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A LITTLE HISTORY
Few people realize that modern emergency medical service has only been around
for the past 70 years. This is the timeline of EMS from the very beginning when
mankind started to provide pre-hospital care and its progression through the
years.
1865 - America's first ambulance service is instituted by the U.S. Army.
1869 - America's first city ambulance service (utilizing horse drawn
carriages) is instituted in NewYork City by Bellevue Hospital.
1870 - Prussian siege of Paris used hot air balloons to transported
wounded soldiers. This was the first documented case of aeromedical
transportation.
1899 - Michael Reese Hospital in Chicago began to operate an automobile
ambulance which was capable of speeds up to 16 mph.
1910 - First known air ambulance aircraft was built in North Carolina and
tested in Florida. The aircraft failed after flying only 400 yards and crashing.
1926 - Phoenix Fire Department begins "inhalator" calls.
1928 - Julien Stanley Wise implemented the first rescue squad (Roanoke
Life Saving Crew) in the nation in Roanoke, VA.
1940's - Prior to World War II, hospitals provided ambulance service in
many large cities. With the severe manpower shortages imposed by the war effort,
it became difficult for many hospitals to maintain their ambulance operations.
City governments in many cases turned ambulance service over to the police or
fire department. No laws required minimal training for ambulance personnel
and no training programs existed beyond basic first aid existed. In many fire
departments, assignment to ambulance duty became an unofficial form of
punishment.
1951 - Helicopters began to be used for medical evacuations during the
Korea war.
1956 - Dr. Elan & Dr. Safar developed mouth-to-mouth resuscitation.
1959 - Researchers at John's Hopkins Hospital in Baltimore, MD developed
the first portable defibrillator as well as perfected CPR.
1960 - Martin McMahon experimented with various types of artificial
respiration by paralyzing Baltimore City firefighters and seeing which method
worked best.
Los Angeles County Fire Chief Keith Klinger proudly announced that every engine,
ladder and rescue company in his department was equipped with a resuscitator.
His department is believed to have been the first large department to adopt
uniformly medical emergency responsibility.
1965 - More people died this year in auto accidents (50,000) than in 8
years of the Vietnam War.
President L. Johnson signed into law the National Highway Safety Act which
started the National Highway Traffic Safety Administration.
1966 - The National Research Council publishes a research paper,
"Accidental Death & Disability - The Neglected Disease of Modern Society".
Otherwise known as "The White Paper", this work was the catalyst for improving
the delivery of pre-hospital care to this day. An excerpt from the report
states: "Expert consultants returning from both Korea and Vietnam have publicly
asserted that, if seriously wounded, their chances for survival would be better
in the zone of combat than on the average city street."
1966 - Dr. Pantridge in Belfast, Ireland, started to deliver pre-hospital
coronary care using ambulances. His research showed that his program
significantly improved patient survivability in out-of-hospital cardiac events.
In Pittsburgh, citizens demand an ambulance service to transport minority
citizens. Freedom House Enterprises took 44 unemployed 18-60 year old men and
gave then 3,000 hours of medical training. The program was deemed a success.
1967 - The American Ambulance Association publishes an article that
states that as many as 25,000 Americans are either crippled or left permanently
disabled as a result of the efforts of untrained or poorly trained ambulance
personnel.
1968 - St. Vincent's Hospital in New York City started this nation's
first mobile coronary care unit. The program at first used physicians, then
paramedics.
The American Telephone and Telegraph starts to reserve the digits 9-1-1 for
emergency use.
In Virginia,The Virginia Ambulance Law is passed and establishes the state's
authority to regulate ambulances, verify first aid training, and issues permits.
1969 - The Miami,FL Fire Department started the nation's first paramedic
program under Dr. Eugene Nagel. The very first out-of-hospital defibrillation
occurred shortly thereafter (the patient survived and left the hospital
neurologically intact).
In Seattle, Dr. Leonard Cobb at Harbor View Medical Center teams up with the
Seattle Fire Department and creates Medic I. Medic I is a Winnebago, (called "Mobi
Pig" by the firefighters manning it), based at the hospital and is dispatched
only on cardiac related calls.
