Biblical times Good Samaritan Sumerians inscribed clay tablets that

provided step-by step instructions for care based on symptoms given

Also instruction on how to create and adm. Medications

Similar to EMS protocols today

The most significant difference between these first protocols and EMS today is a physical exam

Egyptologist Edwin Smith 1862 purchases a papyrus scroll dating to

about 1500 B.C.E. Contained 48 medical case histories

arranged in head-to-toe order of severity Very similar to our PA today

“Book of Wounds” One section of the scroll Explains the treatment of injuries such

as fractures and dislocations King Hammurabi King of Babylon “Code of Hammurabi

18th and 19th Centuries Napoleonic Wars Chief surgeon Jean Larrey formed the

ambulance volanteor flying ambulance which focused on

providing emergency surgery as close to the battlefield as possible

Horse drawn cart First to use triage and transport

Clara Barton during the Civil WarFirst civilian ambulance service 1865 Cincinnati Ohio 1869 the New York City Health Dept.

Ambulance Service operated out of Bellevue Hospital

Specially designed horse-drawn carts

Staffed with physician interns20th Century WWI average evacuation time of 18

hrs. WWII – battlefield ambulance corpTransported from front line to high level

care There were still delays, often days

Korean and Vietnam Conflicts Advances were made Battlefield treatment the air evacIn Vietnam often within 10 to 20 minutes

Throughout history significant advances occurred during wartime

To 1960 few places in the US had adequate pre-hospital care

Emergency care began in the E.R. Rescue techniques were crude Ambulance personnel poorly educated Equipment miminal

No radio communication between agencies

No medical direction

This brings us to. . . . . . .

THE WHITE PAPER 1966 “Accidental Death and Disability: The

Neglected Disease of Modern Society” Published by National Academy of

Sciences, National Resource Council