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The City of Cleveland Division of
Emergency Medical Service Emergency medical services (EMS), also known as ambulance services or paramedic services, are emergency services that provide urgent pre-hospital treatment and stabilisation for serious illness and injuries and transport to definitive care. ...
, also known as Cleveland EMS or CEMS, is the division of the municipal government tasked with emergency
ambulance An ambulance is a medically equipped vehicle which transports patients to treatment facilities, such as hospitals. Typically, out-of-hospital medical care is provided to the patient during the transport. Ambulances are used to respond to medi ...
transport for the City of Cleveland, Ohio. As of January 2019, the
paramedics A paramedic is a registered healthcare professional who works autonomously across a range of health and care settings and may specialise in clinical practice, as well as in education, leadership, and research. Not all ambulance personnel are p ...
and
EMTs An emergency medical technician (EMT), also known as an ambulance technician, is a health professional that provides emergency medical services. EMTs are most commonly found working in ambulances. In English-speaking countries, paramedics are ...
of Cleveland EMS staff 25 Advanced Life Support (ALS)
ambulances An ambulance is a medically equipped vehicle which transports patients to treatment facilities, such as hospitals. Typically, out-of-hospital medical care is provided to the patient during the transport. Ambulances are used to respond to medi ...
during the daytime, and 21 during the night shift. In addition, they also provide special event medical standby service upon request. They are supported by
Emergency Medical Dispatchers An emergency medical dispatcher is a professional telecommunicator, tasked with the gathering of information related to medical emergencies, the provision of assistance and instructions by voice, prior to the arrival of emergency medical service ...
who staff a communications facility known as Radio Emergency Dispatch (RED) center. Counting supervisors and administrative staff, the division is budgeted for 333 employees, with an annual budget of $30.6 million and annual revenues of $14 million. Cleveland EMS is assisted in providing prehospital care by the
Cleveland Fire Department The Cleveland Division of Fire provides fire protection and works with Cleveland EMS to provide emergency medical service to the city of Cleveland, Ohio Ohio () is a U.S. state, state in the Midwestern United States, Midwestern region of th ...
, who provides non-transport "
First Responder A first responder is a person with specialized training who is among the first to arrive and provide assistance or incident resolution at the scene of an emergency, such as an accident, disaster, medical emergency, structure fire, crime, or ...
" services. Cleveland EMS' Headquarters is located at 1701 Lakeside Ave, Cleveland Ohio, 44114.
Cleveland Association of Rescue Employees local 1975
An ILA affiliate, is the primary labor union for Cleveland EMS paramedics, EMTs, and dispatchers.


Cleveland EMS Call Volume


History


1975-1979

Prior to 1975, emergency
ambulance An ambulance is a medically equipped vehicle which transports patients to treatment facilities, such as hospitals. Typically, out-of-hospital medical care is provided to the patient during the transport. Ambulances are used to respond to medi ...
transportation in Cleveland was provided by a combination of
Cleveland Police Cleveland Police is the territorial police force responsible for the policing area corresponding to the former county of Cleveland in Northern England. As of September 2017, the force had 1,274 police officers, 278 police staff, 124 police co ...
patrol wagons, four Cleveland Fire rescue squads, and private
ambulances An ambulance is a medically equipped vehicle which transports patients to treatment facilities, such as hospitals. Typically, out-of-hospital medical care is provided to the patient during the transport. Ambulances are used to respond to medi ...
mostly run by funeral homes. The June 3, 1974 death of Councilman Michael Zone exposed severe shortcomings in this existing system, as it took over 25 minutes for help to reach him after he suffered a
heart attack A myocardial infarction (MI), commonly known as a heart attack, occurs when blood flow decreases or stops to the coronary artery of the heart, causing damage to the heart muscle. The most common symptom is chest pain or discomfort which m ...
. Due in part to the public outcry after Zone’s death, Mayor
Ralph Perk Ralph Joseph Perk (January 19, 1914 – April 21, 1999) was an American politician of the Republican Party who served as the 52nd mayor of Cleveland, Ohio. Early life Born to an ethnic Czech American family in Cleveland, Perk dropped out of ...
established the new City of Cleveland Division of Emergency Medical Service (CEMS) the following year with 120 Emergency Medical Technicians (EMTs) answering their first emergency calls on Monday, October 13th, 1975. This new division of EMS, separate from the police and fire departments, immediately found itself very busy, answering over 60,000 calls annually by 1977. While considered a vast improvement over the previous system, it also found itself to be the center of controversy. A 1976 feature in Cleveland Magazine illustrated several ways that Mayor Perk maximized the political gain from the new CEMS service just prior to the 1975 mayoral election. The same article also outlined problems within the CEMS leadership, a lack of continuing medical education, broken
ambulances An ambulance is a medically equipped vehicle which transports patients to treatment facilities, such as hospitals. Typically, out-of-hospital medical care is provided to the patient during the transport. Ambulances are used to respond to medi ...
, a poor driving record with 84 accidents with 2 years, understaffing, and most disturbingly, that CEMS lacked
Advanced Life Support Advanced Life Support (ALS) is a set of life saving protocols and skills that extend basic life support to further support the circulation and provide an open airway and adequate ventilation (breathing). Components These include: * Tracheal i ...
(ALS)
paramedic A paramedic is a registered healthcare professional who works autonomously across a range of health and care settings and may specialise in clinical practice, as well as in education, leadership, and research. Not all ambulance personnel are p ...
units and had no definite timetable to implement them. The lack of
paramedic A paramedic is a registered healthcare professional who works autonomously across a range of health and care settings and may specialise in clinical practice, as well as in education, leadership, and research. Not all ambulance personnel are p ...
-level care would persist throughout the 1970s as the administration of Mayor
Dennis Kucinich Dennis John Kucinich (; born October 8, 1946) is an American politician. A U.S. Representative from Ohio from 1997 to 2013, he was also a candidate for the Democratic nomination for president of the United States in 2004 and 2008. He ran for ...
refused to allow those CEMS personnel who had trained as
paramedics A paramedic is a registered healthcare professional who works autonomously across a range of health and care settings and may specialise in clinical practice, as well as in education, leadership, and research. Not all ambulance personnel are p ...
to perform advanced skills or administer medications. Assistant Safety Director Tonia Grdina told the
Plain Dealer ''The Plain Dealer'' is the major newspaper of Cleveland, Ohio, United States. In fall 2019, it ranked 23rd in U.S. newspaper circulation, a significant drop since March 2013, when its circulation ranked 17th daily and 15th on Sunday. As of Ma ...
at the time, “The major criticism of the EMS is that its personnel frequently treat victims on the scene instead of transporting them to the hospital immediately.”


