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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 managed pre-hospital care and its
progression through the years.
Chronological time line:
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 - The first Cardiac Care Unit was initiated by Dr. Frank Pantridge M.D.
(Professor) in Belfast, Northern Ireland. In 1966 it delivered pre-hospital
coronary care using ambulances (Cardiac Ambulances). It was staffed with a
cardiologist, a nurse and a cardiac technician. It was equiped with an E.C.G
monitor, a defibrillator, and cardiac drugs and was dispatched form the Royal
Victorian Hospital. His research showed that his program significantly
improved patient survivability in out-of-hospital cardiac events.
In Pittsburgh, citizens demanded 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.
1967 - The first paramedic system was initiated in Miami, Florida in 1967-68
organized by Dr. Eugene Nagel and Dr. J. Miller MD. University of Miami
Medical School held the first paramedic school at the University of Miami
and called these graduates "Physician Extenders." By March, 1967, these
paramedics were transmitting heart rhythms to Jackson Memorial Hospital,
with a unit that weighed a combined 54 pounds. Experimental programs
soon began in Pittsburgh, Seattle, and Los Angeles San Francisco and
Jacksonville and several other cities followed the lead.
Nagel and his associates combined in a single unit, the electrical energy of
the radio signal interfered with the modulator's ability to transform the
millivolts of an EKG into an audible tone for radio transmission. Miami
innovators worked with a small California manufacturer to develop a
modulator with sufficient shielding and bypass capability. The Biocom
modulator proved successful, and in March 1967, Miami's new
"paramedics" began to routinely transmit EKG's to Jackson Memorial
Hospital.
Dr. Michael Crawley and Dr. James Lewis commenced a pilot program in
Los Angeles, California, at Harbor General Hospital. It consisted of
eighteen firefighters, twelve from Los Angeles County Fire Department and
six from Los Angeles City Fire Department.
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.
Hayward North Carolina: This unlikely locale was one of the first areas in the
United States to utilize non-physician paramedics in taking coronary care to the
patient in a prehospital setting. Even more unlikely was the choice of personnel
to serve as paramedics: local members of the volunteer Haywood County
Rescue Squad.
Dr. Ralph Feichter, a native of Haywood County who had received his medical
training in the north, practiced in Waynesville as an internist when he and his
medical associates took note of Dr. Pantridge's work in Belfast. Concluding
that such a system was possible in their mountains, they assembled 40 of the
volunteers for basic training in 1968. At the same time, they applied to the
North Carolina Regional Medical Program (RMP) for a grant to equip two
mobile intensive care vehicles. In April 1969 the volunteers reassembled for
intensive training in cardiac pathophysiology, electrocardiography, arrhythmia
recognition, pharmacology (cardio-active drugs) and CPR. Classes were
conducted two nights per week for about twelve weeks. The course was then
repeated in the fall of 1969.
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 very first out-of-hospital defibrillation occurred In Miami Florida
by paramedics (the patient survived and left the hospital neurologically intact).
Another paramedic program in the United States was conceived in 1968-69 in
Seattle Washington by Leonard Cobb, MD, a cardiologist at Harborview
Medical Center. In conjunction with Fire Chief Gordon Vickery of the
Seattle Fire Department and, Dr. Cobb and his associates began training a
select group of Firefighters from Seattle in 1970. In Seattle, Dr. Leonard Cobb
teamed up with the Seattle Fire Department and created 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.
In Los Angeles on September 12, 1969, firefighters began intensive 180 hours
of training that included classroom, laboratory and chemical instruction, under
the tutelage of C.C.U. Nurse Carol Bebout.
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. The Maryland State Police Aviation Division completed the first civilain scene
medevac on March 19th, 1971.
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.
The first All-Vollunteer ALS program was started in Virginia Beach Virginia
on August 11th 1973. The State curriculum was by Dr. Willaim Andrew
Dickinson and Dr. Jame Perry Charlton both Medical disrectors of Virginia
Beach and Dr. Richard Crampton of Charlotteville (UVA). They assisted the
Office of EMS at a request from the Governor in creating the Cardiac
Technician certification level. Charlottesville launched their program several
moths later.
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. The North Carolina General Assembly [legislature] did not legally authorize
paramedics until 1974.
1975 - The American Medical Association recognizes emergency medicine as a
specialty.
