History of Emergency Medical Services

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When did emergency medical services originate?

There are reports from biblical times where care was performed outside of places for healing. The Edwin Smith Papyrus and Babylonian Code of Hammurabi detailed early treatment and transport protocols. The Good Samaritan parable tells the story of a man who remedied travelers’ wounds with oil and wine on the roadways. The man also helped care for an injured man and assisted in transporting him to an inn to receive further treatment. However, many concepts in emergency medical services (EMS) were actually developed in the battlefield and were later transitioned to civilian EMS.

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Who created the first ambulances?

Spain is attributed with first using ambulances, which were more like battlefield hospitals. Initiated by Queen Isabella of Spain during the 1487 siege of Malaga these treatment areas developed. The royalty felt the need to care for the injured members of their troops, further encouraging the usage of medical and surgical supplies on the battlefields. That said, some artwork also exists that suggests the use of battlefield medical transport by Caesar. The first transports were thought to have been by the Anglo-Saxon hammock around CE 900. The hammock was fitted with wheels, which had chains that were held by other attendants in order to prevent it from gaining speed going downhill. A few hundred years later during the Norman conquest of England, horses were employed in transporting patients. A covered bed attached to poles was carried between horses to aid in a more comfortable journey.

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How did Napoleon’s troops utilize ambulances?

Dominique-Jean Larrey, who went on to become Napoleon’s surgeon, noted injured troops during the Prussian wars remaining on the battlefield until the fighting had ceased, thus receiving no treatment until they could be extracted. He developed ambulances for the Army of the Rhine in 1793, which then got him noticed and he was sent to join Napoleon’s Army of Italy. With his partner Baron Percy, they established two-wheeled and four-wheeled ambulances that were lightweight and easily mobile. These ambulances allowed a surgeon to potentially treat a soldier in the field with early amputations of limbs to prevent gangrene, or they could be utilized to transport soldiers to hospital instead.

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