As a profession, EMS is just a mere child, struggling to come to terms with its identity and wishing to make its own mark in the world. A benefit to being so young is that we are not so far removed from the true beginnings of the organized delivery of prehospital emergency care. The "hows" and "whys" of our origins are still easily available-and, for the most part, from the very people who were instrumental in establishing the systems and practices we take for granted today.
The term founding fathers is often used in reverential treatments of history, and the achievements and motivations of EMS' founding fathers are appropriately impressive. Their accomplishments-from establishing standardized training for providers to improving prehospital cardiac resuscitation to creating better system management-helped move EMS forward. The individuals highlighted in this article took personal and professional chances on fledgling ideas in order to build systems they believed would save lives. They allowed the next generation to build on a foundation with clinical, operational and administrative improvements that helped EMS survive and thrive. Knowing these individuals and their contributions is a critical step in coming to terms with where we've been, understanding where we are and identifying future directions for our profession.
A Tribute to Karl William Edmark, MD
Karl William Edmark, MD, was a cardiovascular surgeon and lifelong inventor who was committed to improving outcomes for patients undergoing cardiac surgery. His best-known contribution was to defibrillation science. In the early to mid 1950s, defibrillators used alternating current (AC), which was unreliable and used a high-voltage wave form. Edmark developed a defibrillator that utilized direct current (DC), which provided lower-energy shocks with less trauma to patients and was more reliable and effective in terminating ventricular fibrillation. Edmark's invention, known as the Edmark Pulse Defibrillator, was first used to save the life of a 12-year-old girl in Seattle in 1961.
Edmark founded Physio-Control in 1955. He later hired W. Hunter Simpson to direct the company's growth, while he continued to develop products to benefit patients with cardiac conditions. Edmark's company went on to revolutionize emergency medical care by introducing the first portable defibrillator/monitor that enabled paramedics to provide defibrillation in the field, before transporting the patient to the hospital. This improvement was an important factor in the advent of Seattle's Medic One, a pioneering emergency medical service founded in 1970.
David Boyd, MD
An Illinois trauma surgeon responsible for establishing trauma centers in the Chicago area, Boyd in 1974 became the director of the federal Division of EMS within the Department of Health, Education and Welfare (the precursor to the Department of Health and Human Services). He developed the framework and guidelines necessary to implement EMS systems throughout the United States and utilized federal grant funds as an incentive for EMS system development, which resulted in the creation of state and local EMS regions across the country. Although the HEW Division of EMS would be short-lived, his efforts and leadership left a lasting impression on the structure of EMS delivery systems nationwide. Boyd served on EMS Magazine's editorial advisory board for several years.