This past week was National EMS Week honoring all those who work in Emergency Medical Services. The Star of Life pictured here is the universal symbol for EMS. Created in 1977 by the National Highway Traffic Safety Administration, the six cross bars represent the six functions of EMS: Detection, Reporting, Response, On-Scene Care, Care in Transit, and Transit to Definitive Care.
EMS in the United States dates back to the Civil War when the Union Army developed a system to evacuate soldiers from the battlefield. After the war, cities and towns began forming rescue squads using the same principles devised by the Army. Horse-drawn ambulances, like the one pictured here, could be found in larger cities across the nation.
With the coming of the automobile, those vehicles gave way to electric (like the 1909 model pictured below) or gasoline powered ambulances (like the 1908 White Steamer pictured to the lower right).
What didn't change was the ability of ambulance drivers to do anything more than transport the sick or injured to hospitals. These untrained men worked for hospitals, undertakers, fire departments, and even local gasoline service stations.
It wasn't until 1966, when the National Academy of Sciences--National Research Council released a report on accidental death and disability that criticized the lack of quality emergency care, that the national Highway Safety Act was passed in Congress. The law mandated improvements in the EMS system, and led in 1969 to the first formalized curriculum for educating EMS personnel.
We've come a long way since the 1960s. Today states are divided into EMS regions with individual EMS systems operating on the distinctive needs of their areas. Illinois is divided into eleven regions. (See the regions' map shown on my 4/12/14 blog post.) Due to its size, Chicago is a region all by itself. Each region operates under the direction of one or more medical directors, doctors trained in emergency medicine. Each region has its own paramedic standing medical orders (SMOs) and standard operating procedures (SOPs). These medical orders can differ slightly from region to region. For example, some regions include IV Versed for seizures in their SMOs while other regions still rely on IV Valium. SMO decisions on drugs are generally made on the latest scientific research, but doctor preference also plays a part in the process.
To see how SMOs differ from region to region, check out the following websites:
EMS Region XI Chicago:
EMS Region IX - Northwest Community EMSS:
If you're writing a scene involving paramedics, Google your local state's EMS system for the region serving your area, then Google that region's SMOs. By reading the SMOs, you'll make sure you write it right.