One of the first and most influential hospitals in the United States, Bellevue was founded in 1736 in lower Manhattan as a six-bed infirmary and almshouse for the indigent of New York City. Over the next 200 years, the hospital launched the nation’s first maternity ward, its first children’s clinic, and, interestingly, its first urban ambulance service.

The idea for a hospital ambulance system stemmed from the Civil War, during which army ambulance service was common. The physician Edward B. Dalton (1834–1872) had been in charge of the field ambulance corps of the Army of the Potomac during the war, and when he was put in charge of transportation and organization at Bellevue Hospital, he drew largely from his battlefield experience. The methods he installed served as a pattern widely copied throughout the country.

Beginning in 1869, ambulances were dispatched by telegraph from Bellevue Hospital’s Centre Street branch; in the first year alone, they responded to more than 1,800 calls for help throughout the city. The horse-drawn carriages were typically staffed by highly trained doctors or surgeons from the hospital; however, if a doctor was not available, the hospital would send an orderly or even a janitor or cook to the scene. Often these ambulances arrived hours late and with attendants with little or no training or equipment to treat the patient. Because of this, the majority of the more seriously injured patients died before reaching the hospital.

As the city’s population grew rapidly and industrial accidents became more and more common, the city realized it needed a larger, more efficient ambulance system. (In 1929, the city had only 45 ambulances available to handle 343,000 emergency calls per year.) Today, ambulances in New York City are operated by the Ambulance and Transportation Division of the Department of Hospitals.

In 1999, a retired physician from New York University named Morton Galdston (c. 1913–2003) published a collection of notes he had taken as an intern on 1-month ambulance duty at Bellevue 60 years earlier. His observations provide a description of the economic, social, and public health factors that led to the establishment of an urban ambulance system, and a glimpse of what emergency medical treatment was like at the time.

ADDITIONAL FACTS

  1. Originally, all traffic in New York City was required to yield to an ambulance—except firefighting equipment and the postal service.
  2. For Bellevue Hospital, the Ambulance Board authorized two ambulances of the type recommended by Dalton. Furthermore, they specified, “Each ambulance shall have a box beneath the driver’s seat, containing a quart flask of brandy, two tourniquets, a half-dozen bandages, a half-dozen small sponges, some splint material, pieces of old blankets for padding, strips of various lengths with buckles, and a two-ounce vial of persulphate of iron.”