The Beginning of EMS

[CTEXPLORER]

I know there are some retired EMS workers here, and it wasn't a million years ago EMS was strated, atleast in the US. What was it like back then? I remember watching the show "Emergency" when I was little, which wasn't long ago. I know that show was of the first EMS unit in the US in California somewhere. I remember the squad would go and care for the patient, then the ambulance would go, literally chuck the patient into the ambulance and go, and nobody was with the patient! How different! Was that really how it was, I'd like to here how it was in the beginning. What technologies did they have? How did they operate?

[Defiant1]

kind of, back in the late 60's, the "ambulances" were just hearses, and EMT's didn't have much training if any, basically, it was a taxi service. i had done a report on the history of EMS a while back, i should try and find it, if i do i could e-mail it to you.

[CTEXPLORER]

Sure, that would be cool.

[paramedicmike]

Go back and watch some of those episodes of "Emergency" again. Some of your observations about what happened in the show aren't as astute as they could be.

Have you done any of your own research on this topic? Like on the origins of battlefield medical care and how it evolved into what we have today? Like on some of the influential papers written on the topic (something about death and disability being a neglected disease...that's a hint)? Less than five minutes on Google turned up several screens worth of information.

Or are you looking for a first hand perspective from some of the vets who lived and worked in this time?

I understand you're still a student. However, having done some research will help you when you come to the table with questions. Try that first and then we can help with other questions that may either be left unanswered by or as a result of your research.

Good luck!

-be safe.

[Ridryder 911]

I am glad young people are interested in the history of the profession. You can a learn about your industry as well as what the future might hold. One can see history does repeat itself many times especially in medicine. This is why medical schools require history of medicine classes.

Actually, EMS was involved in multi-areas, not just California. As well, hearses were still used into the 80's in some areas until Federal specifications was implemented. I am not aware if there are any funeral home that still provides EMS but, I know I had heard of one that was still doing it, and this was the early 90's.

So we have cam a long ways since the first EMS units, however; we still have a long ways to go. As humorous as the television show Emergency is some do not realize the impact one show, would make in medicine. I can attest most of the early medics became such after viewing this show, and those probably taught your instructors or instructors instructor and so on.... the series promoted our profession, and without it, I can personally say EMS would still be 50 years behind.

Just think, if your EMS cannot provide ACLS, that medical care in that series is still ahead of you and that was 35 years ago. One would think we would had advanced by now, instead of making excuses.

I wish that there would be another television show that would compare as Emergency, maybe EMS could finish the involvement.

Here is a link for a brief history of EMS and associated things.

http://www.rescuehouse.com/content/ems-his...ems-history.php

Good luck,

R/r 911

[bandaidpatrol]

kind of, back in the late 60's, the "ambulances" were just hearses, and EMT's didn't have much training if any, basically, it was a taxi service. .

I tend to disconcur with your view of history. I hope that's not part of this report...

To sum it up, as an ambulance attendant in "the 60's", we did the best we could with what we had.

Industry was just not on our side yet. We grew out of several professions; battle field surgeons, barbers, home nursing and funeral directors. Battle field surgeons and medics and corpsmen created the procedures that we use today; barbers were often the only persons available to provide stoppage of bleeding-less surgeons on battlefields hundreds of years ago, nurses riding to hospitals with ill patients in hospital wagons - few nurses-many ill patient, and the need to transport someone laying down. That is where funeral directors came in, we picked up victims on stretchers, and transported them flat in our hearse be it a wagon or a car. So, naturally, this was the best idea for a modern ambulance. We already had the car, and the bed; why not make a little money on the side? And I do stress a little. I can go into great detail on the history of pre-hospital transportation, but you'll have to do that research yourself, all the back to a hammock strung between two camels.

