Evolution of Emergency Medical Technicians and Paramedics in the U.S.A.

Abstract

Before the 1950’s, emergency medical transportation received little attention from physicians and government. Many ambulances in cities were staffed by hospital interns, while most outside of cities were staffed by volunteer fire fighters or employees of mortuaries. The development of modern resuscitation, starting with emergency airway control and exhaled air resuscitation, aroused interest in improving ambulance services which developed around certain individuals (1–5) and organizations (6–l8). Much has been learned from foreign countries where physician staffed ambulances have provided advanced life support, including defibrillation, tracheal intubation and venous infusion at the scene, since the early 1960’s. Working with the National Academy of Sciences/National Research Council, recommendations were developed for improved ambulance design and equipment (9) which are still valid in the 1970’s; and for basic ambulance attendants1 — Emergency Medical Technicians (EMT I) training (10), which were catalyzed by the Freedom House Ambulance Pilot Project with disadvantaged blacks in Pittsburgh (11/12) • Original ambulance attendants1 manuals (13) were expanded and improved by various organizations (14) and followed by a detailed national educational training program (15).