Few people realize that modern EMS has only been around for the last 40 years. In the first half of the 20th century, many ambulance services were operated by community funeral homes. The hearses were used to transport sick and injured persons to the hospital, as well as those individuals who died, to the funeral home. The funeral home attendants had little first aid training. The funeral homes were in the ambulance business simply because their vehicles were large enough to accommodate the long stretchers.

     After World War 2, a number of civilian rescue squads and ambulance services began to emerge in the United States. Most of the rescue personnel, while well intentioned, were untrained, poorly equipped, unorganized and unsophisticated. The systems were unregulated. There were no minimal training standards for ambulance personnel and no training programs existed for basic first aid. Pre-hospital care in the U.S. evolved into a patchwork of well intentioned, but uncoordinated efforts. This all began to change in the mid-sixties.

     In 1966, the National Academy of Sciences published a report entitled Accidental Death and Disability: The Neglected Disease of Modern Society. This report quantified the magnitude of traffic-related death and disability while vividly describing the deficiencies in pre-hospital care in the United States. The "white paper" made a number of recommendations regarding ambulance systems, including a call for ambulance standards, state-level policies and regulations, and adopting methodology for providing consistent ambulance services at the local level.

     Also in 1966, the Highway Traffic Safety Act established the U.S. Department of Transportation and awarded that agency the authority and responsibility to improve EMS education, including the development and implementation of training standards. States were encouraged to develop state EMS offices with part of the costs paid by the Highway Safety Programs.

These two historic milestones spearheaded the evolution of EMS in the United States.

Reproduced from http://ci.muscatine.ia.us/fire/emshist.htm