History of Pre-Hospital Emergency

History of Ambulance

During World War I, prehospital services improved qualitatively, gradually dispatch centers assisted paramedics by the invention of wireless. Even before World War II, physicians could get to the patients by modern aambulances and they could contact to dispatch centers to provide better medical care. In the 1960's, the role of the pre-hospital emergency system was strengthened with the development of medical knowledge, especially in the field of resuscitation and defibrillation and the need to accelerate the provision of these services. Since 1966, the US Highway Pre-Hospital Services (DOT) program has been implemented. In 1967, pre-hospital cardiac care services were introduced in Ireland. In 1972, the University of Cincinnati launched the first specialized emergency medicine training program. In 1973, the National Prehospital Services Act and its components were drafted and implemented in the United States. According to this law, the components of a pre-hospital system must include at least the following: staff, appropriate training system, communication and dispatch system, transportation, receiving medical centers, intensive care units, public safety system, public access to care, registration standardization of recording information, public education, cooperation in crises, medicines and equipment, etc. Pre-hospital services for children have been designed in the United States since 1984. During World War II, the military trained special units to provide field care and bring the wounded to aid stations with nurses and physicians. In the Korean War, service to the wounded evolved with the rapid transfer by helicopter to the Mobile Surgery Unit of Army Hospital nearby, where immediate surgery was performed. Most of the progress made in the immediate care of the wounded is the result of the experiences of the Vietnam and Korea wars. Unfortunately, emergency care for the injured and patients at home has not progressed to this level. Until the early 1960s, emergency ambulance services and emergency patient care varied widely across the United States. In some places, advanced first aid was provided by well-trained teams with modern, well-equipped ambulances. In a small number of urban areas, care was provided by hospital-based ambulance services using interns and novice physicians. In many places, emergency care and ambulance service were provided only by the funeral undertaking office, which used a corpse carrier that could be turned into a stretcher and act like an ambulance. In some places, police or fire station used a station wagon carrying a stretcher and a first aid kit. In most cases, there was a driver and a paramedic in both vehicles who knew some first aid training. In the few areas where a commercial ambulance was available to transport patients, they usually had the same staff and were originally used as a means of transporting patients to the hospital. Many countries did not provide any formal pre-hospital emergency care or patient transfer activities. First aid for the injured at the scene was provided by police or firefighters, and a police or fire truck transported them to the hospital. Traditionally, patients with acute diseases were transported to the hospital by relatives or neighbors, who were visited and evaluated by the family physician or hospital attendant, and then called in the required specialist and operating room staff.

Transportation of critically ill patients to medical centers for receiving medical services has long been a problem in human life. Ancient Roman legends say that war chariots were used to transport the sick, thus they were removed from battle scenes and healed. In ancient times, there were no separate medical centers. Probably around 4000 BC, the temples of ancient Egypt provided medical services in addition to religious affairs. In ancient Greece, temples were also used to treat the sick. Perhaps the first independent medical centers were established in present-day Sri Lanka around 430 BC. Later, in the first century BC, the Romans established and named a hospital or medical center to treat wounded gladiators in the cities.

With the formation of medical centers, the issue of transferring patients to these centers became more serious and different ethnic groups chose different methods for this issue. Native American tribes used sledges, Egyptians used pannier ridges, and other nations used other methods to transport the sick.

In the 15th century, King Ferdinand of Spain and his wife, Queen Isabel, designed a mobile hospital called an "ambulancia" that rushed to the aid of wounded soldiers on the battlefield. In 1793, Dr. Dominique-jean Larrey, the chief physician of Napoleon's corps during the Franco-Prussian War, designed a mobile hospital called the ambulance volante, which was used to carry out initial operations and transport the wounded back to the front line.

At the same time, Baron F.P. Percy designed a carriage capable of carrying large numbers of wounded from the front line to safer areas and named it Mobile Emergency Room. During the American Civil War, Jonathan Letterman devised a wagon to carry the wounded, known as the "Rucker wagon."

The use of such vehicles in 1832 to transport patients during the cholera epidemic in London also became popular in 1832. Finally, the first hospital-based pre-hospital system was designed in Cincinnati, USA in 1865. In 1869, ambulances were deployed to New York City with some relief supplies, including splints, etc., and drugs such as morphine. The first motorized ambulances (cars) were designed in Chicago in 1899.


History of Emergency

The first medical emergency team was formed during Napoleon's campaign, in which a man named Larry evacuated the wounded on the battlefield with the help of other people from the battlefield and treated them in 1790. The first equipped medical emergency system was established in 1966, and EMS was formed in a modern way in 1973.


History of Medical Emergencies in Iran:

A large number of people were killed and injured due to the collapse of the roof of one of the waiting rooms of Mehrabad Airport in Tehran in 1966, while there was no pre-designed system to help and transport the injured in such sudden accidents. In a painful accident, the roof of the waiting room of Mehrabad Airport collapsed (due to vibrations caused by the sound of the engines of giant jets) at 2:50 pm on December 5, 1973, during which 16 people were killed and 11 were injured. This incident was recorded as one of the most tragic events in our country due to its wide coverage in the domestic and foreign media that year. Then, Iran's Emergency Medical System was established and called as 115 with the cooperation of the United States, and Iran was recognized as the fourth country in the world to provide pre-hospital emergency services, which is a great honor. In its second experience in forming a pre-hospital emergency system, the United States eliminated many of the shortcomings of the first experience that it had for itself, and it can be said that Iran's pre-hospital emergency in 1975 was more complete and better than the US pre-hospital emergency. At that time, the three-digit number 123 was assigned to call the emergency services and Benz Van ambulances were used to serve the people. Then, the number 115 was announced throughout the country for people to call the emergency services.


History of Medical Emergencies in Semnan Province:

Pre-hospital emergency (115) of Semnan city was established in 1977 with the construction of Imam Reza emergency base, with 12 emergency medical technicians and in 1978 (6 technicians) and in 1991 (5 technicians) were added. With the outbreak of the Islamic Revolution and then the imposed war, 115 emergency activities entered special conditions and the staff of this center gained very valuable experiences. In recent years (since 2005), EMS has been revived, both qualitatively and quantitatively, by creating the necessary infrastructure. In addition to adding a large number of equipped ambulances, recruiting educated personnel, increasing urban and road bases, establishing air, coastal and rail relief bases, expanding and equipping communication and dispatch centers, and strengthening emergency radio communications are other achievements of this system.

In 2002, a headquarters was established with the title of guidance, information and care headquarters, and since the end of 2005, this headquarters and the group of the health and treatment department in emergencies have been merged into the 115 Emergency Department, and created a center called the Management of Medical Emergency and Accident. The Management of Medical Emergency and Accident of Semnan Province has been operating since July 2006 and in the same year, the Communication Center of Semnan Province was set up by recruiting the required physicians and nurses.