It maintains a fleet of 165 ambulances and performs over 272,000 medical transports every year to, or between, 23 hospitals in the Montreal metropolitan region.

By the late 1970s, however, police ambulance training and equipment had fallen behind contemporary standards and the service was finally withdrawn.

Urgences-santé was created in 1981 by forming a centralized dispatch system for the region's 25 privately owned ambulance services.

As part of the program, a single telephone number for emergency medical services was introduced for the islands of Montreal and Laval (842-4242).

Consolidation of the private companies and the formation of a militant labour organization caused much instability including a strike in 1986.