History of Emergency Medical Service (EMS)
1500 B.C. - The development of EMS has been based on tradition and, to some
extent, on scientific knowledge. Its roots are deep in history. For example, the Good
Samaritan bound the injured traveler’s wounds with oil and wine at the side of the
road, and evidence of treatment protocols exist.
1797 - Although the Romans and Greeks used chariots to remove injured soldiers
from the battlefield, most credit Baron Dominique-Jean Larrey, chief physician in
Napoleon’s army, with institution of the first prehospital system designed to triage
and transport the injured from the field to aid stations.
1860’s - Flying ambulances (dressing stations) were made to effect transport, and
protocols dictated much of the treatment. In the United States, organized field care
and transport of the injured began after the first year of the Civil War, when neglect
of the wounded had been abysmal.
1865 & 1869 - Civilian ambulance services in the United States began in Cincinnati
and New York City, respectively. Hospital interns rode in horse drawn carriages
designed specifically for transporting the sick and injured.
1915 - The first known air medical transport occurred during the retreat of the
Serbian army from Albania. An unmodified French fighter aircraft was used.
1922 - The first volunteer rescue squads organized in Roanoke, Virginia, and along
the New Jersey coast. Gradually, especially during and after World War II, hospitals
and physicians faded from prehospital practice, yielding in urban areas to centrally
coordinated programs. These were often controlled by the municipal hospital or fire
department, whose use of “inhalators” was met with widespread public acceptance.
Sporadically, funeral home hearses, which had been the common mode of transport,
were being replaced by fire department, rescue squad and private ambulances.
WWII - Mortality was linked to the time required to get to a dressing station.
Additionally, application of a splint devised by Sir Hugh Owen-Thomas resulted in a
reduction of mortality due to femur fractures from 80% to 20%.
Korea/Vietnam - The use of rotary wing aircraft for rapid evacuation of casualties
from the field to treatment areas was demonstrated during later conflicts, especially
in Korea and Vietnam.
1958 - That Dr. Peter Safar demonstrated mouth-to-mouth ventilation to be superior
to other methods of manual ventilation. Of note, Dr. Safar used Baltimore
firefighters in his studies to perform ventilation of anesthetized surgical residents.
1960 - Cardiopulmonary resuscitation (CPR) was shown to be efficacious. Shortly
thereafter, model EMS programs were developed based on successes in Belfast,
where hospital-based mobile coronary care unit ambulances were being used to treat
prehospital cardiac patients. American systems relied on fire department personnel
trained in the techniques of cardiac resuscitation. These new modernized EMS
systems spurred success stories from cities such as Columbus, Los Angeles, Seattle,
MODERN EMS IN THE U.S.
Demonstration of the effectiveness of mouth-to- mouth ventilation in 1958 and
closed cardiac massage in 1960 led to the realization that rapid response of trained
community members to cardiac emergencies could help improve outcomes. The
introduction of CPR provided the foundation on which the concepts of advanced
cardiac life support (ACLS), and subsequently EMS systems, could be built. The
result has been EMS systems designed to enhance the “chain of survival”.
1966 - The white paper, Accidental Death and Disability: The Neglected Disease of
Modern Society prepared by the Committee on Trauma and Committee on Shock of
the National Academy of Sciences— National Research Council, provided great
impetus for attention to be turned to the development of EMS. This document
pointed out that the American health care system was prepared to address an injury
epidemic that was the leading cause of death among persons between the ages of 1
and 37. It noted that, in most cases, ambulances were inappropriately designed, ill-
equipped, and staffed with inadequately trained personnel; and that at least 50% of
the nation’s ambulance services were being provided by 12,000 morticians.
1969 - While doing background research at Los Angeles' UCLA Harbor Medical
Center for a proposed new show about doctors, television producer Robert A.
Cinader, working for Jack Webb, happened to encounter "firemen who spoke like
doctors and worked with them". This concept developed into the television series
Emergency!, which ran from 1972 to 1979, portraying the exploits of this new
profession called paramedics. The show gained popularity with emergency services
personnel, the medical community, and the general public. When the show first aired
in 1972, there were just six paramedic units operating in three pilot programs in the
whole of the US, and the term paramedic was essentially unknown. By the time the
program ended in 1979, there were paramedics operating in all fifty states. The
show's technical advisor, James O. Page, was a pioneer of paramedicine and
responsible for the UCLA paramedic program; he would go on to help establish
paramedic programs throughout the US, and was the founding publisher of the
Journal of Emergency Medical Services (JEMS). The JEMS magazine creation
resulted from Page's previous purchase of the "PARAMEDICS International"
magazine. Ron Stewart, was the shows medical director who was instrumental in
organizing emergency health services in southern California earlier in his career
during the 1970s, paramedic program in Pittsburgh EMS, substantial role in the
founding of Toronto, Canada, paramedic program, and Nova Scotia, Canada,
1970's -1980's- the paramedic field continued to evolve, with a shift in emphasis from
patient transport to treatment both on scene and en route to hospitals. This led to
some services changing their descriptions from "ambulance services" to "emergency
The training, knowledge-base, and skill sets of both paramedics and emergency
medical technicians (EMTs) were typically determined by local medical directors,
what it was felt the community needed, and what was affordable. There were also
large differences between localities in the amount and type of training required, and
how it would be provided. This ranged from in-service training in local systems,
through community colleges, and up to university level education. This emphasis on
increasing qualifications has followed the progression of other health professions
such as nursing, which also progressed from on the job training to university level
As paramedicine has evolved a great deal of both the curriculum and skill set has
existed in a state of flux. Requirements often originated and evolved at the local
level, and were based upon the preferences of physician advisers and medical
directors. Recommended treatments would change regularly, often changing more
like a fashion than a scientific discipline. Associated technologies also rapidly
evolved and changed, with medical equipment manufacturers having to adapt
equipment that worked adequately the hospital environment to be able to cope with
the less controlled pre-hospital environment.
