Our EMS is Basically a Toddler – A Special Report

By Andy Murray

As a profession, EMS is a child, struggling with who it is, what it does, and wanting to make its mark on the world. There roots date back to the American Civil War, who were medically trained soldiers assigned to bases, using horse drawn carts to get patients to a doctor. In 1865 Cincinnati created the first civilian ambulance group, soon followed by New York in 1869, who advertised 30 second response times (better than Austin/Travis County’s which is 3:30 minutes), an on-site surgeon, and a quart of brandy. World War 1 began the era of motorized ambulances, medics used either gas, electric, or steam powered carriages. It was also the first war to utilize medical equipment such as traction splints. Shortly after the war, civilian ambulances were soon connected to a radio dispatcher to create better patient service.


The 1950’s began “modern” Ems, which started with the melding of 5 different businesses: towing operators, medical equipment companies, funeral homes, hospitals, and police/ fire departments. For year’s funeral homes had been unregulated and carrying live patients to the hospital for treatment, providing nearly half of the country’s ambulance services. In 1960, Kennedy declared that “Traffic accidents constitute one of the greatest, perhaps the greatest, of the nation’s public health problems”. This sparked LBJ to, in 1966, declare this to be “the neglected disease of modern society.” Soon after, the standardization of Ems began with the adoption of the National Highway Traffic Safety Act which gave Ems standard training, promoted state involvement, encouraged community oversight, recommended radio communication, and stressed a single emergency number (911).


1973 brought the EMS Systems Act (EMSS Act) a mass development of Ems programs, the Department of Health, Education, and Welfare creating over 300 all over the country. The Department of Transportation created the EMT-Basic, EMT-Advanced, and EMT-Paramedic ranking system, each with their own curricula. A Law (93-154) established a general training and rules for radio communication. More recently, the National Registry of Emergency Medical Technicians (NREMT) was established, which further developed the training and protocols.


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