1976 - On April 9, 1976, 19 of America's first paramedics--trained to a higher
level of performance and certified under one of the most exacting programs to
in the United States--were officially certified as North Carolina MICTs.
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. The City of San Diego Fire
Department starts a paramedic engine company pilot program.
1992 - American Medical Response starts to sell stock on the NYSE and starts
a nationwide consolidation of the private ambulance industry. LaidLaw buys
MedTrans and all of its assests and subsiderary ambulance services. 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. Rural
Metro Corporation and San Diego Fire and Life Safety Services enters into a
joint contract to provide paramedic services to the City of San Diego. This
agreement is the first of its kind in which bith enities share in the expense and
also the profit of providing 911 servcie and BLS transportation.
1999 - LaidLaw announces in The Wall Street Journal that it is looking for a
buyer for its entire ambulance operation. Paramedicine is a young profession,
only in existence for approximately 30 years now. The very first organized
"paramedics" or first-aiders and firefighters were The Knights of Saint John
The Baptist of Jerusalem. However, the first "Volunteer Rescue Service" was
founded by Julian Stanley Wise in Roanoke Virginia in 1928 It was called "The
Roanoke Life Savings and First Aid Crew." They provided first aid, but it
wasn't until 1969 that a volunteer squad received the training and equipment to
function as paramedics. Emergency care in our cites was influenced by "mash
units" and military medicine by "Medics and Corpsman" in Korea and Vietnam.
Similar to the care given to soldiers by The Knights of Saint John - Knights of
Malta during the great crusades. After World War II the Highway Safety Action
Program was drafted up to assist states in preventing automobile accidents. The
Hoover Commission reviewed but did not add the prehospital care issues until
1949. In the mid 50's, Dr. James Ealand from The John Hopkins University
developed the technique for mouth to mouth ventilation by sustaining life with
expired air from rescuers. Anasthesiologist, Dr. Peter Safer and The
Baltimore Fire Departments Chief of Ambulance Service, Martin MacMahon
practiced, developed and defined these techniques with firefighters, nurses and
doctors that allowed themselves to be paralyzed while rescuers "practiced" and
studied the new technique. Mouth to mouth was recommended by The National
Academy of Science. However it was not approved by The American Red
Cross or the American Heart Association for approximately 15 years. On May 11th. 1959, after 6 years of development with experiments at The
Hopkins Institute conducted by Dr. James Jude, Dr. W. D. Kowenhoven, and
Dr. Guy Knickorbacker, the first portable defibrillator was delivered. It was
produced by The Edison Electric Institute and weighed 45 lbs. Cardio
Pulmonary Resuscitation is credited to this group of researchers.
With the A. B. C. recognition (airway, breathing and circulation) and C.P.R. the
American Red Cross and the American heart Association established standards
for training and delivery of this rescue technique. However, C.P.R. was a primary
function for "rescue crews" only and in 1972, Jacksonville Florida was the safest
place to be in the U.S. as every firefighter was trained in C.P.R. Years later,
Seattle has become the safest place on earth to suffer a "heart attack" as more
lay people are trained in C.P.R than any other city due to aggressive marketing
by the American Red Cross and The American Heart Association. President Eisenhower created the Presidents Committee for Traffic Safety to
promote the Highway Action Safety program. In 1962 Willaim Randolf Hearst
Jr. chairman of the committee formulated an amendment to the Action Program
that would deal with prehospital medical care issues. The senior medical advisor
to Metropolitan Life Insurance, Dr. George M. Wheatley was appointed to head
a task force called the Committee on Health Care, Medical Care and
Transportation of the injured. This committee was subdivided into four groups;
alcohol and drugs, prehospital care, driver health, and medical treatment.
Ambulances were redesigned and training guidelines established. Baltimore
Fire Chief Martin MacMahon and anesthesiologist, Peter Safar along with the
Public Health Service, The American Red Cross, The American College of
Surgeons, and other safety and health agencies, produced the first standards for
ambulance design. After four years Dr. Weatley presented the "new guidelines' to
Chairman Hearst; Secretary of Health, Education and Welfare; John
Gardner; and vice chairman to the Presidents Committee for Traffic Safety's
Advisory Council, Russell Brown. Standard 11 of the the Highway Safety
Action Program was now finished. Due to an increase in highway related
deaths, Joeseph Califano, special assistant to President Lyndon Baynes
Johnson drafted up new laws for automobile design and the legislation known
as The Highway Safety Act. In 1965 more than 50,000 Americans died in
automobile accidents alone on highways. It was signed into law on September
9th. 1966 by President Lyndon Johnson. The National Traffic Safety Advisory
Committee was formed which replaced the Presidents Committee on Traffic
Safety. The federal highway safety effort comprised of 18 standards to include;
• Improved highway design.
