0071643192.pdf

EMS AND DISASTER MEDICINE^896

ORIGINS OF EMERGENCY MEDICAL SERVICE

A need for an extension of emergency care in the community grew into what

we know today as the EMS system. EMS was established in the 1960s.

Important steps in the development of EMS (see Table 20.1):

■ Highway Safety Act (1966)

■ Authorized the U.S. Department of Transportation (DOT) to develop

prehospital services

■ Established the National Highway Traffic Safety Administration (NHTSA)

■ Emergency Medicine Services Act (1973)

■ Provided government funding and training for states to develop

regional, county, and local EMS systems

■ Identified 15 essential components of an EMS system (see Table 20.2)

■ Development of communication and ambulance standards (1973–1974)

■ 911 system

■ Dedicated radio frequencies for EMS

■ Federal specifications for ambulances

■ Emergency Medical Treatment and Active Labor Act (EMTALA) 1985

■ Part of the Consolidated Omnibus Budget Reconciliation Act (COBRA)

■ Penalized emergency departments that refused care

■ Trauma Care Systems Planning and Development Act (1990)

■ Authorized government funds to states for development of trauma systems

EMS DESIGNS

Multiple EMS designs exist and depend on the type of community served. In

general, there should be one ambulance per every 7000–10,000 people.

■ Volunteer model: Used primarily in rural areas where there are no funds

to pay personnel

TABLE 20.1. Origins of Emergency Medical Service

YEAR LEGISLATION EFFECT KEYWORD

1966 Highway Safety Act Funding of prehospital services (via U.S. DOT

Department of Transportation)

National Highway Traffic Safety Administration NHTSA

1973 Emergency Medical Services Government funds and training for states to Funding

Act develop EMS systems Components

1973—1974 Establishment of 911 system 911

communication and Established dedicated EMS radio frequencies

ambulance standards and ambulance specifications

1985 Emergency Medical Treatment Penalized emergency departments that EMTALA

and Active Labor Act refused patients COBRA

1990 Trauma Care Systems Planning Government funds to states for trauma systems Trauma

and Development Act

The Highway Safety Act of

1966 established the initial

government funding for

prehospital services.