#AtoZchallenge: History of Paramedicine – W is for White Papers & Wedsworth-Townsend

Those who know me know that one of the biggest interests is in the area of Fire/EMS (though I am not, myself a Firefighter or an EMT/Paramedic).  I decided this year to do my A-Z Challenge using the theme “History of Paramedicine”….

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AtoZ-WWhen I decided to sign up for the A-to-Z Challenge the letter “W” was pretty much cinched in my mind.  I knew I would either be doing The “Wedsworth-Townsend Act” or “The White Papers”  or both….

The publication of The White Papers  (Accidental Death and Disability:  The Neglected Disease of Modern Society) by the NHTSA in 1966 was a pivotal point to Modern EMS and important part of the History of Paramedicine.   The report showed that in fact a soldier on the battlefields of the Vietnam war had a better chance of survival then did a Civilian victim of a traffic accident, heart attack, or stroke.   It was shown that this was in part due to emergency medical treatment given on the field (in contrast with civilian sector where treatment didn’t begin till at the hospital).

Some of the inadequacies demonstrated by the above report were that of inadequate and inconsistent training,  inadequate supplies, inadequate ambulance design, lack of easy to remember emergency number for civilians {this number would eventually come to be the 9-1-1 number we know today}

It was also shown that very few people actually had Basic First Aid training and those that did didn’t have CPR (or other life saving technique) training – This even included, Fire Departments, Police Officers and even Ambulance Services.

The publication of the White Papers and legislative acts that followed (such as the Wedsworth-Townsend Act in 1970 (or the EMSS Act of 1973) drastically changed the direction of EMS and how it was practiced.  Training and certification of EMT’s became standardized and the National Registry of EMTs (NREMT) was started in 1971.  Also, ambulance design became standardized, and country-wide number was chosen for emergency calls (9-1-1) {Note not all countries use the 9-1-1 System – some use 9-9-9}.

One of the major legislative acts following the publication of the White Papers was that of the Wedsworth-Townsend Act – Named for Senator James Q. Wedworth and Assemblyman Larry Townsend, who introduced the bill in January of 1970.

Prior to the Wedsworth-Townsend act regulations & laws indicated that in LA County,  only a Critical Care Unit nurse or physician could administer invasive medical treatment (such as IV’s or defibrillation).  When the first Rescue Squads were started in in Los Angeles in 1969 the squad had to stop off at the hospital to pick up a nurse before heading to the call.

The bill was signed into effect in July of 1970 by, then governor of California, Ronald Reagan.  It is said that at first he was set to veto the bill (I believe) questioning whether or not Rescue Personnel would be allowed to cross county lines.  It is said that his father had died of either a Heart Attack or Cardiac Arrest (yes, there is actually a difference) because of refusal of the ambulance service in question to cross county lines….  When he learned that in fact they would be he (as I understand) quickly signed the bill into law.  Many other States would adopt similar bills based on the Wedsworth-Townsend act, allowing properly trained personnel (Paramedics) to administer life-saving invasive treatments under the medical control of a supervising Emergency Room physician.

It is on the Wedsworth-Townsend act that the pilot show of Emergency! was based

 

 

 

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