The History of Emergency Services

Ever since there has been war, there have been those tending to the injured in the field. The first civilian ambulance was incorporated in 1865, in Cincinnati. The history of Emergency Medical Technicians can be traced back to a time when patients were offered a thirty second response time, as well as ambulance surgeons who offered brandy to their patients.

Since that time, medical teams have treated injured soldiers in each war. During World War I, injured soldiers lying in the fields were located using signal boxes. Medical teams began to use new equipment such as traction splints at this time. After the war, ambulances were used. These ambulances carried surgeons and were equipped with newly available two-way radios. In some areas, however, the ambulance was actually a hearse, and run by local funeral homes. These were known as ‘combination cars.’

Before World War II, there was no formal training for ambulance personnel beyond basic first aid. For some fire departments or police departments who took over ambulances (due to severe manpower shortages) ambulance duty was a form of punishment.

In the 1960’s, CPR and defibrillation were developed as standard care for cardiac arrest. New drugs were developed to treat patients as well. A report named “Accidental Death and Disability”, or the ‘White Paper’ was written by the National Highway Traffic Safety Administration, outlining the governments’ urgent need to improve emergency care and ambulance service.

Until the 1970’s, ambulance service was unregulated. This meant that in some areas, patients received care from advanced responders, while in other areas ambulances were operated by the local undertaker. In 1971 after the ‘White Paper’ study was released, it was heralded as “‘the single greatest contribution of its kind to the improvement of emergency medical services.”

The National Highway Safety Traffic Act was adopted to standardize the training of emergency medical services which, until that time, had widely fluctuated from trained responders to funeral home drivers. Along with standardized training, the National Highway Traffic Safety Act urged each state’s involvement, recommended radio communication and promoted one emergency number.

In response to the recommendations from President Johnson to create a national agency that would establish standards of emergency ambulance services, the National Registry of Emergency Medical Technicians was created in 1970. This is a non-profit organization that is dedicated to providing a national certification process for EMS professionals. Through this certification process, EMS will be uniformly assessed to ensure they are highly skilled and competent in their field.

In 1972, the lead agency for EMS became the Health Services and Mental Health Administration. The Physician Responder Program was started at this time. The program later changed into paramedic programs, with a strong emphasis on physician supervision. The EMS Systems Act soon followed, establishing three hundred EMS systems throughout the country.

In 1995, the National Association of State Emergency Medical Services Directors, the National Association of EMS Physicians and the National Highway Traffic Safety Administration met. Their goal was to discuss the future of Emergency Medical Services. The product of this meeting became known as the EMS Agenda for the Future.

Each party agreed that due, in part, to increased attention from the community and media, as well as increased consumer demands, the public would have high expectations of EMS. EMS would be looked at as leaders in the community, as a safety net for the public. Standards of care developed by EMS could then be used so others could measure their system operations against these standards. The EMS Agenda for the Future also suggested that EMS would need to carefully determine how best to care for patients to provide the best possible outcomes, while using the most cost-effective methods. To do this, EMS would need to follow evidence-based, researched, practices. These are called ‘best practices.’

The suggestions made by the EMS Agenda for the Future were reviewed by five hundred individuals and organizations, who then developed fourteen attributes for Emergency Medical Services. These attributes were developed so EMS could constantly strive towards excellence, so EMS could reach its greatest potential.

Today, the goal of EMS worldwide is to bring care to the patient (both on scene and en route to the hospital), not the patient to the care. Emergency Medical Technicians are highly respected and skilled professionals of the healthcare field. Through nationally accredited programs, EMT’s receive excellent training. The certification process focuses on continued education for EMT’s during their career, a practice which keeps their skills current and focused on the latest techniques and practices.



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