The ambulance

A hearse is different from an ambulance, the floor of a hearse has rollers on it, an ambulance needed wheel and post cups, and a flat surface to roll the bed on. For that purpose, they created the Combination Professional Car. It was an industry standard that the floor panels could be flipped over, so as to allow for the unit to be used for both a hearse and an ambulance. Color was another concern; black was a morning symbol for those in grief, but a stress trigger for those in need. So, we needed something that fit both profiles. White was angelic, and comforting. We chose white and maroon for all of our ambulances. But we did have hearses that were all black. For the most part, a combo car had just one red light, two spot lights, one white and one red, and a siren under the hood. It had one row of cabinets in the front, and open floor panels. These were all nicely decorated, to make it an acceptable appearance. The landeau panels with the funeral spires could be removed to reveal "Ambulance Service" etched in eisenglass windows. The cots didn't raise yet, and the bar to hook it to the wall was kept under the floor during a funeral. We could transport three on the floor, and two on the ceiling. Even with the cot in there. The cot was a Ferno-Washington, it had a feather mattress, covered with duck canvas. We also carried two folding stretchers, with "U" shaped feet, it could allow the patient to be set up, just like the ferno cot. We also carried two folding stretchers that lay flat to hang from the ceiling. The weight limit for the hooks was 175lbs. The folding stretchers came from Junkin, our funeral service supplier.

The equipment

We carried just about the same things you have now, to a point. We had two Keller-Blake Traction Splints, four flat stretchers for accident victims (it was known that accident victims should be kept flat, still and warm), eight blankets, two pillows, 100 Cravats, 15 Rolled gauze Bandages, 400 4" gauze Squares, three pairs of scissors, two surgical hemostats, a carton of 100 tongue blades, four large battle dressings, two 22x18" battle dressings for burns, One of each Adult and Child E&J Oral Airways (They were made of steel), two oxygen bottles- cross between a Jumbo D and an E cylinder-made of steel, they were kept in our E&J Lytport 1 Resuscitator-Inhalator-Aspirator units, four 28" box splints, four 24"x3" splints, four 18"x3" splints, four 15"x3" Splints, 1 Emergency Birthing Kit-set up for a twin delivery, clean sheets wrapped in foilpaper for burns, boric acid for burns, sandbags for head stabilization, wash clothes and towels, a glass pitcher of clorox, a bottle of spirits of ammonia, a "Hope-Puritan Bag-Valve-Mask Assembly", soap, thermometers, rolls of cotton, salve, eye and head dressings, one oxygen tent, a few emesis basins, a vomit pan, a urinal and a 3' x 18" wooden board to perform CCM on.

We also carried a first aid box, usually an MSA pre-filled kit, or a salesman sample box. Another good one was a carton to hold radio tubes.

The training

We didn't have "EMT"'s till the early 70's. But after 1966, we did have to be trained. I was trained in 1952. Standard and Advanced ARC First Aid. That was that. But along the way, we did receive other training. Oxygen, CCM (Closed Cardiac Massage) Yes, before the BVMA was brought about by AMBU and Hope-Puritan, if a resuscitator wasn't on hand, we did mouth to mouth.

In 1963 a course came about called the Ambulance Attendant, it was the earliest organized training I had. It was advanced first aid, oxygenation, resuscitation, airway insertion, airway suctioning, splinting, defensive driving, CPR (came after CCM, it was also called CPCR-Cardio-Pulmonary Cerebral Resuscitation) and Childbirth.

I'll get into the training and equipment for the earlier ambulances later on.

[Ridryder 911]

I was hoping you would catch this post... Band-Aid Patrol..

R/r 911

[CTEXPLORER]

Me too, great info BandAidPatrol, and great link RidRider911. I can't imagine what it was like then. With so little supplies, and correct me if Im wrong, but I would guess there weren't a whole lot of ambulances around, and not many hospitals, so it would probably be a while before patients go infinitive care. Do any of you have old stories of back when you started this job?

[bandaidpatrol]

Unless a patient was in dire need of surgery, the attempt at limb reattachment, had signs of internal bleeding or was unconscious.. They went to the nearest place medical care was available, sort of like today. Only that meant a doctors home or office. Honestly, if they were dead, and the hospital was more than a half hour away, we just took them back to the funeral parlor. The nearest big hospital was over two hours by road, there were no choppers till after 1970, then it was a big mess getting one. Nearest hospital was about as big as our home, and they were outfitted with probably the oldest MD's in the state. Literally OLD.

I'll add more later.

[PRPGfirerescuetech]

"On the 1st day...EMS gods created needles, oxygen, .9NSS, Ridryder911, and gauze..."

More excerpts later...