SEBRING — In 1972, a television show called “Emergency!” about a Los Angeles paramedic unit debuted on NBC. Only 12 such units existed in the United States.
Within five years, more than 50 percent of Americans lived or worked within 10 minutes of what would now be called an emergency medical service unit, according to chroniclers of the show, but the show was part of a larger movement.
This week, Highlands County joins other local governments all over the nation in recognizing May 19-25 as National Emergency Medical Services Week.
While “Emergency!” did raise viewers’ expectations of emergency medical care, according to EMSWorld.com, far more credit goes to a 1966 research study into accidental death; the American Medical Association (AMA); the Department of Health, Education and Welfare (DHEW); the U.S. Congress’ EMS Systems Act of 1973, and local governments’ willingness to set up EMS units.
The Emergency Medicine Residents’ Association at EMRA.org states that pre-hospital care actually dates back to the American Civil War, which created a need for organized field care and transport of the injured. It wasn’t until 1856, EMRA.org states, that the first civilian ambulance service started in Cincinnati, Ohio, followed by a civilian ambulance surgeon in New York City four years later, carrying a quart of “emergency brandy” for each patient.
Ambulance services continued to make innovative leaps after World Wars I and II, EMRA.org states, at first with volunteer squads and then run by hospitals, fire departments, rescue squads, private ambulances and even funeral home hearses.
It was the growing contrast between deaths in foreign wars and deaths on U.S. streets that pushed the modern system forward again in the 1960s.
In 1966, President Lyndon B. Johnson received a study titled, “Accidental Death and Disability: The Neglected Disease of Modern Society,” which listed accidental injuries as the “leading cause of death in the first half of life span.”
Put simply, anyone not yet middle-age was at risk of dying in an accident at home, at work or on the road.
The Journal of EMS cites the study as saying, in 1965 alone, vehicle accidents killed more Americans than lost in the Korean War, and stated that someone’s chances were better to be wounded in a combat zone — with its dedicated medical corps — than on an average city street.
The report, Journal of EMS states, called for standardized training of rescue squads, police and ambulance attendants — the start of the first EMS standards.
The report also gave way to the National Highway Safety Act of 1966, EMRA.org states, which established the U.S. Department of Transportation and its subsidiary department, the National Highway Traffic Safety Administration, which also pushed for EMS standards.
EMSWorld.com lists a timeline for the next events. First, AMA hosted a conference in 1967 to set ambulance personnel standards. Then, in 1968, St. Vincent’s Hospital in New York City launched the nation’s first mobile coronary unit, and AT&T designated 911 for emergencies.
Prior to that, people dialed zero: “O” for the operator, who then relayed the call.
In 1969, the Miami Fire Department started the nation’s first paramedic program. Seattle followed suit rather quickly.
By 1972, the year “Emergency!” premiered, DHEW allocated $16 million for EMS demonstration programs in five states, so the process had already begun.
Highlands County’s EMS Department started in 1975, the same year the AMA recognized emergency medicine as a specialty, and when the National Association of Emergency Medical Technicians was formed.
In Fiscal Year 2013-14, just before its 40th anniversary, Highlands EMS logged 14,814 responses, carried 9,908 patients (10% of local residents), and averaged 8.05-minute response times, according to the county website at hcbcc.net.
That year’s budget of $5.22 million — $3.5 million from bills to patients — with an average cost of $13.83 per person.
EMS Director Dustin Fitch says average response time is now seven minutes from time of dispatch, and may get shorter the more ambulances the county gets.
Right now, the county has at least 10 units. County Commission Chair Jim Brooks said when he headed EMS as “EMS coordinator” from 1980-1985, it was five.
In Fiscal Year 2017-18, the Highlands County Board of County Commission voted to set up a fire assessment to hire volunteer firefighters full-time and upgrade equipment and buildings, to house fire and EMS units together.
Fire crews have already taken dual training in firefighting and lifesaving, as paramedics or emergency medical technicians.
Other changes instituted under the new system, with Public Safety Director Marc Bashoor serving as fire chief, was to rename the ambulances as “Medic Units” with numbers the same as the fire stations where they’re housed.
Fire Services was renamed “Highlands County Fire Rescue,” and while EMS is still its own department, Bashoor has said his goal is to have them work as one system.
Fitch is most impressed with how much EMS technology has improved since he started as a volunteer in 1997.
Historically, ambulances were hearses, then Chevrolet Suburbans followed by box vans. By 1997, they were box ambulances, but now they are custom-built with all manner or anti-roll protections, air bags and self-leveling cabins, he said.
One of the newest innovations, although they may not be in the local budget just yet, are mobile X-rays and computer-aided tomography (CAT) scanners. They would let EMS crews diagnose a stroke in the field.
What was once a folding cot is now a hydraulic-operated stretcher capable of self-loading onto the ambulances, saving crews’ backs.
Where once crews filled out reports on carbon-paper forms, digital tablets and portable laptops let crews fill out reports “as soon as they get off the truck,” Fitch said.
One recent upgrade is a mobile application called “Twiage,” a combination of “Twitter” and “triage” that relays medical information between ambulances and emergency rooms.
Rather than treat the patient, load him/her on the ambulance, fill out paperwork, then radio information to the emergency room, EMS crews simply punch a few buttons on an app and send it, wirelessly.
It saves time and confusion when a patient arrives.
Most of all, like the innovations of the last 55-155 years, it helps save lives.