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How Ambulances Work

The History of Ambulances

ambulance, civil war reenactor
A Civil War reenactor loads an "injured Confederate soldier" onto a horse-drawn ambulance during a reenactment of the Battle of Gettysburg, Pennsylvania. WilliamSherman/Getty Images

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The concept of ambulances grew out of the need to transport wounded soldiers from the battlefield, rather than leaving them behind to succumb to their injuries, die of hunger or thirst, or fall into the hands of enemies.

In the 500s C.E., the Byzantine Emperor Mauricius outfitted rescue squads of horsemen with special saddles that enabled them to carry wounded men to field hospitals. In the 11th century, crusaders came up with the innovation of wagons, staffed by nurses. By the early 1700s, European cities were using corps of volunteers to carry injured civilians on foot using stretchers. Starting in the late 1770s, volunteers switched to horse-drawn vehicles [source: Pollock].

Shortly after the American Civil War, Dr. Edward Barry Dalton, a former army surgeon appointed to head the Metropolitan Sanitary District in New York and surrounding counties, developed what probably was the first modern-style ambulance system, in order to cope with a cholera epidemic. Police and sanitation inspectors who came upon a sick person would contact a dispatcher by telegraph, who then sent a wagon staffed by a disinfection team, which then transported the patient to a hospital.

That organized approach worked so well that in 1869, New York's Bellevue Hospital started a hospital-based ambulance service [source: Pollock]. In fact these four principles (calling in, dispatch, transportation and hospital) are still the core of the modern ambulance system, even if the modes of delivery might have changed.

The development of the automobile in the late 1800s made it possible to transport patients much faster than horses could. The first motor ambulance, an electric-powered vehicle owned by a hospital in Chicago, took to the streets in 1899. In the early 20th century, the addition of pneumatic rubber tires was a life-saving innovation, because it made the ride smoother and kept patients from suffering further injuries on the way to the hospital [source: Bell].

By the 1950s, ambulances were all over the place in the U.S., but the business of picking up the sick and injured was often chaotic and haphazard. In addition to hospitals and fire departments, towing operators got into the act, as well as funeral home operators. There weren't a lot of rules or regulation until the mid-1960s, when passage of the National Highway Traffic Safety Act standardized training for emergency workers [source: West Virginia Department of Education].

In 1973, 300 EMS systems were established throughout the U.S. Over the next several decades, with the help of additional federal regulation and funding, emergency medical services began to develop into the sophisticated systems that we have today [source: West Virginia Department of Education].

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