Prior to the late 1960s, emergency medical service (EMS) in the United States didn’t exist—at least not in the manner that it is provided today. Ambulances were used to transport patients to hospitals or other healthcare facilities—and not much else. In 1960, only six states had standard education programs for rescue personnel—paramedics and emergency medical technicians didn’t come into being until the early 1970s—and only four states regulated ambulance-design specifications. By 1965, the vast majority of emergency medical services from coast to coast largely were unregulated.
The situation took a turn for the better with the creation of the President’s Council on Highway Safety. A year later the National Highway Safety Act of 1966 was enacted. This law established the Department of Transportation (DOT) and transferred EMS responsibility to it from the Department of Health, Education, and Welfare (HEW). Today, more than 23,000 EMS agencies exist in the U.S. today, according to the 2020 National EMS Assessment report published by the National Association of State EMS Officials (NASEMSO). These agencies provide all manner of advanced life support (ALS) and basic life support (BLS) services. But significant challenges still exist for the EMS community. This whitepaper explores the most significant, and offers solutions for resolving them.