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| HISTORY OF MEDICINE |
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| Year : 2019 | Volume
: 17
| Issue : 2 | Page : 42-43 |
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History of prehospital care
M Sanjay, Kundavaram Paul Prabhakar Abhilash
Departments of Emergency Medicine, Christian Medical College, Vellore, Tamil Nadu, India
| Date of Submission | 22-Jul-2019 |
| Date of Acceptance | 05-Aug-2019 |
| Date of Web Publication | 29-Aug-2019 |
Correspondence Address:
Dr. Kundavaram Paul Prabhakar Abhilash
Department of Emergency Medicine, Christian Medical College, Vellore - 632 004, Tamil Nadu
India
 Source of Support: None, Conflict of Interest: None  | Check |
DOI: 10.4103/cmi.cmi_24_19
How to cite this article:
Sanjay M, Abhilash KP. History of prehospital care. Curr Med Issues 2019;17:42-3 |
Prehospital care plays a salient role in the emergency medical services (EMS) by treating patients at the scene (out-of-hospital treatment) and transporting them to a higher center for definitive management. In early days, it was also called as ambulance services, first aid squad, or rescue squad. Dominique Jean Larrey, a French military surgeon, during the battle of spires (battle between French and Prussians), was distressed by the fact that the wounded soldiers at the battlefield were not treated immediately until hostilities had ceased.[1] Hence, he discovered the idea of ambulance services or “flying carriage” to provide immediate care to the wounded soldiers at the battlefield and to rapidly evacuate them to the area where medical assistance was available. He initiated two/four-wheeled horse-drawn wagon to rapidly transport soldiers from the battlefield for immediate treatment. Larrey's projects for “flying ambulances” were first approved by the Committee of Public Safety in 1794, and his ambulances were used for the first time during the Italian campaigns in 1796.[1]
In 1832, the introduction of a transport carriage facility to shift patients suffering from cholera in London was considered a major advancement in the evolution of modern ambulance services. Later, in 1865, the first civilian ambulance services were started at Cincinnati, followed by the New York service provided out of Bellevue Hospital which started in 1869[1],[2], with ambulances carrying medical equipment such as splints and morphine. Another ambulance service, named “Vienna Voluntary Rescue Society,” was found by Jaromir V. Mundy, Count J. N. Wilczek, and Eduard Lamezan-Salins in Vienna after the disastrous fire at the Vienna Ringtheater in 1881. Besides providing first aid, in 1887, St. John Ambulance Brigade also established military modeled ambulance services for public events in London. After the existence of automobile technologies, the first modern motorized ambulance was brought into the service in 1899 in Chicago.[1]
After World War I, when two-way radio became available, it provided efficient radio dispatch of the ambulance to many areas. In 1966, President Lyndon B. Johnson received a report “Accidental Death and Disability: The Neglected Disease of Modern Society”[1],[2],[3] commonly known as “The White paper,” in which he identified accidental injuries as the Leading cause of death in the first half of the life span.[1],[2] The report concluded that ambulance services in the US varied widely in quality and were often unregulated and unsatisfactory. These studies placed pressure on governments to improve emergency care in general, including the care provided by ambulance services, thus resulted in the creation of a standard ambulance system with advanced equipment and well-trained EMS personnel. Hence, this report was considered as an important milestone in the progress of advanced prehospital setting in the US.
In the early 1970s, the curriculum for emergency medical technicians and paramedics was created to inculcate optimal knowledge and practical skills, later National Registry of Emergency Medical Technicians, which is a national certifying examination, established to provide a uniform standard of training and to evaluate the competence of EMS practitioners at various levels.[1],[3]
In 2007, the Former President of the Society for Emergency medicine, Tamorish Kole, noticed the ill-functioning of EMS system in India and found that 90% of ambulances were functioning without any emergency equipment, not even oxygen; moreover, 95% of ambulances were staffed with untrained EMS personnel.[4],[5] After his peer review, many measures were taken to improve the quality of prehospital care in India. Although prehospital care is rapidly emerging over a decade, it is still at its infancy in many developing countries like India.
Financial support and sponsorship
Nil.
Conflicts of interest
There are no conflicts of interest.
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