#AtoZchallenge: History of Paramedicine – L is for Legislation

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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Modern EMS is believed to have originated back in the days of Napolean, but it wouldn’t be until the 1960’s that major changes would be made.

By 1960 there was a number of unregulated systems throughout the U.S. Sometimes, physicians would staff the ambulances other times there would only be minimally (or even non) trained personnel.

From 1960 until 1973 a number of events would take place that would eventually lead to a more structured EMS system in the United States.

In 1961, a report was to be presented by a commission empanelled by President Kennedy and chaired by Michael DeBakey to improve the care of patients with heart disease and cancer. The report is said to have been lost in the shuffle at the time, but the treatment of heart disease, stroke, trauma, and cancer would become an important aspect in the argument of the need for an improved EMS system. Regional Medical Programs (RMPs) developed in 1964 as a result of the final report of the Committee on the Costs of Medical Care would also have a big impact on the development of EMS. Although later disbanded by President Nixon, the legacy of the RMPs on EMS is significant.

In 1966 a report titled titled “Accidental Death and Disability: The Neglected Disease of Modern Society” commonly known throughout the EMS World as the “White Papers” would have a huge impact on the improvements found (in successive years) in EMS. This report criticized widespread deficiencies in emergency care and documented absence of quality emergency care.

Also, in 1966 legislation was passed that led to the creation of the National Highway Traffic Safety Administration (NHTSA). As a result of the NHTSA EMS training would become standardized, a single emergency number would be stressed and radio communications recommended. Another big step would be the creation of the National Registry of Emergency Medical Technicians (or NREMT) in the early 1970’s

The creation of the Highway Safety Act in 1966 would provide federal involvement to improve EMS in areas such as ambulance specifications, equipment standards, educational requirements, and staffing. The legislation reflected some of the prevalent themes of the 1960s, which had also been seen in the RMP.

In 1972 an analysis of the EMS system, put together by the National Academy of Sciences – National Research Council, would show that despite stated EMS commitment, the federal government still lacked a coherent policy and had failed to sufficiently advance EMS. A bill was introduced that would “authorize assistance for planning, development and initial operation, research, and training projects for systems for the effective provision of health care services under emergency conditions.” However, these bills were opposed by Nixon and as a result, they did not pass. A second bill was introduced that excluded a clause directing the administration to continue the operation of the Public Health Service Hospital. This time the bill was to pass.

The EMS Systems Act came about in 1973 adapting training curricula for EMT, EMT-P, and First Responders. New rules would also be established for EMS Radio communications and ambulance specifications

Today, Rules, Policies, and Regulations continue to be ever changing, but the events set in motion in the 60’s and early 70’s continue to shape what EMS is today.

Sources:

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1470509/

https://wvde.state.wv.us/abe/Public%20Service%20Personnel/HistoryofEMS.html

http://www.scdhec.gov/health/ems/history.htm

Be sure and check out the EMS History app by Limmer Creative as well as the EMS Museum website

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Here’s some blogs for you to check out:

Shelli RoseWarne (Author of Paranormal Romance)

Sayling Away

God, Entertainment, and Annoying Things

#AtoZchallenge: History of Paramedicine -J is for JEMS

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Mention JEMS in the medical profession (especially when it comes to Emergency Medical Services and people instantly know of what you speak, but for those of you who may not be familiar, I’ll start by explaining what JEMS is, for those of you who may not know. JEMS stands for Journal of Emergency Medical Services.

From what I have found “JEMS Communication” was started in 1979 by James O Page (I’ll be posting about him later on in when we get to letter P). JEMS Communication – responsible for the publication of JEMS magazine and Fire Rescue Magazine

When I was trying to google information on the “History of JEMS” I kept getting information on the history of James Bond… I’m sure he’s great and all, but not what I’m looking for.

I did, eventually, manage to find 3 sources of information (mainly relating to James O Page – I’ll get to him more later in letter P) that talked about JEMS. One of those sources says that JEMS was founded by James Page in 1979 another source I found had the following to say, “It was 1976…… I continued to follow Jim though his new magazine, Paramedics International (which later became JEMS). ” {In the interest of space I clipped out parts, but you can read the article on JEMS.com by Dr. Bryan Bledsoe}. Seems I recall reading somewhere else (but darned if I can think where or locate it now) that James Page had started a magazine or journal under one name (presumedly Paramedic International) and later changing it to JEMS. This all would have taken place sometime in the 70’s.

I really hate to leave this hanging like this, but I keep trying to fall asleep at the keyboard.

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Really Quick…. A few blogs for you to check out.

Moontime Tunes

Whatever (My World According to Me)

Scribblings

early day tomorrow and it’s getting late so that’s all I’ve got for you…. Chyeck out the A-to-Z list for more blogs

#AtoZchallenge: History of Paramedicine – I is for IV Therapy

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I’m afraid I’m going to have to keep this post short (lots to do and running behind schedule).

Trying to locate information on the IV Therapy and the history thereof as it relates to the History of Paramedicine has proven to be unsuccessful. I did however learn a few interesting facts.

