Emergency Services history

Then, in 1869, New York City advertised a 30 second response time and provided an Ambulance Surgeon and a quart of brandy for their patients!

In 1910, the American Red Cross began providing first-aid training programs across the country, initiating an organized effort to improve civilian bystander care.

The 1960’s provided another challenge to public health as traffic accidents began to lead to considerable trauma and death.

Also as part of the 1966 act, DOT offered grant funding to states with the goal of improving the provision of EMS.

The state's EMS Section was created in 1968 under the leadership of Joseph Salzmann.

In 1969, the first nationally recognized training course for EMTs was held in Wausau, Wisconsin, as a test site for the new DOT curriculum.

It was during this time that while EMS began to get a stable foothold, emergency medicine began to establish itself as a distinct specialty with the first residency training program in 1972 at the University of Cincinnati3.

While training was not mandated by law until 1974, many ambulance attendants completed the 81-hour Department of Transportation (DOT)-approved course voluntarily.

By 1975, there were 32 EM residencies across the nation preparing physicians that would interface with EMS at all levels from responders and educators all the way to medical directors.

Advances in care standards and education continued well throughout the 1980’s, including changes in the principles of funding for EMS with the Omnibus Budget Reconciliation Act.

The next step came in 1981 with the Consolidated Omnibus Budget Reconciliation Act which consolidated funding into state preventive health block grants, eliminated funding under EMSS Act, reduced compliance with federal guidelines, and lastly, abolished the federal lead agency.

NHTSA implemented a statewide EMS technical assessment program in 1988.

In 1989, the Office of Technology Assessment released a report detailing the challenges faced by rural EMS (United States Congress, Office of Technology Assessment, 1989) (see the discussion of rural EMS below).

The state elected to provide emergency air and ground transportation as a public service and created a sophisticated trauma system that designates trauma centers on the basis of compliance with standards and demonstrated need (IOM, 1993).

In 1995, through the urging of then NHTSA Administrator Ricardo Martinez, NHTSA and HRSA commissioned a strategic plan for the future EMS system.

Prior to 1997, San Francisco’s EMS system fell under the jurisdiction of the public health department, with the fire department providing first-responder support.

The report also noted that most of the available information is localized and anecdotal (GAO, 2001b).

JCAHO (Joint Commission for the Accreditation of Healthcare Organizations). 2002.

When hospital EDs go on diversion status, ambulances may have to drive longer distances and take patients to less appropriate facilities (GAO, 2003). Fully 45 percent of EDs reported going on diversion at some point in 2003, and the problem was especially pronounced in urban areas.

The Development of 9-1-1. [Online]. Available: http://www.nena.org/PR_Pubs/Devel_of_911.htm [accessed September 28, 2004].

The Federal Interagency Committee on Emergency Medical Services (FICEMS) was established in 2005 to ensure coordination among federal agencies supporting EMS and 911 systems.

Federal Interagency Committee on Emergency Medical Services (FICEMS). [Online]. Available: http://www.usfa.fema.gov/subjects/ems/ficems.shtm [accessed January 5, 2006].