• Improved and uniform highway signs.
• Improved emergency medical services
• More strict enforcement of drunk driving regulations. Standard 11 from this report focused on ambulance redesign and radio
communications. Federal funds were spent on improvements in training:
Also in 1966 national standards for E.M.T. training were established. Federal
funds and grants were provided for individual E.M.S. systems likeJacksonville
Florida's Fire Departments purchase of new ambulances and equipment and
developed a New Model for delivery of care for the sick and injured. And funds
were used for helicopter transportation like the Arizona Medical Evacuation
System which is still in operation today. Systems staffed by trained emergency medical technicians (E.M.T.s), the
E.M.S., as we know it today, began in 1966. That year, committees on Trauma
and Shock of the National Academy of Sciences National Research Council
published a document called "Accidental Death and Disability: The Neglected
Disease of Modern Society." Public attention brought about reforms that began
in the late 60's and early 70's. This report indicated that ambulances were staffed
by poorly trained personnel from funeral homes or enthusiastic volunteers
without the proper the equipment and or training on how to use them. The report better known as "The White Paper" was clear to point out that:
• "The General Public is insensitive to the magnitude of accidental death
and disability." And that "millions of Americans lacked the basics of first
aid."
• "Communication is seldom possible between an ambulance and the
emergency department that it is approaching."
• There were wide spread problems with telephone access to the proper
emergency service and difficult and complicated 7 digit numbers were
used.
• Dispatch centers were staffed with poorly trained personnel with a manual
access to information that created a slow process with a large factor for
error.
• "It would seem feasible to designate a universal easily remembered
number for all dial telephones throughout the nation."
• Pilot programs are recommended to determine the efficacy of providing
physician staffed ambulance. Out of this also gave birth to the "Organized Trauma Systems" in Illinois by
Doctor David Boyd and in Maryland by Dr. R. Adams Cowley. He founded the
"Cowley Shock Trauma Center" in Maryland and developed the model that all
trauma systems follow. His research invented "The Golden Hour" for treatment
to prevent irreversible shock. In Belfast Northern Ireland Dr. Frank Pantridge M.D. (Professor)initiated the
first Cardiac Care Unit. It staffed a nurse and a cardiac technician and carried
cardiac drugs, and E.K.G. monitor, a defibrillator and ventilation equipment. It
was dispatched and responded from the Royal Victoria Hospital. A British
Medical Journal published the results form the program and he was requested to
speak at the American College of Cardiology in the U.S. The first Coronary
Care Unit in the United States was mobilized form Saint Vincent Hospital in
New York City in 1968. Doctor William Grace used medical students and
Cardiologist to staff the vehicle. Paramedics would eventually take over in this
role. However, The Columbus Ohio Coronary Care Program used specially
trained firefighters that assumed the role early on from the pilot program staffed
by Cardiology students from the Ohio State University. In 1969, North Carolina
began the first volunteer paramedic rescue squad. Also in 1969 the Rescue
Squad in Roanoke, Virginia received the training and equipment to function as
paramedics. In the late 60's, The City of Miami, Seattle, Los Angeles and Jacksonville
also selected firefighters to staff Cardiac care units. In San Francisco and in
Portland Oregon, private ambulance personnel were selected and trained. This
was about the first time that the term "paramedic" was used. The 911 system was initiated in 1967 by the Presidential Commission on Law
Enforcement and Administration of Justice. AT&T announced "911" as the
number to dial after a single number for emergency requests nationwide was
recommended. The first 911 call was made in Haleyville, Ala. in February 1968.
Presently, an estimated 280,000 calls are made per day. In New York City alone
the number of calls is estimated to exceed 12.5 million per year in 2005. A new
911 system in Los Angeles will be completed in 2000 and was approved by a
$235 million bond issue. In Chicago and New York the new systems costs $217
million each. In 1968, AT&T reserved "911" nationally as the recognized number to access in
an emergency. The very first call to 911 came into a small town dispatch center
in Haleyville, Alabama. Also, in 1968, Emergency Medicine was recognized as a
speciality when The American College of Emergency Physicians was formed.
