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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 New York 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 car 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! debuts. 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 of 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
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