ABSTRACT
The National Academy of Sciences (NAS) proposed the creation of an emergency medical services (EMS) system in 1966. 1 Until then, ambulance services were mostly provided by funeral homes that offered transport but no medical services. The NAS white paper advocated training, equipping, and regulating an EMS service. In 1966, Congress passed the National Highway Safety Act, requiring states to prepare an EMS program or lose their highway construction funds. The federal Department of Transportation established EMS operating standards and the qualifications for emergency medical technician (EMT) and paramedic positions. In 1973, Congress passed the Emergency Medical Services Systems Act, which funded regional systems. In 1981, Congress reduced EMS funding, but by then, EMS systems were firmly in place nationwide.