In 1969 The American College of Orthopedic Surgeons created the first
standard course for training E.M.T.'s for ambulance personnel. The first paramedic system was initiated in Miami, Florida in 1967-68
organized by Dr. Eugene Nagel and Dr. J. Miller MD. The pioneer paramedic program was initiated in Miami, Florida at Jackson
Memorial Hospital by Dr. Eugene Nagel "The Father of Paramedicine," and
Dr. Jim Hersman. Dr. Eugene Nagel from the University of Miami Medical
School held the first paramedic school at the University of Miami and called these
graduates "Physician Extenders." By March, 1967, these paramedics were
transmitting heart rhythms to Jackson Memorial Hospital, with a unit that weighed
a combined 54 pounds. Experimental programs soon began in Pittsburgh,
Seattle, and Los Angeles as several other cities followed the lead. The Miami program was operated by the City of Miami Fire Department and
administered by Fire Chief Larry Kenny for practical reason due to:
• Strategically located stations
• Sophisticated radio equipment
• Response vehicles
• Training programs
• Highly trained personnel with the ability to work well in the street  Dr. Nagel developed the first telemetry unit for transmitting E.C.G. recordings via
radio waves from the field to the hospital. The very first paramedic unit in the
the world responded from The Miami Fire Department's; Station # 1. At first
a physician was on board. The first successful defibrillation was preformed
in June, 1969 by "Paramedics." It is obvious that the New Emergency
Coronary Care Programs opened the door to expanded skills, scope of practice
and gave new tools to the field of EMS. And, in 1967, Dr. Michael Crawley and Dr. James Lewis commenced a pilot
program in Los Angeles, California, at Harbor General Hospital, that consisted
of eighteen firefighters, twelve from Los Angeles County Fire Department and six
from Los Angeles City Fire Department. In Los Angeles on September 12, 1969,
the firefighters began an intensive 180 hours of training that included classroom,
laboratory and chemical instruction, under the tutelage of C.C.U. Nurse Carol
Bebout. They were skilled on intra-cardiac injection and defibrillation as well
other advanced techniques. There were 30 nurses in the class and to the
surprise of some, the fire department personnel scored 2 through 7 out of 36
students. Diane Kersten RN. bought the Los Angeles firemen/paramedics their first fishing
tackle box to replace the "doc-bag" that was ineffective in carrying the drugs. By
December, 1969, they were ready to go; however, they had no legal authority.
Los Angeles County Board of Supervisors' Kenny Hahn (who became known as
the "Father" of the Los Angeles Paramedic Program) pushed legislation through
the Board and presented it to State Senator James Wedworth and State
Assemblyman Larry Townsend. Both the house and the senate approved
legislation that gave legal authority for paramedics to perform, and on July 14,
1970, Governor Ronald Reagan signed the Wedworth-Townsend Act into law.
Los Angeles County and City Paramedics were on the go. Another Los Angeles area paramedic program was started at Daniel Freeman
Hospital, in Inglewood California in 1971. The ambulance was staffed by
doctors that only treated cardiac patients. Another paramedic program in the United States was conceived in 1968-69 in
Seattle Washington by Leonard Cobb, MD, a cardiologist at Harborview
Medical Center. In conjunction with Fire Chief Gordon Vickery of the Seattle
Fire Department and, Dr. Cobb and his associates began training a select group
of Firefighters from Seattle in1970. These men were subjected to a grueling
program that was comprised of primarily cardiology. The mission of the first
Mobile intensive Care Unit was to deliver care, at a physicians level of expertise,
to the citizens of Seattle that suffered from catastrophic cardiac events. Over the
ensuing years it became evident that the lives of those suffering from other acute
medical emergencies could be positively effected by the advanced level of
medical care available on the streets of Seattle. Thus, Medic One evolved from
treating only cardiac emergencies to managing patients with severe trauma, drug
overdoses, poisonings, complicated emergency childbirth and gastro-intestinal
bleeds, just to name a few. As Medic One grew in recognition and reputation in
Seattle and then into other parts of King County in 1972, so did Harborview
Medical Center. It grew from the areas County Hospital to the Northwests only
level one Trauma and Burn Center. It currently serves, not only Washington
residents but the entire Northwest region, including Oregon, Idaho, Montana,
Alaska and parts of British Columbia. In the mid 1970's Harborviews Trauma Center, Seattle Medic One, and
Paramedic Training for all Paramedics in King County was entrusted to an exarmy
Major, Vietnam Veteran, and soon to be world renowned Nuerologist, Dr.
