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The Emergency Medical Care System

Richard F. Manegold, MD; Michael H. Silver
JAMA. 1967;200(4):300-304. doi:10.1001/jama.1967.03120170072012.
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Medicine's lifesaving techniques and the system organized to deliver them are in sharp contrast. Progress in medicine's lifesaving techniques is dramatic. Today there are cardiac monitors and pacemakers, exquisite surgical techniques, drugs of great potency, institutions splendidly equipped and superbly staffed. These are available for many.

Emergency medical systems in most cities and nearly all rural areas, however, do not often enough bring the patient at the right time to the right place; nor is there assurance the patient will get the proper treatment by the proper professional. Progress in this system is not dramatic.

An emergency need exists in a patient's mind until he is convinced by a health professional that his life or well-being or that of a loved one is not threatened. When an emergency exists, professional decisions are required to determine the time, the type, the amount and the place of treatment. The child with a


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