1980-1989

In 1980, Mayor
George Voinovich George Victor Voinovich (July 15, 1936June 12, 2016) was an American politician who served as a United States Senator from Ohio, United States senator from Ohio from 1999 to 2011, the 65th governor of Ohio from 1991 to 1998 and the 54th mayor of ...
recruited Mitchell Brown, a veteran of Pittsburgh’s
Freedom House Ambulance Service Freedom House Ambulance Service was the first emergency medical service in the United States to be staffed by paramedics with medical training beyond basic first aid. Founded in 1967 to serve the predominantly black Hill District of Pittsburgh, P ...
, to head CEMS in a move to improve the service. Things would get worse before they got better, however, with budget cuts dropping the number of CEMS
ambulances An ambulance is a medically equipped vehicle which transports patients to treatment facilities, such as hospitals. Typically, out-of-hospital medical care is provided to the patient during the transport. Ambulances are used to respond to medi ...
from 12 in 1982, to 8 by 1985. Despite these budget challenges, Brown was able to implement a new in-house communications center, called Radio Emergency Dispatch (RED) center, and upgraded two CEMS units to
ALS Amyotrophic lateral sclerosis (ALS), also known as motor neuron disease (MND) or Lou Gehrig's disease, is a neurodegenerative disease that results in the progressive loss of motor neurons that control voluntary muscles. ALS is the most comm ...
status on February 1st, 1985. Brown was later promoted to safety director, where he vetoed a 1988 proposal by the
Cleveland Fire Department The Cleveland Division of Fire provides fire protection and works with Cleveland EMS to provide emergency medical service to the city of Cleveland, Ohio Ohio () is a U.S. state, state in the Midwestern United States, Midwestern region of th ...
to take over CEMS.


