Changing the Practice of Emergency Medicine
From crude beginnings in field hospitals across the world, emergency responders and surgeons have partnered to create an array of emergency response equipment that has stood the test of time. With every new generation tools are refined and re-imagined in an attempt to provide better and faster care to those in need.
It would be impossible to deliver high quality responsive care without the numerous tools of the trade that have developed over the years. Every aspect of Emergency Medical Services including communication, transport, and treatment methods have grown and developed in ways that would make our founding fathers and mothers proud. From defibrillators to stethoscopes, resuscitators to radios, these tools mark significant changes to the field.
It is the tools of the trade that not only tell how EMS has grown over time but how society has embraced emergency professionals and have come to depend on their care and expertise during their times of need.
LITTERS TO COTS AND STRETCHERS
Litters at one time were a universal way to transport people. Historically there were a variety of litters used to transport those who could afford the privilege. Litters were also used to transport injured or infirm. In the United States, patient transport has evolved from the two pole stretchers widely used on patients and horseback litters to wheeled that eliminate the physical strain of carrying another person and even mechanical stretchers that assist with life support during transport.
Today there is a fleet of stretchers, cots and litters that help emergency response personal transport patients, baskets, back/spinal boards and hospital beds all serve a unique purpose and help provide the most stable transport possible in any rescue scenario.
AIR-WAY & RESUSCITATION TOOLS
Originally designed by Dr. Henning Ruban, hand pumps were designed to provide life-giving air to a patient by forcing air into the lungs. However most of the early pumps required at least two people to operate them. As techniques and new materials were developed and improved resuscitation devises became more effective at providing breathing support during transportation. The Kiss of Life, one of the most well none mid- 19th century devises, had about 15 minutes of oxygen that could be used by a patient during transport. The manufacturer touted its light weight and easy operation as key selling points. Later improvements included attached oxygen tanks and integration into full CPR machines to assist with compression as well as air flow.
DEFIBRILLATION & CARDIAC CARE
Cardiac support is an important part of emergency care. The human body is designed to work as a whole and when one organ fails the rest of the organs in the body are in danger of failing too. Although open chest defibrillation has been around since the turn of the 20th century, it wasn’t until 1954 that a group of Johns Hopkins surgeons discovered the ability to preform closed chest defibrillation in the surgical suite, and by the 1960s the technique and machinery became portable.
The first specially designed emergency response defibrillation unit was the Life-Pak 33. The Life-Pak brand is still in use today although its gone through major improvements over the years to keep pace with other units on the market. Recent regulations in a number of states also provided for the implementation of AED devises that are publicly accessible so that people with little training can provide the necessary life saving care when called upon.
LAERDAL’S RESUSCI-ANNIE & OTHER SIMULATORS
Medical professionals in every field, including EMS, spend hours training and perfecting their procedures and life saving techniques. One of the earliest tools developed specifically for EMS was “Annie”. Laerdal created the simulator to allow people to practice CPR and oxygen delivery techniques in a variety of settings. Today, Annie still makes appearances in professional and public classrooms to help teach people about live saving techniques.
PRE-HOSPITAL COMMUNICATION
Since the advent of the telephone, people have come to depend on being able to communicate with others in their time of need. Early pre-hospital communications were hardly effective as telephones were few and far between and telegraph or radio operators were highly trained specialists requiring special knowledge of the equipment to make communication effective. But like all other medical inventions, the field of pre-hospital communications also improved with technology. One of the most significant advancements was portability. Even before there were walkie-talkies and cell phones, emergency medical personal used portable telephones and telemetry machines to communicate with hospitals and physicians. As technology continued to improve so did the efficiency of communication during transportation. Today’s paramedics can send all kinds of information through cellular services so that the attending physicians in the Emergency Department are fully prepared for their patient upon arrival.
Despite all the advancements in personal communication technology, EMS and other emergency responders are dependent on the 911 service and emergency dispatchers across the country. The role of dispatch is critical to providing up-to-date and accurate information for responders, victims, and hospital staff. Dispatch is the backbone to any emergency response operation.