When EMS was getting started in the late 1960s, I am not sure Nancy Caroline would have thought that Emergency Medical Services would have developed into the Mobile Intensive Care Units they are today in some parts of the United States. The original white paper published, Accidental Death and Disability: The Neglected Disease of Modern Society, focused mainly on the deaths due to trauma related accidents and the patients dying because of not being transported to a hospital in timely manner.The first EMS model was basically a scoop and run type service. By virtue, the model was based on the trauma victim needs to get to a hospital in a timely manner. The training was very minimal and included some very basic first aid skills that may compare to what is taught in some current babysitting classes today. The current standard first aid classes taught by the American Red Cross and National Safety Institute are much more comprehensive than the training received by the original “scoop and run” first responders of the late 1960. Almost as much time was spent on driving skills as it was on first aid and medical skills, and most EMS workers were considered “Ambulance Drivers”.
In the mid 1970s the focus shifted to what could be done for the medical patients. The training started to increase on the application of rendering care to the ill as well as the injured. The first pilot programs of where the current paramedic programs stemmed from were launched in Miami, Los Angeles and Seattle. These early pioneers had a very restrictive protocol. Each call, the paramedic would have to call the hospital and receive order to do some very basic first aid skills such as place the patient on oxygen. This “Mother May I” type of EMS delivery continued for well over a decade.
The focus finally began to shift in the 1980s from a transport agency to an agency that provided medical care and services. Terms such as ambulance driver and ambulance service were replaced with Emergency Medical Technicians and Emergency Medical Services to reflect the changes that EMS was now providing. The medical community began taking more of an interest in EMS in relation to how the outcomes of the patients treated in the pre-hospital settings could be improved. Local protocols were developed based on what the community needed and could afford.Next article……EMS 1980 to Present Day.
