aid Corps. This all volunteer ambulance agency serves portions of Washington D.C. and Montgomery County Maryland. In 1940, radio communications are introduced to Washington’s emergency agencies including fire department units like the rescue squad and its ambulance. Hospital ambulances are similarly equipped linked to the Metropolitan Police Department’s radio system. While police are more abundant in the community and sometimes arrive at emergencies first, this still causes confusion and inefficiency as the police in truth want no part of tracking and coordinating ambulances. Sometimes the closest ambulance is not the one sent and occasionally units from different hospitals pass one another en-route to different calls. Hospitals are largely in and around the Downtown hence service for the growing outskirts takes longer with units out of service for greater periods. There is no central authority to oversee operations or make changes as demands warrant.

Late in 1941, the nation is thrust into World War II and the Chevy Chase First Aid Corps ceases service its members signing up for military duty pledging to re-start upon their return. Meanwhile Washington D.C. sees an explosion in wartime population further taxing an already beleaguered ambulance service. The war also brings a loss of ambulance drivers replaced by volunteers many being women. Doctors also in short supply cease responding on the ambulances leaving only interns and volunteer drivers with minimal if any training. As the system becomes strained it is clear no one has the authority to make needed changes. The police department has the greatest oversight but ignores problems as ambulance responsibilities are viewed more as a burden they are stuck with.

By mid 1943, the fire department adds another ambulance this attached to its newly formed Rescue Squad 2. Soon after, a doctor and President of the city’s Police and Fire Surgeons Board implements a plan for improvements. This includes removing the ambulance at Garfield Memorial that becomes a second ambulance at Emergency Hospital. The city’s Health Department is given greater authority with drivers now as that agencies employees accompanied still by a medical intern. The two fire department ambulances are incorporated into the system used if needed or if closer to a serious incident. Soon after, ambulance radios are moved to a separate radio frequency connected to the new Ambulance Control Board at Fire Alarm Headquarters. In 1944, a third fire department ambulance is added to the firehouse of Engine 31 in Upper Northwest. Later in 1945, volunteers of the defunct Chevy Chase First Aid Corps return from military duty and as promised re-start service again. This time they operate outside the city in Montgomery County, under the name Bethesda-Chevy Chase First Aid Corps soon after Rescue Squad. This all volunteer service continues responding into the city covering portions of Upper Northwest.

Through the 1950s, Washington D.C. enjoys a period of post war growth bringing development including to the outer fringes as well as into adjacent suburban counties. Improvements come to aging hospitals as some move to new facilities while others like Emergency and Garfield consolidate to the new Washington Hospital Center. The ambulance system still strained and poorly coordinated is recommended for sweeping change. In mid 1957 the hospital and health department public ambulance service is formally transferred to the District of Columbia Fire Department. Units are divorced from the rescue squads and Engine 31 the fleet of six units strategically placed in various city fire stations. The District of Columbia Fire Department’s Emergency Ambulance Service is staffed round the clock by first aid trained firefighters with patients taken to the closest hospital emergency room a third such facility expanding to 24-hour operation.

Thus begins a new era in Washington D.C. emergency services. Of course this is not an end but a beginning as over time new problems arise and the entire approach to public ambulance service transforms into emergency medical service. Over the next fifty years, new issues, challenges and of course an array of changes lay ahead for the service, the city and the fire department serving and protecting our nation’s capital.