Manchester has relied upon the Fire Department to provide many services and we have taken pride in our proactive approach to emergency medical assistance. Basic first aid had traditionally been provided at fire and accident scenes. In April 1915, a Pulmotor resuscitator was purchased and placed in the equipment room of Company #1 for emergency use.

Assistant Chief Sedrick Straughn and Captain Joseph McCooe instructed many classes in American Red Cross first aid during the 1960's and 1970's. During the early 1970's, national attention focused on increased levels of training for pre-hospital medical personnel. Firefighter Kenneth Cusson was a driving force behind upgrading the capabilities of the South Manchester Fire Department and in 1973 he and five other firefighters (Robert Barker, Peter Beckwith, Robert Bycholski, Walter Scadden and William Whitaker) volunteered to train as Emergency Medical Technicians (EMT). Many others followed their lead and today Emergency Medical Technician certification is a condition of employment.

The logical progression in providing emergency medical care was the institution of an advanced life support (ALS) or paramedic program. In 1978, discussions concerning a program commenced with Arnold "Ike" Kleinschmidt and Kenneth Cusson in the forefront. Dr. Robert Butterfield from Manchester Memorial Hospital was also involved, having assisted East Hartford in establishing a similar program. The Manchester Board of Directors created the Emergency Medical Services Council in 1980 as an advisory panel to explore the feasibility of paramedics. Local 1579 I.A.F.F., the Town Firefighter's union, voted to support a Fire Department based program and offered their assistance. In February of 1981 the EMS Council drafted a proposal to have the South Manchester Fire Department operate the service utilizing monies from the General Fund. The paramedic service would protect the entire Town, providing 24 hour service and operating under the medical supervision of Manchester Memorial Hospital.

The original ALS personnel consisted of James Brown, Kenneth Cusson, Andrew D'Appollonio, Danny Huppe and Michael Mason (Paramedics) and Charles Genovese, Rudolph Kissmann Jr. and Mark Kravontka (EMT-Intermediates). These personnel began training at The University of Connecticut Health Center in Farmington on March 21, 1983 and graduated on June 29, 1983 (the EMT-Is attended for the first three weeks only). At 0800 hours on July 11, 1983, the South Manchester Fire Department began providing paramedic level care to the citizens of Manchester. The first crew consisted of Firefighter/Paramedics James Brown and Michael Mason along with James Clark, Manchester Memorial Hospital's Emergency Medical Services Coordinator, who rode with the crews during the first few months of operation. The paramedics utilized the Department's 1977 rescue truck which had some compartments modified to accommodate the ALS equipment. There were no calls requiring ALS skills for the first 28 hours of operation.

In 1988, the call volume supported the need for a second ALS unit and the Department purchased a Chevrolet Suburban. This vehicle was modified by Linear Dynamics in Montgomery, PA and placed in service on March 2, 1989 at 1800 hours as Medic 1. This vehicle became the primary response unit with a staff of two firefighter/paramedics and Rescue 1 became the back-up unit, staffed with one firefighter/paramedic.

Also in 1988, the Department also recognized the need for a mid-management level position for the Emergency Medical Services program and created the job title of Captain - EMS/Hazardous Materials. Kenneth Cusson was promoted to to this position to help guide the program he initiated, serving until his retirement in 1994. On September 10, 1995, James Brown was named as Cusson's successor.

The Department advanced to a new level of patient care in October 1996 with the purchase and deployment of two Lifepak 11 monitor/defibrillators. With this equipment, the ALS crews are now able to collect and transmit 12 lead EKG data to area hospitals, saving valuable time with definitive drug therapies for heart attack victims.

The call volume of this valuable service has increased steadily over the past 25 years. During 1983 (slightly less than 6 months - 11 July to 31 December), the service responded to 703 incidents. Thirty-four were cardiac arrests with 5 "saves", 10 calls for which the rescue was unavailable due to simultaneous incidents and 2 calls were for out of town assistance. In 1996, the department responded to 2,827 calls for medical assistance. 2,483 were answered by Medic 1 and 344 were handled by Rescue 1. There were 49 cardiac arrests with 8 "saves." In 2007 the call volume for medical incidents increased to 5,749; 48% of which were ALS responses.