1990-1999

Despite an increase in the late 1980s to 14 EMS units, during the early 1990s many of the same concerns persisted regarding CEMS, including deaths due to delayed responses, unreliable vehicles, low employee pay, high turnover, a large number of low-priority calls, and an overall high call volume given the number available
ambulances An ambulance is a medically equipped vehicle which transports patients to treatment facilities, such as hospitals. Typically, out-of-hospital medical care is provided to the patient during the transport. Ambulances are used to respond to medi ...
. Public proposals to improve EMS very similar to those advocated during the mid 1980s again graced the pages of the local newspaper, the
Plain Dealer ''The Plain Dealer'' is the major newspaper of Cleveland, Ohio, United States. In fall 2019, it ranked 23rd in U.S. newspaper circulation, a significant drop since March 2013, when its circulation ranked 17th daily and 15th on Sunday. As of Ma ...
. Councilman Ken Johnson proposed forming a volunteer EMS first-response unit, while Cleveland firefighters continued their campaign to take over EMS, and the same ambulance company manager who penned a 1984 op-ed again proposed letting private
ambulances An ambulance is a medically equipped vehicle which transports patients to treatment facilities, such as hospitals. Typically, out-of-hospital medical care is provided to the patient during the transport. Ambulances are used to respond to medi ...
respond to 911 calls. Mayor Michael R. White instead chose to embrace the recommendations of an EMS/Fire task force and invested heavily in CEMS. RED center was upgraded with a new computer aided dispatching and call-prioritizing system in 1993, and by 1997 20 CEMS ambulances were in service reducing response times by 28%. This increased investment in CEMS was credited with helping Cleveland realize its lowest
homicide Homicide occurs when a person kills another person. A homicide requires only a volitional act or omission that causes the death of another, and thus a homicide may result from accidental, reckless, or negligent acts even if there is no inten ...
rate in decades, with CEMS crews saving many victims of
penetrating trauma Penetrating trauma is an open wound injury that occurs when an object pierces the skin and enters a tissue of the body, creating a deep but relatively narrow entry wound. In contrast, a blunt or ''non-penetrating'' trauma may have some deep d ...
who would otherwise have been perished. During the 1990s working conditions for CEMS
EMTs An emergency medical technician (EMT), also known as an ambulance technician, is a health professional that provides emergency medical services. EMTs are most commonly found working in ambulances. In English-speaking countries, paramedics are ...
and
paramedics A paramedic is a registered healthcare professional who works autonomously across a range of health and care settings and may specialise in clinical practice, as well as in education, leadership, and research. Not all ambulance personnel are p ...
also improved, as the city switched to from 8-hour shifts to 12-hour shifts. Additionally after a protracted battle between the city administration an
the Cleveland Association of Rescue Employees (CARE)
the main labor union for CEMS, safety equipment such as ballistic vests, helmets and protective coats were obtained for the first time. It is also worth noting, that on November 5th, 1993, CEMS came close to suffering its first line-of-duty death when paramedic Christopher Holt was struck by an automobile at the scene of a freeway accident. Through the incredible efforts of his CEMS colleagues and staff at
Metro hospital Metro Group of Hospitals is an Indian hospital network with 10 NABH and 4 NABL accredited hospitals operational across India. With 2,500 beds, the hospital network is the largest tertiary care provider in the region. Founder The hospital sys ...
, Holt not only survived critical injuries, but returned to work the following year.


