National EMS Week kicks off May 19th-25th, celebrating its 50th anniversary. The theme for this year is “Honoring Our Past, Forging Our Future”. Most people today probably could not imagine a time where emergency medical services were not a 911 call away. The reality is that EMS is relatively young in the United States and the City of Tiffin. This article will reflect on the development of EMS nationally, locally and share some aspects of what the future may hold.
History of EMS in the United States
It was the year 1966, America was imbedded in the Vietnam War, Medicare went into effect, the Baltimore Orioles won the World Series and The Mamas & The Papas topped the billboard chart. The same year, the National Academy of Sciences released a report to President Johnson titled “Accidental Death and Disability: The Neglected Disease of Modern Society”. The report provided details to the administration showing the need for prevention and management of accidental injuries. Included were details of the grim reality that vehicle and other accidents were resulting in high causalities around the country. It was recommended that standardization of emergency training for “rescue squad personnel, fireman and ambulance attendants” be implemented leading to the first national emergency medical technician (EMT) curriculum in 1969.
The 1970’s brought progress and change in the EMS field. The University of Cincinnati started the first program for emergency medicine physicians. Paramedicine spurred from war time medics and EMT’s receiving training from nurses and doctors. 1970 saw the formation of the National Registry of EMT’s right here in Columbus, Ohio. This organization is still the driving force for EMS certification and training today. In 1972 the TV series EMERGENCY! debuted on national television. The iconic sound of the alarm sending Johnny and Roy from Station 51 out into the field would spur EMS and paramedicine into the national spotlight. For those not familiar, the show featured two L.A County Fire Department paramedics who responded to medical emergency calls. In the show Johnny and Roy would provide advanced care in the field including IV’s, medication administration and cardiac rhythm transmission to Rampart Hospital. In the infancy of EMS, procedures were very basic and included little advanced care. Ambulances and hearses were many times the same. Unless a nurse or physician was picked up on the way to a call the goal was to simply get the patient to the hospital as soon as possible. It was discovered that in order to increase the survival rate in the field, paramedics needed to be able to complete advanced tasks on scene. EMERGENCY! highlighted this advanced training platform and opened the eyes to the nation about the importance of adopting the same practices in communities across the country. In 1975 The National Association of Emergency Medical Technicians is founded and standards of care and training are formalized.
EMS in the City of Tiffin
Thanks to retired Deputy Chief Richard Steinmetz, I am able to share a brief history of how EMS was developed in Tiffin. The following information was taken from his book, History of Tiffin Fire Dept.
The popular year of 1966 brought EMS to the forefront in the city as an ordinance was passed creating the Department of Ambulance Service. The separate department was under the purview of the Fire Chief. In 1975 the city’s first run ambulance was placed at fire station #2. Staffing the ambulance were part time employees including firefighters and police officers who worked on their days off. Eventually another ordinance was passed that placed the division of EMS within the fire department. It was not until 1979 that members were certified as Advanced EMT’s and were allowed to start IV’s and administer some medications in the field. The mid 1980s brought the age of paramedicine to Tiffin. With the council’s approval, six members of the ambulance service obtained their paramedic certifications through Providence Hospital in Sandusky. The new paramedic emergency service would serve the City of Tiffin, Clinton Township, parts of Hopewell and Eden Townships.
Modern EMS
Paramedicine and EMS systems look vastly different in 2024 compared to 1975. When President Johnson received the “white paper” in 1966 the goal was to provide first aid in the field to reduce mortality from vehicle accidents. EMT’s and paramedics still respond to vehicle accidents today, however that is just a small percentage of the medical calls received. With the advent of 911 and increased funding for EMS systems and training, ambulances transitioned from hearses to mobile emergency rooms. Standards of care increased nationally creating a higher level of practice and accountability for those being treated in the field.
In Ohio the current scope of practice for certified paramedics include procedures such as endotracheal intubation, surgical cricothyrotomy, manual cardiac defibrillation, administration of cardiac medications, cardiac rhythm interpretation and intraosseous needle insertion. Paramedics train to treat conditions ranging from cuts and bruises to emergency child birth, cardiac arrest, anaphylaxis, mental health crisis and more. These exams and procedures are all performed in the field in any and all conditions, day and night, rain, snow and sun. Paramedics can operate under the medical direction of a physician using protocols without having to be physician supervised in the field. This is a vast improvement in the level of service provided over the last 50 plus years.
In 2023 Tiffin Fire/Rescue Division responded to more than 3100 EMS calls for service where over 2300 patients were transported for further medical care. The department provides 4 advanced life support ambulances out of 2 stations. Fire and EMS is fully integrated into one department. All fire fighters are cross trained in EMS consisting of 29 paramedics, 1 advanced EMT and 6 EMT basics.
Future of EMS
I do not possess the power to predict the future, one can only dream of what is to come next. That does not mean that we cannot put our best effort into trying, even though the ideas may be more fun than reality.
It is the year 2044 and 2 paramedics enjoy their morning coffee at the fire station after checking vehicles and supplies. This of course is all done with the push of a button as each medic unit uses a built-in infrared scanner that automatically takes inventory. If something is found in need of replacement an order is sent to the robot delivery system that brings it to the medic in need. Soon after, the crew is alerted to a call through the automated dispatch system and the information displays through the medic’s glasses onto a virtual screen. The crew gathers patient information and jumps into the special response drone where they fly to the scene, drastically reducing response times. Once they arrive the medics greet the patient and deploy equipment needed for assessment. Holography is used to bring the emergency room doctor into the patient’s room. From there the physician and medics treat the patient and schedule follow up, making transport to a hospital unnecessary for most medical conditions.
Although I cannot imagine most or any of this playing out in 20 years, some aspects of this fun scenario are more realistic than most realize. Community based paramedicine is not new. In fact, there are many communities including ours that practice it in one form or another. As medical facilities become more and more overwhelmed the need to treat patients in their homes grows larger. As more funding becomes available for these programs this practice will become more prevalent in communities across the country. Technology will continue to advance allowing practitioners the ability to better communicate in the field. Telemetry and virtual practitioner visits have become a common place in medicine and will continue to expand. EMS will no doubt be part of this change.
The need for firefighters and EMT’s continues to grow and our community is not immune to that need. Our local officials and vocational school are working hard to address that need by creating a high school program right here in Seneca County. We look forward to what that brings to EMS and the fire service in the future.
Thank you to all of the EMT’s and paramedics that work every day to serve the needs of our community members. The City of Tiffin is blessed with tremendous administrative and community support for all public safety. We are here for you, thank you for being here for us. Please join Tiffin Fire/Rescue Division in celebrating National EMS Week as we look forward to the next 50 years of progress.
Mike Homan
Deputy Fire Chief
Tiffin Fire/Rescue Division