The Paramedic / EMS Bureau began providing service in November 1974 as Metro Ambulance Service.  Nashville area Funeral Homes had notified city officials it was no longer financially feasible for them to continue to provide ambulance coverage for Nashville and Davidson County.  City fathers decided the Fire Department was best suited to handle emergency medical calls.

The Paramedic / EMS Bureau is headed by Deputy Chief Steven R. Meador.  Meador began his career with the Nashville Fire Department in 1975 as an E.M.T.  He soon graduated from the Paramedic Program at the University of Tennessee in Nashville.  He served as both a paramedic assigned to ambulance detail and as shift training coordinator.

Meador has come up through the ranks in the positions of EMS District Chief and Assistant Chief.  Chief Meador was responsible for the development of the “Workload Management” system in 1995 which has been referred to as the “government version of system status management”.    He was promoted by Chief Halford to head the Bureau as Deputy Chief on July 1st, 2001.