EMS & Resuscitation History

Adam Thompson introduces himself as an EMS educator and paramedic professor, embarking on a historical overview of EMS (Emergency Medical Services). The journey begins in the 1800s with Napoleon designating vehicles for battlefield injuries, marking one of the earliest forms of ambulance services. Dominique Jean Larrey, a key figure, emerges as a pioneer in battlefield medicine, suggesting the introduction of 'ambulances volantes' or flying ambulances. These horse-drawn wagons were not just transport vehicles but a comprehensive EMS system with medical supplies and personnel, including doctors and non-commissioned officers. The narrative transitions to the United States in the 1860s, highlighting the first medic-ambulance combinations used in the military and the inception of civilian ambulance services shortly after, showcasing the evolution of EMS from horse-drawn wagons to motor vehicle ambulances in Chicago by 1899.

The narrative continues into the 1920s, where fire departments, starting with Phoenix, began incorporating EMS services, recognizing their pivotal role in emergency and rescue operations. The establishment of the Roanoke Lifesaving Crew in 1928 by Julian Stanley represents another advancement, introducing vehicle type ambulances equipped with medical devices. The 1940s saw EMS being adopted by police and fire departments universally, with funeral home vehicles also used for patient transport due to their capacity. This period underlines the growing recognition and integration of EMS into existing public service departments, paving the way for advancements in emergency medical care and transportation methodologies.

The script progresses to the Korean War era, where helicopters began transporting battlefield casualties to MASH units, introducing air medevac concepts later adopted in civilian EMS. This innovation underscores the military's influence on EMS development. The 1950s and 60s in Europe saw the use of mobile intensive care units, a concept the U.S. admired but found challenging to implement. The pivotal moment for EMS in the U.S. came in 1965 with the publication of the EMS white paper by the National Academy of Sciences, leading to the National Highway Safety Act in 1966 that entrusted the Department of Transportation with EMS oversight and the inception of 911 services. Dr. Eugene Nagel's contributions in the late 1960s, especially in paramedic training and pre-hospital care innovations in Miami, are highlighted as foundational to modern paramedicine.

The 1970s brought significant advancements and formalization to EMS and emergency medical care. Key developments included the establishment of the National Registry of Emergency Medical Technicians, the release of the first EMT textbook, and the EMS System Act of 1973. This decade also saw emergency medicine recognized as a medical specialty, a monumental step for the field. The creation of the National Standard Curriculum for paramedics by the U.S. Department of Transportation marks a critical point in setting educational standards for EMS professionals, ensuring a consistent level of care and knowledge across the board.

The history of resuscitation is explored, tracing back to ancient methods like rectal fumigation by Mayans and Incas, progressing through various experimental and often bizarre techniques across centuries. This includes the development of mouth-to-mouth resuscitation recommended by the Paris Academy of Sciences in 1740 and various mechanical methods attempting to revive the deceased or those in cardiac arrest. Significant milestones include the first successful defibrillation in 1947, the development of mouth-to-mouth resuscitation as a standard procedure in 1956, and the introduction of closed-chest cardiac massage in 1960, laying the groundwork for modern CPR techniques and training.

The narrative concludes with the evolution of CPR and significant technological advancements in emergency medicine. The 1960s saw the development of portable defibrillators and the formal introduction of CPR to the public and military, leading to widespread training initiatives by the American Red Cross and the American Heart Association in the 1970s. The script also highlights the evolution of EKG technology from its cumbersome beginnings to the compact, lifesaving equipment used today. The Star of Life emblem, introduced by the National Highway Traffic Safety Administration, symbolizes the comprehensive EMS process, from detection to definitive care, marking a unified symbol for emergency medical services worldwide.