1970 - The Charlottesville-Albemarle Rescue Squad in Charlottesville, VA
starts the nation's first volunteer paramedic program under Dr. Richard Crampton.
One of their first patients was President Lyndon Johnson, who suffered a heart
attack while visiting his son-in-law Chuck Robb at UVA.
1971 - The television show Emergency! debuted. Emergency contributed to
changed public attitudes concerning the fire service and emergency medical care.
At the start of the show, there were only 12 medic units in the entire country.
Four years later at least 50% of the population of this country was within 10
minutes of a medic unit.
1972 - The Department of Transportation and Department of Defense team up
to form a helicopter evacuation service.
In Seattle, Medic II is instituted. Medic II is a program to train 100,000
citizens in CPR. Harbor View Medical Center starts up the nation's most
intensive training program for paramedics. The course is 5,000 hours long,
compared to 3,600 hours a medical student endures to become a doctor!
1973 - St. Anthony's Hospital in Denver starts the nation's first
civilian aeromedical transport service. (The program was called "Flight for
Life").
The Star of
Life is published by the DOT.
The EMS Systems Act (public law 93-144) is passed by Congress, which funds 300
regional EMS systems.
1974 - A Federal report discloses that less than half of the nation's
ambulance personnel had completed the Department of Transportation 81-hour basic
training course or its equivalent.
1975 - The American Medical Association recognizes emergency medicine as
a specialty.
The University of Pittsburgh & Nancy Caroline MD, is awarded a contract to
develop the first nationwide paramedic training course.
The National Association of EMT's is formed.
1977 - The National Council of EMS Educators is formed.
1978 - Phoenix Fire Department implements paramedic engine companies.
1979 - The Journal of Emergency Medical Services
(JEMS) starts publication. The American Ambulance Association is formed.
1980 -
The National
Registry of EMT's published its first national standard exam for EMT-Intermediate.
1981 - Direct funding of EMS systems by the Federal Government is
replaced by block grants.
A study shows that 73 percent of all American fire departments, career and
volunteer, are involved in some level of EMS service.
In Salt Lake City, Jeff Lawson, MD, comes out with an emergency medical
dispatcher program and priority dispatching.
Nationwide, the medical community first recognizes AIDS.
1983 - Jack Stout starts systems status management in Denver.
"One for Life" law is passed in Virginia. This law assesses one dollar from each
motor vehicle license and replaces all other state funding for emergency medical
services. This provides funds to each city and county in Virginia and
substantially increases support for regional EMS Councils, Rescue Squad
Assistance Fund and EMT instructors.
1985 - The National Association of EMS Physicians is formed.
1986 - The Comprehensive Omnibus Budget Reconciliation Act (COBRA) is
passed by Congress. This affected transfers of patients from ED to ED and
prevented "dumping" (financially motivated transfers of patients).
1987 - Automatic Vehicle Locators (AVL) debuts.
1990 - The Trauma Care System Planning & Development Act is passed by
Congress.
Fire Department organizations join together in a resolution to expand into EMS.
1991 - The Commission on Accreditation of Ambulance Services sets
standards and benchmarks for ambulances services to obtain.
1992 - American Medical Response starts to sell stock on the NYSE and
starts a nationwide consolidation of the private ambulance industry.
A public opinion survey conducted for the American College of Emergency
Physicians found that nearly half of adult Americans could not identify 9-1-1 as
the emergency number, or confused it with 4-1-1, the directory assistance
number.
1993 - It is proposed that EMT-P's assume an expanded role in primary
care of non-emergent patients by learning expanded skills.
1995 - Los Angeles City Fire Department institutes EMT Assessment &
Paramedic Engine companies.
1996 - New York City EMS is absorbed by FDNY.
1997 - San Francisco and Chicago institute paramedic engine companies.
Information on the progression of EMS was obtained from the following
sources: Emergency Medical Services - 2nd Edition (1978) by James O. Page
Making a Difference - The History of Modern EMS (1997) by James O. Page
The Paramedics (1979) by James O. Page
15 Years of Paramedic Engines (1993) by Gary Morris
Information obtained from
http://www.angelfire.com/co/fantasyfigures/710history.html
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