Emergency Medical Service, or EMS, is relied upon across the globe in developed countries to provide adequate medical care to patients during emergency circumstances in the field. The modern system is comprised of three parts: dispatch, the rescue agency, and definitive care, such as a hospital.
During an emergency, help is summoned by use of an established number, in most places within the U.S. 911. This number connects the caller to a dispatcher, who then ascertains the nature of the emergency, and dispatches the appropriate units: fire, rescue, or law enforcement. The dispatcher is trained to instruct the people at the scene, until units arrive. Emergency agencies, such as rescue squads, remain on call with their vehicles or in their stations until they receive an emergency call and dispatch information, from the dispatch center.
When the agency receives word of an emergency, they quickly proceed to the location. In cases of medical emergencies, teams of paramedics and emergency medical technicians, or EMTs, provide medical care and rapid transport to a location of definitive care, such as a hospital. Depending on the type of medical emergency, there are generally two levels of emergency response. Basic life support has all of the skills and equipment to provide resuscitation, emergency care and transport. Advanced life support usually has additional skills and equipment to include: the administration of drugs, EKG monitoring and interpretation, and intubation.
The organization of EMS varies throughout and can be different depending on location. The primary goal of EMS is stabilization of the patient’s condition, and the support of life functions as well as transportation to definitive care as quickly as possible.
By most accounts, the origin of EMS began in the latter portion of the 1700’s. Not surprisingly, the concept of aiding wounded soldiers in the field eventually became the basis for modern emergency medicine. While removing wounded soldiers from the battlefield was standard practice as early as in Ancient Greece and Rome, urgency regarding the wounded was not thought of practically until the campaign of Napoleon Bonaparte. In the 1790’s Napoleon requested Baron Dominique-Jean Larrey to study the implications of treating wounded soldiers on the battlefield. One of Larrey’s critical findings was that leaving wounded soldiers on the battlefield was detrimental to their health, and caused greater anguish and suffering. He concluded that having a system in place to treat the wounded immediately would prevent a substantial number of deaths. The main problem faced by such medical treatment was the distance between the ambulances and the soldiers. This was remedied by having horse-drawn carriages, staffed with medical personal, treat soldiers on the way to the field hospital. The carriages used in this effort were known as ambulance volante, or flying ambulances.
It was not long until the military uses of emergency medical transport were seen as possible benefits to the civilian world. Like in the battlefields throughout history, civilian EMS began as a simple transport for the sick and injured. The first recorded service was a component of the fire department, at the Cincinnati General Hospital, in 1865. Another early account was located in New York City at the Free Hospital of New York, under the supervision of Dr. Edward Dalton, in 1869. Usually such care was restricted to larger cities. One of the earliest examples of prehospital care was the Roanoke Life Saving and First Aid Crew, located in Roanoke, Virginia, under the direction of Julien Stanley Wise in 1928.
World War I and World War II brought many changes to the field of military EMS. Soon it became extremely advanced compared to its civilian counterpart. The question of disparity between the two systems was raised in the 1950’s by Dr. JD Farrington, and later compounded when the National Academy of Sciences and the National Research Council prepared a report entitled “Accidental Death and Disability: The Neglected Disease of Modern Society” in 1966. This report acted as the catalyst for broad improvement of the civilian EMS system across America, and began to answer the question posed by Farrington. In states such as California, Washington, Pennsylvania, and Oregon, and effort was made to create a certification solely for the purposes of EMS. This certification was known as Paramedic. Although this plan initially ran into opposition from doctors and fire departments, soon the obvious benefits were recognized and accepted. Following with the changes occurring in the field the USDOT began formulating regulations for ambulance service.
In the process of regulation, soon the National Registry of Emergency Medical Technicians(NREMT) was formed. They created written examinations and criteria for obtaining an EMT certification, which are followed in whole or in part by most states today.
Note: In most countries worldwide, the standard emergency number is 112. This is used in conjunction with any regional numbers that may be present, such as 999, which is used in the U.K. In this area someone could dial either number for help. 112 also works on any GSM phone, being the GSM standard.
Big thanks to ascorbic for the correction and info!