When I was a kid, if anyone had to go to the hospital for a medical emergency, the telephone operator would call a funeral home and they would take you in a hearse, although with a temporary red bubble light stuck on top. They were the only vehicles that could accommodate a person lying down. Up through the 1960s, ambulance service in the USA was a local concern, operated by the police or fire departments, hospitals, or funeral homes. It was mainly a matter of transport, as few places had EMTs. Your odds of survival often depended on how long the trip took.
In Pittsburgh’s majority-Black Hill District, hospital transport was carried out by the city police, and they weren't all that enthusiastic about it. Local leaders looked into the problem, and in 1967, the nonprofit organization Freedom House Enterprises partnered with Presbyterian-University Hospital to develop an ambulance service with trained paramedics. The Black paramedics of the Hill District responded so well that people started calling Freedom House in an emergency instead of the police or hospital. Freedom House suffered political backlash and defunding from city leaders, but its standards of care started a revolution in ambulance service that was felt nationwide. Read about the paramedics of Freedom House Ambulance Service at Smithsonian. A video documentary is included.