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A capsule history of US emergency medical care

Beverly J. Montgomery
JAMA. 1980;243(10):1019-1021. doi:10.1001/jama.1980.03300360005002.
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"Not so long ago, serious injury was considered an 'acceptable' reason for death," says David R. Boyd, MD, head of the US Department of Health, Education, and Welfare's (DHEW) national emergency medical services (EMS) program.

Indeed, it was only in 1966 that a national civilian trauma care network began. It was predated by the MASH (Mobile Army Surgical Hospital) network developed during the Korean and Vietnam conflicts, which gave many surgeons their first experience with a transportation-dependent method of triaging and saving the most seriously injured patients.

Now seriously injured patients in the United States are generally considered to be salvageable— if they receive the right treatment. Following is a capsulized history of how America became the world's leader in the delivery of emergency medical care:

  • 1966—Civilian concern over trauma injuries was catalyzed by the National Academy of Science's study entitled "Accidental Death and Disability: The Neglected Disease of


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