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! 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 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