Physicians began to take more interest in paramedics from a research perspective as
well. By about 1990, the fluctuating trends began to diminish, being replaced by
outcomes-based research. This research then drove further evolution of the practice
of both paramedics and the emergency physicians who oversaw their work, with
changes to procedures and protocols occurring only after significant research
demonstrated their need and effectiveness (an example being Advanced Life
Support). Such changes affected everything from simple procedures, such as CPR,
to changes in drug protocols. As the profession grew, some paramedics went on to
become not just research participants, but researchers in their own right, with their
own projects and journal publications.
Changes in procedures also included the manner in which the work of paramedics
was overseen and managed. In the early days medical control and oversight was
direct and immediate, with paramedics calling into a local hospital and receiving
orders for every individual procedure or drug. While this still occurs in some
jurisdictions, it has become increasingly rare, with physicians building an increasing
confidence and trust in the work of paramedics. Day-to-day operations largely
moved from direct and immediate medical control to pre-written protocols or
standing orders, with the paramedic typically seeking advice after the options in the
standing orders had been exhausted.
1972 - Mundelein Fire Department first Paramedics pass a class held at Condell
Hospital, and the Village Purchases their first ambulance.
CURRENTLY- All full-time Mundelein fire fighters are Paramedics as well as fire
fighters; they attend a class which is held at Condell Hospital, which is resource
hospital for area fire departments. Paramedics receive training and certification
beyond the requirements for an EMT. In order to be licensed as an EMT-P
(Paramedic) individuals must complete an additional 950 hours of classroom and
clinical training involving supervised experience in an ambulance, patient care
experience, and basic and advanced life support protocols. They are required to be
an EMT-B and take an Anatomy and Physiology Course, prior to enrolling in the
Condell Medical Center is an Illinois Department of Public Health designated
Resource Hospital. The Condell Medical Center EMS System, along with eleven
Provider Departments, Associate and Participating Hospitals provide EMS education
and emergency medical services to the community. All of this means that Condell
trains the paramedics who often bring patients to the hospital by ambulance. All
Paramedics within the Condell System work under the Project Medical Director,
which is Michael Pearlman MD.
Once the Paramedic completes the course requirements they become licensed under
the Illinois Department of Health. The license is good for four years; within that
time Paramedics must attend continuing education to renew their license. These
classes are normally held once a month at their respective fire departments; they
contain a lecture and a practical portion along with a written test. The Paramedic
must pass all of these areas to be awarded the hours toward renewal of their license.
Where We Transport
The Mundelein Fire Department provides an Emergency Medical Service as such
must transport patients to the closest hospital, which is Condell Medical Center.
Occasionally we will transport to Lake Forest Hospital, this is only if the patient
pain, stroke victims, and major trauma must be transported to Condell Medical
Center. If you just need transport to a alternate facility you may contact a private
ambulance company such as Superior Ambulance or Murphy Ambulance
About Condell Medical Center
Advocate Condell Medical Center has been providing high quality care to
residents in the north suburbs for more than 80 years. Ranked among U.S. News
& World Report’s top hospitals, Advocate Condell is the largest health care
provider and only Level I trauma center in Lake County, Illinois. Advocate Condell
is a non-profit, acute care hospital offering a full spectrum of medical services.
This includes everything from obstetrics, radiology services and rehabilitation
to open heart surgery, neurosurgery and oncology. Recognized for its quick
treatment of heart attack patients, Advocate Condell holds full accreditation from
the Society of Chest Pain Centers. In addition, Advocate Condell is accredited by
the Joint Commission as a Primary Stroke Center. The hospital also features the
only dedicated pediatric emergency department in Lake County. With the addition
of a new patient tower that opened in 2011, Advocate Condell is the only hospital
in Lake County to offer all private adult patient rooms.
|Our Newest Ambulance and Some of the Equipment it Carries
About Lake Forest Hospital
From its beginning in 1899 as the Alice Home Hospital on the campus of
Lake Forest College, and continuing since 1942 in its present location on the
grounds of the former Dick family farm, Northwestern Lake Forest Hospital
remains on the leading edge of medical technology and is committed to
providing quality healthcare with a personal touch.
Over the past 113 years, and with the generous support of the community,
Northwestern Lake Forest Hospital has grown into a 201-bed not-for-profit
community hospital offering an unmatched continuum of healthcare services.
In addition to the medical office buildings on its main Lake Forest campus,
Northwestern Lake Forest Hospital offers healthcare services at its Grayslake
campus and other convenient area facilities and anticipates continued
growth in the future.
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