In the present day, a hearse on the road is usually headed for a cemetery, but historically, that wasn’t always the case. Before the 1970s, hearses were often used to transport people in cases of medical emergency. They served as the city’s ambulances.

Before the advent of The Medical Center-run ambulance service the city has today, hearses served as ambulances because funeral homes had vehicles large enough to carry someone in a stretcher, said Kevin Kirby. Kirby serves as the Warren County coroner and is the owner of J.C. Kirby & Son Funeral Chapels.

The first civilian ambulance service in the United States was established by the Commercial Hospital in Cincinnati in 1865, according to a history of the Kentucky Emergency Medical Technician Instructor’s Association. Horse-drawn wagons functioned as early ambulances. The first automobile ambulance was established in Chicago in 1899 at the Michael Reese Hospital.

In Bowling Green and around the country, ambulance services evolved as part of the job of funeral homes because they had vehicles big enough to accommodate a patient lying down, according to the history.

When Kevin Kirby was growing up, many hearses were what Kirby called “combination cars,” which could serve as either a hearse or an ambulance with a few quick alterations, he said. Station wagons were also sometimes used for ambulances, he said.

Kirby’s father, J.C. Kirby, worked at a funeral home in the late 1940s that provided an ambulance service, Kirby said. When he opened his own funeral home in 1962, J.C. Kirby also offered an ambulance service.

Kevin Kirby started going out with his father on some ambulance runs when he was 7 or 8 years old, he said. He was exposed to a lot of tragedy during those runs as the ambulances responded to wrecks, suicides and homicides among tamer runs such a taking women who had recently had babies home from the hospital, he said.

“It taught me very quickly how fragile life is,” Kirby said.

Kirby realizes it takes a particular type of person to be able to handle the emotions raised by work in the ambulance service, but he’s always been drawn to that kind of work because it provides an opportunity to help people.

“It’s a good feeling,” he said.

Kirby started to drive the ambulances/hearses when he was 16. At first, his father rode with him as he drove to make sure he could handle the situation, but he soon allowed Kirby to drive without his supervision.

It was fun to be able to drive as fast as possible to get to the scene of an emergency as a teenager, but Kirby said he never drove recklessly when he was behind the wheel of an ambulance.

The speed at which he drove the ambulance/hearse made caution even more important, he said. He remembers keeping one foot on the gas and the other on the brake so he could stop quickly if necessary.

“When you do it, you’re all ears and eyes,” he said.

Driving an ambulance was probably safer when Kirby did it years ago than it is now, because now the interiors of cars are so quiet that it becomes more difficult for drivers to hear the sirens of ambulances approaching, he said. That wasn’t the case with older model vehicles.

While many funeral homes had only one or two vehicles that doubled as ambulances, J.C. Kirby had four, Kirby said. They tried to send at least two men on calls, but sometimes Kirby had to go alone, and police officers would help load individuals into the ambulance.

J.C. Kirby was the first ambulance service to have two-way radios to communicate, which it got in about 1964, Kirby said. They also added oxygen in the ambulance at about the same time.

“It was starting to form into what it is today,” he said of the ambulance service.

Calls to respond to emergencies came from police, who had a list of the funeral homes that they rotated through, he said.

Emergency medical technician training was also starting to be used around the same time Kirby started driving ambulances. At 16, Kirby took one of the first EMT classes to be offered at Western Kentucky University, he said. However, he couldn’t be certified at the time because he was too young.

In 1966, Congress passed the Highway Safety Act, which established new regulations for emergency care personnel, according to the history. In Kentucky, being a licensed vehicle operator remained the only requirement to work as an ambulance attendant until 1974, when the state legislature required certification as an EMT.

As grants were provided for training EMTs and purchasing ambulances and equipment, funeral homes increasingly stopped offering ambulance services as more private and public emergency medical services were created, according to the history.

One of the first EMT instructors in the state was Henry Baughman, a former Army medic, X-ray technician and military instructor who served as a professor of health and safety at WKU, according to the history. Baughman taught the first EMT class at a university at WKU in 1971.

The hospital-organized ambulance service came into existence in Bowling Green in April 1974 when the city of Bowling Green, Warren County and the City-County Hospital decided to take part in a joint venture to provide ambulance service, said Randy Fathbruckner, director of emergency medical services for Medical Center EMS.

At the time, many federal government requirements in terms of training, equipment and vehicles were coming into play for those that provided emergency medical services that would have been both very costly and difficult for funeral homes to meet, he said.

Oversight for the EMS program was given to the City-County Hospital at the time, and in 1980 The Medical Center took over complete operation of the service, Fathbruckner said.

The hospital-run ambulance service was able to provide a higher level of care to patients than the service provided by funeral homes, he said.

Last year, the Medical Center EMS responded to more than 18,000 requests and this year that number is likely to be near 20,000, Fathbruckner said.

A lot has changed in EMS since the early days of ambulance services in Bowling Green, he said. The old hearses and station wagons were replaced by vans and training has become much more intensive. EMTs go through 140 hours of training, with paramedics receiving an additional 1,500 hours of training in addition to clinical and field internships, he said.

The technology used by EMS has also improved, with programs such as one called First Watch that monitors all the calls that come in and analyzes them for trends, such as outbreaks of flu or large numbers of heat-related calls to help better serve the public, Fathbruckner said.

The Medical Center EMS is also the only ambulance service in the state to have accreditation from the Commission on Accreditation of Ambulance Services, he said. It received the distinction in 2003.

That means the service meets a gold standard for ambulance services and has to be re-examined every three years for re-accreditation, Fathbruckner said.

“They look at everything from top to bottom,” he said.