Hamilton County Emergency
N.A.E.M.T. 2005 Paramedic Ambulance Service of the Year.
Hamilton County E.M.S. was established on February 1, 1988.
Prior to that time, the ambulance service for the un-incorporated
areas of Hamilton County was provided by several volunteer Fire
Departments and private ambulance services. Initially, the
service consisted of one ambulance on each side of the Tennessee
River and a staff of 17 employees. That soon expanded as several
municipalities requested the service be provided to them also.
Within the first year of service, there were five units in
service, 24-hours a day, and the number of employees had grown
The Chattanooga Fire Department had provided ambulance coverage
for the City Of Chattanooga since 1973. In 1992, the Mayor of
Chattanooga asked that Hamilton County assume responsibility for
this coverage and the expanded operation began in July. What had
been a fledgling operation, designed primarily to provide
Advanced Life Support to a rural area, had grown to include 14
Ambulance units, 100 employees, and a coverage area of 571
square miles and 300,000 citizens. Within 20 years of operation,
the number of annual responses had gone from 1700 to 27,000.
The organization is designed around a fire department style rank
structure and divided into three teams, each responsible for a
rotational 24-hour on, 48-hour off schedule. Three district
supervisors (Lieutenant) on each team provide line supervision.
They are responsible for the daily operation of their respective
districts and provide on-scene medical command until relieved by
higher authority. The Lieutenant is assigned to a mobile
response unit and is free to travel around his district, as need
demands. Each supervisor is trained in extended skills, such as
R.S.I. and induced hyperthermia, and responds to provide
additional assistance as needed.
The daily operation of each team is the responsibility of the
shift supervisor (Captain). They are assigned to a fast-response
vehicle and oversee all aspects of their respective teams
including staffing, days off, discipline, and general leadership
functions. Each team Captain is also tasked with additional
responsibilities, such as station repairs, employment
opportunities, and medical equipment/protocols. In this
function, they monitor ambulance station status, maintain all
repair records and follow-up on crew performance.
The Service operates a supply depot facility, staffed by three
employees, that maintains all materials required for
pre-hospital medical care. Overseen by a supply officer/Asset
Manager (Lieutenant), they are tasked with ordering all stock,
maintaining and repairing all medical equipment, and
distribution of inventory as requested, and maintenance
schedules of all rolling stock. During a mass casualty incident,
our Supply team responds with pre-packaged containerized
supplies and establishes N.I.M.S. sectors as the incident
requires. Our Supply Division also maintains Homeland Security
District Three equipment and supplies.
A full-time training supervisor (Captain) and training officer
(Lieutenant) provides training for the Service as well as A.E.D.
training for general government employees. Each E.M.S. crew is
provided at least two hours training monthly, including drug
updates, new procedures, customer service, and safety concerns.
The training staff also offers outreach courses, such as CPR, to
area community organizations. They also maintain records of all
required certifications and offers update classes in BTLS and
ACLS. In addition to their training duties, they are tasked with
overseeing the Services exposure control plan. They provide
immunizations as required by local protocol for employees,
documents exposures, and functions as liaison with the local
A Customer Service Officer (Lieutenant) answers needs of both
external and internal customers. He handles care and billing
questions, coordinates Quality Improvement issues, and
investigates public and/or Service complaints. He also assists
with training issues and oversee Service safety issues.
A part-time contracted physician provides medical control for
the Service. He is responsible for development of protocols and
serves as chair of the CQI committee. He is responsible for
investigation of medical practice complaints and recommends
corrective actions. He is assigned a radio and protective
equipment and responds to requests as needed. He serves as
on-line medical control and approves all standing orders when
A full-time microcomputer specialist oversees the entire
computer operation. He is also responsible for future
technological needs and direction of the Service. All E.M.S.
stations are linked electronically as part of the county
network. Medical transport records are maintained electronically
as part of the county network. Each station is equipped with a
P.C. and each employee has an e-mail address. Memos,
notifications, and announcements are sent electronically and all
supply orders are paperless. Each vehicle is equipped with a
"Panasonic Toughbook" mobile display system and outfitted with
automatic vehicle locators. This allows instant location and
information sharing between all mobile units and the
I hope that you have found this history and description of our
Please feel free to visit our Site and
contact us if you have any questions.
- Kenneth L. Wilkerson, Chief