The History of the Emergency Medical Service

The simple dialing of 9-1-1 springs Emergency Medical Services (EMS) into action, providing the fastest emergency medical care possible. But the truth is, EMS as we know it today didn't develop until the late 18th century, with significant advances in technology and regulation not taking place until the latter half of the 20th century.

Origins

• Patient rescue from medical emergencies goes all the way back to biblical times with the parable of the Good Samaritan, who bandaged and carried a wounded man on a donkey to an inn to take care of him. And in the Middle Ages, knights created the Order of St. John in 1099 to dedicate themselves to treating battlefield injuries in times of war. That group of knights would eventually be known as the Knights Hospitaller.

First Ambulance

• The earliest record of a transport system for emergency patients is in the late 18th century. Dominique-Jean Larrey, Napoleon Bonaparte's most trusted physician, created what was known then as the "flying ambulance" to transport casualties during the Napoleonic Wars, in 1792. Larrey's design of a horse-drawn carriage that carried soldiers was revolutionary for its time, which back then had no widely used system of transportation for the wounded. The invention would lay the groundwork for modern ambulances.

Ambulances at Turn of 20th Century

• Modern ambulances are specific to hospitals that employ them. This system of medical services originated in 19th century America, where the Commercial Hospital (now the Cincinnati General Hospital) in Cincinnati, Ohio, first employed its own exclusive vehicle in 1865. Bellevue Hospital in New York City followed with its own ambulance, and is believed to be the first to carry its own medical equipment in the vehicle. The first motorized ambulances, operating on electricity, ran out of Michael Reese Hospital in Chicago, Illinois, and New York City hospitals at the turn of the 20th century.

"The White Paper"

• In 1966, the National Academy of Sciences released a report entitled: "Accidental Death and Disability: The Neglected Disease of Modern Society." The report, which has come to be known in the EMS community as simply "The White Paper," detailed the myriad problems in medical service at the time. The report prompted the U.S. government to significantly upgrade the regulation and practices of emergency medical care. This began with the Highway Safety Act of 1966, designed to reduce traffic accidents and injuries or death resulting from emergency medical service. Furthermore, the Emergency Medical Care Committee was formed in 1976 to regulate scheduling of ambulance services across the United States.

Emergency Medical Services Today

• Emergency Medical Services is the most widely ccepted form of medical emergency service in the world. It operates at various levels with varying degrees of regulation, most commonly in the U.S., Canada and Europe. The generally accepted levels of care in EMS are standard care, basic life support, and advanced life support. The most common job titles in EMS are "Emergency Medical Technician," or "EMT," and "paramedic." Registered Nurses and physicians are also typically part of the EMS process, although EMTs and paramedics are the principal practitioners. EMS services also engage in specialized care for medical emergencies, such as strokes or cardiac arrest, as well as search and rescue missions involving ice or water rescues.