 the best place for them to get care. Triage was also first used. The soldiers, after the war, took the same ideas and began to set up volunteer ambulance services in their home towns.
Not all places did this the same way. In Britain, ambulances were operated by the local hospital or police service. In Canada, the undertaker commonly had the only carriage that could move a person who had to lie down. In bigger cities, the ambulance service was done by the local health department, police or fire department.
People do not agree on when "ambulance attendants" (paramedics) were first formally trained. In the United States, it was probably in 1928 in Roanoke, Virginia. In Canada, it was probably 1889 in Toronto, Ontario. In the United Kingdom, it was probably even earlier.
As far as advanced skills, the military "medics" were the first to give medications like pain killers during the Second World War. Later, helicopters were used to move hurt soldiers to hospitals during the Korean War. It wasn't until much later that non-military paramedics were allowed to give medications or use helicopters.
Pre-hospital medicine[change | edit source]
By the early 1960s experiments in improving care had begun in some civilian centres. The first such experiment involved the provision of pre-hospital cardiac care by physicians in Belfast, Northern Ireland, in 1966 . This was repeated in Toronto, Canada in 1968, using a single ambulance called Cardiac One, staffed by a regular ambulance crew, plus a hospital intern, who was tasked with performing the advanced procedures. While both of these experiments had certain levels of success, technology had not yet reached the required level (the Toronto 'portable' defibrillator/heart monitor was powered by lead-acid car batteries and weighed nearly 100 lbs.). The required telemetry and miniaturization technologies already existed in the military, and particularly in the space program, but it would take several more years before they found their way to civilian applications. In North America, physicians were judged to be too expensive to be used in the pre-hospital setting, although such initiatives were implemented, and in some cases still operate, in the United Kingdom, Europe, and Latin America.
Around 1966 in a published report entitled "Accidental Death and Disability: The Neglected Disease of Modern Society", (known in EMS trade as the White Paper) medical researchers began to reveal, to their astonishment, that soldiers who were seriously wounded on the battlefields of Vietnam had a better survival rate than those individuals who were seriously injured in motor vehicle accidents on California freeways. Early research attributed these differences in outcome to a number of factors, including comprehensive trauma care, rapid transport to designated trauma facilities, and a new type of medical corpsman, one who was trained to perform certain critical advanced medical procedures such as fluid replacement and airway management, which allowed the victim to survive the journey to definitive care. As a result, a series of grand experiments began in the United States. Almost simultaneously, and completely independent from one another, experimental programs began in three U.S. centers; Miami, Florida, Seattle, Washington, and Los Angeles, California, the first of these to go from being an experiment, to being a working unit, was in Los Angeles, with the passage of the Wedsworth-Townsend Act, other staes would soon push their own Paramedic bills through, and soon, every fire department in every major city in the country had their own paramedic squads. Each was aimed at determining the effectiveness of using firefighters to perform many of these same advanced medical skills in the pre-hospital setting in the civilian world. Many in the senior administration of the Fire Departments were initially quite opposed to this concept of 'firemen giving needles', and actively resisted and attempted to cancel pilot programs more than once.
The public discovers paramedicine[change | edit source]
In a curious example of '