2000-Present

As the new century dawned, the 21 ambulances of CEMS took on increased importance as the region saw the first of several hospital closings, with St Luke’s closing in 1999, Mt Sinai in 2000, and St Alexis/St Michael in 2003. Through union concessions and chronic understaffing, CEMS was spared from the budget cuts that affected the police and fire departments in 2003. The following year, 24 of the laid-off firefighters and police officers who had EMT or
paramedic A paramedic is a registered healthcare professional who works autonomously across a range of health and care settings and may specialise in clinical practice, as well as in education, leadership, and research. Not all ambulance personnel are p ...
training were re-hired to work for CEMS to fill vacancies created as other employees left the division. Attrition within CEMS accelerated greatly after a 2007 decision by Commissioner Edward Eckart to switch CEMS workers from the 12-hour shifts they had worked since the early 1990s, to 8-hour shifts in order to save money on overtime. This move backfired, as 88 CEMS workers resigned within 2 years and overtime spending soared as the remaining personnel were forced to work extra mandatory shifts to provide
ambulance An ambulance is a medically equipped vehicle which transports patients to treatment facilities, such as hospitals. Typically, out-of-hospital medical care is provided to the patient during the transport. Ambulances are used to respond to medi ...
coverage
CARE
challenged the schedule change, and ultimately prevailed in court. 12-hour work shifts were resumed. Despite the move back to 12-hour shifts, CEMS continued to face cutbacks, as the City of Cleveland was especially hard-hit by the
global recession A global recession is recession that affects many countries around the world—that is, a period of global economic slowdown or declining economic output. Definitions The International Monetary Fund defines a global recession as "a decline i ...
caused by the housing crisis. By 2010, despite no change in call volume, only 15 CEMS
ambulances An ambulance is a medically equipped vehicle which transports patients to treatment facilities, such as hospitals. Typically, out-of-hospital medical care is provided to the patient during the transport. Ambulances are used to respond to medi ...
remained in service. Further strain was added to CEMS when the
Cleveland Clinic Cleveland Clinic is a nonprofit American academic medical center based in Cleveland, Ohio. Owned and operated by the Cleveland Clinic Foundation, an Ohio nonprofit corporation established in 1921, it runs a 170-acre (69 ha) campus in Cleveland, ...
administration closed Huron Road Hospital in 2011, leaving the entire east side of
Cleveland Cleveland ( ), officially the City of Cleveland, is a city in the U.S. state of Ohio and the county seat of Cuyahoga County. Located in the northeastern part of the state, it is situated along the southern shore of Lake Erie, across the U ...
without a
trauma center A trauma center (or trauma centre) is a hospital equipped and staffed to provide care for patients suffering from major traumatic injuries such as falls, motor vehicle collisions, or gunshot wounds. A trauma center may also refer to an emer ...
. In a bid to improve EMS, city officials decided to implement the long-proposed idea of merging its fire and EMS divisions, boldly announcing in November 2011 that the merger would be complete by the end of 2012. As one of the initial steps, city officials ended the expensive and inefficient practice of using fire department heavy rescue squads staffed with 4
firefighters A firefighter is a first responder and rescuer extensively trained in firefighting, primarily to extinguish hazardous fires that threaten life, property, and the environment as well as to rescue people and in some cases or jurisdictions also ...
as backup
ambulances An ambulance is a medically equipped vehicle which transports patients to treatment facilities, such as hospitals. Typically, out-of-hospital medical care is provided to the patient during the transport. Ambulances are used to respond to medi ...
. The city then used the money saved to open three additional CEMS
ambulances An ambulance is a medically equipped vehicle which transports patients to treatment facilities, such as hospitals. Typically, out-of-hospital medical care is provided to the patient during the transport. Ambulances are used to respond to medi ...
for a total of 18 CEMS units. The city also cross-trained 6 CEMS
paramedics A paramedic is a registered healthcare professional who works autonomously across a range of health and care settings and may specialise in clinical practice, as well as in education, leadership, and research. Not all ambulance personnel are p ...
at the Cleveland fire academy. Despite these steps, city officials abandoned the merger plan after th
firefighter's union
voted down a merger proposal in May of 2014. After the merger plan was abandoned, the city again decided to invest in CEMS to meet the demands of a rapidly increasing call volume. After the passage of an income tax levy in 2016, additional staff were hired and new
ambulances An ambulance is a medically equipped vehicle which transports patients to treatment facilities, such as hospitals. Typically, out-of-hospital medical care is provided to the patient during the transport. Ambulances are used to respond to medi ...
were purchased to increase the total number of units to 25 during the daytime and 21 at night by the beginning of 2018. During this time, local trauma care also improved, as
University Hospitals A teaching hospital is a hospital or medical centre that provides medical education and training to future and current health professionals. Teaching hospitals are almost always affiliated with one or more universities and are often co-located ...
attained Level 1
Trauma center A trauma center (or trauma centre) is a hospital equipped and staffed to provide care for patients suffering from major traumatic injuries such as falls, motor vehicle collisions, or gunshot wounds. A trauma center may also refer to an emer ...
status at the end of 2015. This relieved
MetroHealth The MetroHealth System is a nationally ranked non-profit, public health care system located in Cleveland, Ohio. Founded in 1837 as City Hospital, The MetroHealth System serves the residents of the city of Cleveland and Cuyahoga County. It is on ...
of the responsibility of being the sole Level 1
trauma center A trauma center (or trauma centre) is a hospital equipped and staffed to provide care for patients suffering from major traumatic injuries such as falls, motor vehicle collisions, or gunshot wounds. A trauma center may also refer to an emer ...
in Cuyahoga County and helped fill the void left by the sudden closure of Huron Road hospital 5 years earlier. Cleveland Emergency Medical Services began carrying nasal-spray Narcan, the opioid antagonist drug that reverses an opioid overdose in 1985. In 2016, the division’s ambulances began offering Project DAWN (Deaths Avoided with naloxone) Narcan kits to citizens. Narcan, a naloxone nasal spray, can be used by untrained individuals relatively simply. The kits were also available at EMS headquarters. Project DAWN is a community-based overdose education program that dispenses Narcan to combat Ohio’s opioid overdose crisis. During the 2020 global pandemic, Cleveland EMS saw its first decline in call volume in several years. This mirrored local and national trends, where people avoided healthcare facilities because of concerns they might contract the CoVID-19 virus. During this time, Cleveland EMS continued to answer emergency calls, with medics wearing increased personal protective equipment, including N95 respirators. Despite these measures, several EMS providers still contracted CoVID-19. Cleveland EMS providers were among the first local healthcare providers to receive the CoVID-19 vaccine once it became available in late 2020. They also helped distribute the vaccine to others by staffing vaccination clinics.


References


External links

{{Official website, http://www.city.cleveland.oh.us/CityofCleveland/Home/Government/CityAgencies/PublicSafety/EMS}
Cleveland Association of Rescue Employees 1975 Homepage
Ambulance services in the United States Healthcare in Cleveland Government of Cleveland