The concept of IV Therapy and the knowledge that medicines could be injected has been around since the mid 1600’s. However early attempts to do so were largely unsuccessful (due to lack of scientific. methods).
The First syringe fine enough to pierce the skin was developed by Charles Gabriel Pravaz and Alexander Wood in 1853.
Early Syringes were usually made of steel.
The first “plastic needles” were developed in the 1950’s – spurned by the increasing knowledge of the dangers of cross-contamination and the need for a more disposable needle.

Resources:

http://inventors.about.com/library/inventors/blsyringe.htm

http://www.asaabstracts.com/strands/asaabstracts/abstract.htm;jsessionid=CCA645139573F5B3DD741DA658D95E22?absnum=759&index=14&year=2000

http://workplacenurses.com/id39.html

http://en.wikipedia.org/wiki/Hypodermic_needle

Quick Author Note: Though there was already a move to change this practice, as late as the late 1980’s and into the early 1990’s it was not uncommon for Paramedics to recap IV needles by placing the cap on a flat surface and scooping said cap up with the needle (something I myself saw done in several instances)… Nowadays this practice is widely frowned upon and Disposable Needle containers are standard on pretty much every ambulance, negating the need to recap needles.

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Once again I am having to skip out on the list of 5 blogs to follow that I (should be) adding. You can click HERE to check out the list of blogs signed up for the A-to-Z Challenge.

#AtoZchallenge: History of Paramedicine – H is for Hospital

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As expected, Hospitals play a huge role in pre-hospital care.

One of the first hospital based ambulance was based out of Commercial Hospital in Cincinnati, OH in 1865. This was soon followed by other hospital based ambulances across the country. Of course in those days the “Ambulance Attendants” could do little more than provide the most basic of first-aid care. Beyond that, the “scoop and run” method was all that could be done.

In 1969 Paramedic programs were developed and implemented in both Los Angeles (In conjunction with Harbor General – Now known as Harbor-UCLA Medical Center) and Seattle (In conjunction with Harborview Medical Center – part of UW Medicine) — Interesting to note (for A-Z Challenge) that both these start with the letter H. It was through on these early programs that other Paramedic programs around the U.S. were based.

If I am to understand correctly, in the beginning stages of the “Modern EMS” system there was a lot of disdain and doubt going on. Early on, firefighters were under the thinking that ‘We fight fires, not rescue bodies and deliver babies’. Ambulance Duty was considered a form of punishment to most firefighters. In addition to that there was doubt by Medical Doctors as to whether or not a non-medical professional (ie one who has not been through a complete regiment of training required by doctors) could learn to provide care, normally only found in the hospital setting, in a pre-hospital setting. Pretty much everything the early EMT’s and Paramedics did was a game of “Mother May I” (or in this case “Doctor May I”) Standards of Care and Standard Operating Procedures as we know them today didn’t really exist in the field. As trust between doctor/hospital and EMT/Paramedic has grown, focus has shifted from that of a permission (by doctor) needed basis to treating according to pre-set standards first and contacting the hospital either to advise an “en-route” report (including status of patient & necessary data) or to seek advice when pre-set standards have been exhausted.

Resources:

http://en.wikipedia.org/wiki/Emergency_medical_services

https://emra.org/committees-divisions/ems/ems-history/

http://en.wikipedia.org/wiki/Paramedic

http://www.naemt.org/Libraries/NAEMT%20Documents/EMS%20Historical%20Perspective.sflb

An Interesting Read about the early days of EMS in Alameda County (Did you know that as last as the early 1970’s ambulance attendants/drivers had to ring the bell to many hospital Emergency Rooms in order to have the doors opened at night (this was if there was even someone on staff there.)

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I’m sorry to skip out on listing the 5 “blogs to follow” this time around. I still have letter I to get done and several other things that require my time. You can click HERE to check out the list of blogs signed up for the A-to-Z Challenge.

#AtoZchallenge: History of Paramedicine – G is for Gadgets

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G — What can I talk about that starts with the letter G? The only thing that has come to mind was Gadgets…. But then what can you say about Gadgets when it comes to the history of Paramedicine? Aren’t most gadgets considered relatively modern?

Actually, there are a number of (what I guess you could call) “Gadgets” that have come about over the history of Paramedicine.

A couple things that come to mind are the invent of the BioPhone which allowed Paramedics to talk to doctors at their “base hospital” and the Defibrillator which was instrumental in managaing heart rythm in the field. While it’s history is not specifically related to Paramedicine, IV needles are another item that has played a big part in both the hospital and pre-hospital setting. I could probably go on if I had the time to do more research.

Today, there are many so called gizmos & gadgets used in the world of Paramedicine.

The National EMS Museum has some great resources on the history of Paramedicine. I highly recommend you go check out their website.

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5 Blogs to check out:

Writing Wings

Writer in Transit

Here’s the Story

The Giggling Trucker’s Wife Writes

SnapShots of a Life