Until the late 1990s, ambulance services in Nova Scotia were delivered by privately owned companies registered as Ambulance Operators. Each provider followed its own protocols and used a variety of operational tools and equipment.

First responders at the time were called “Ambulance Attendants.” Training was brief, just a
few weeks in the classroom, and often lacked advanced skills or formal entry requirements.

While many services provided only basic care, some, like the Victoria General Hospital in Halifax, offered higher standards. A few dedicated attendants even pursued advanced training out of province, including in Pittsburgh and Pennsylvania, to enhance their skills beyond local norms.