Michael Copass. He has been described as a cross between Dr. Schweitzer
and General Patton. Under his leadership the Paramedic program in
Seattle/King County has become known world wide as the front-runner in prehospital
Emergency Medicine. Every Paramedic "practicing medicine in the
streets" (we do not have protocols!) in the Seattle/King County area is required to
complete the Harborview Training Program, now reduced to about 12 months,
regardless of prior training. There is NO reciprocity from other programs. In the early 70's The US Department of Transportation and Defense used
U.S. Army helicopter Medivac Units at bases to transport victims to hospitals.
Saint Anthony's Hospital in Denver Colorado was the first civilian Air
Transportation Service. Soon these organizations were established:
• The Association of Air Medical Services
• The National Flight Nurses Association
• The National Flight Paramedics Association Reform was initiated by The National Highway Traffic Safety Administration
of the Department of Transportation (D.O.T.) and the Department of Health,
Education and Welfare, through theEmergency Services Act of 1973, created
funding for the development of an improved prehospital emergency care system.
These reforms and the work of dedicated professionals and organizations
designed effective emergency medical Service (E.M.S.) systems locally. In 1970 The National Highway Safety Administration designed and developed
The Star of Life to improve the image of E.M.S. The star contains the familiar
serpent and staff which is the recognized image of healing. The Points of the star
indicate the following:
• Detection
• Reporting
• Response
• On Scene Care
• Care in Transport
• Transfer to Definitive Care For more information on The Star of Life, please preview The Golden
Wand of Medicine. A must stop on the WWW for all emergency personnel traveling through
CyberSpace!!! The E.M.S. Systems Act was introduced in 1973 and became law in 1974.
Passed by President Gerald Ford, it defined the 15 components of an E.M.S.
System(see below under The System). It also provided funding for 300 regional
E.M.S. Systems throughout the nation. Federal funds were allocated to purchase
ambulances and equipment required to meet the new specifications similar to the
"New Model" developed in Jacksonville Florida. Prior to this new standard, oversized Cadillacs, Buicks, and Pontiacs were the
primarily used ambulances. These new ambulance specifications listed
ambulances is 3 categories: • Type one:
Truck Chassis with modular components (a box on the rear portion of the
truck chassis, not attached to the cab). • Type two: Van Chassis with a raised roof. • Type three: Van Chassis with a modular component (a box attached to the cab) In 1972 the Federal Communications Commission designed a new nationwide
system for radio traffic called the common system approach. And in 1973, seven
years after The American College of Emergency Physicians were formed, the
American Medical Association recommended emergency medicine as a
specialty. The National Association of Emergency Medical Technicians was
formed. In 1977, the National Council of State E.M.S. Training Coordinators
was established to recognize and standardize the need for EMS training. Twelve
years after "The White Paper," EMS suffered the first budgetary slashes as the
Carter Administration wished to down-size many programs. It was sidetracked by
the "crisis" in Iran and the hostage situation. In 1976 the Comptroller General
issue a report to the U.S. Congress that indicated that although progress has
been made, problems still existed in EMS. Did he have an insight into the future
with the City Budget becoming tighter and insurance companies and H. M. O.'s
becoming less cooperative with payment. Or did he realize that the overwhelming
indigent and non-insured public would put a strain on the system as we now
know it as we have become the inner city clinics and doctors on wheels. Or, was
he off track all together??? References: • Jems Magazine: Vol 21 # 9, 9-1996, Scott Foems
• Making A Difference "The History of Modern E.M.S."© 1997 by Mosby-
Year Book, Inc. Jems Communications, Mosby Publication, A Times
Mirror Company
• "The Orange Book" Emergency Care and Transprtation of the Sick and
Injured
The American College of Othopedic Surgeons
• James Jordan, Paramedic Evergreen Medic one, Seattle, WA.
(Responsible for the detailed version and information on The Seattle,
MEDIC ONE System. Truly, One of, if not THE BEST EMS SYSTEM in
the world)
• Tom Anglim, Paramedic, EMS Instructor and Quality Assurance Manager,
San Diego, CA.
• The Paramedics Jems.com by James O. Page
More 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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