The #Coronavirus chronicles, part 26: The evolution of emergency services — #EMS #EMT #Paramedic #Television #COVID19

As a result of the COVID-19 pandemic, I’ve been spending a lot of time — probably too much time — at home. As such, one of the pitfalls is that I’m probably watching way too much TV. Yes, I know, I really need to get out of the house more.

With that, one of my more recent addictions is old Emergency! reruns on COZI TV. I have childhood memories of this being one of my favorite shows; I remember riding around on my bike as a kid, making a siren noise and pretending I was a paramedic. Outside of watching sports, I seem to have a thing for medical dramas — I’ve been watching shows like Transplant and the Chicago series, and I’ve also been a fan of M*A*S*H for many years.

Watching these old Emergency! reruns and comparing them against current Chicago Fire episodes makes me think about how much EMT, EMS, and paramedic services have evolved throughout the years. I think that evolution is fascinating — enough to the point that I’m writing a ‘blog article about it.

First, let me start with a little background information. Emergency! is largely credited with raising awareness of emergency medical services. The show also traces its roots to a report titled Accidental Death and Disability: The Neglected Disease of Modern Society (a.k.a. “the white paper”). The show takes place in the 1970s, and it’s a far cry from the EMS and EMT services with which we’re familiar today.

The pilot episode talks about the Wedsworth-Townsend Act (which is also the name of the episode). The episode largely focuses on the origins of the paramedic program in LA. In the episode, Dr. Brackett (played by Robert Fuller) makes a plea for passage of the bill to allow paramedics to provide emergency services. In the same episode, Firefigher John Gage (Randolph Mantooth) expresses his frustration after losing a patient largely due to not being able to get him the help he needed in time.

Emergency services changed all that. Before those days, an ambulance was nothing more than a station wagon with a stretcher; the idea was to get an injured person to medical help as fast as possible. Unfortunately, many people died before they could get the help they needed.

(I should note that the idea of getting medical help before transport was actually depicted in M*A*S*H — injured personnel often went to a battalion aid station before being sent to a M*A*S*H unit.)

In the show, the idea was to provide medical assistance — more than basic first aid, but less than a doctor’s services — to make the patient stable enough to transport him or her to the hospital. Johnny and Roy, the paramedics, were trained to apply those services, but in order to do so, they needed to contact the hospital (using the famous biophone) to obtain both instructions and authorization to administer medical services. Additionally, the paramedics served a dual role; while they were licensed to provide medical assistance, they were (I’m guessing first and foremost) firefighters whose primary role was search and rescue. They drove a truck mostly designed for search and rescue operations; it was not capable of patient transport. They had to call for an ambulance separately in order to get the patient to the hospital.

These days, these roles are different (Chicago Fire does a good job of depicting this — I should also note that, as far as I understand, Chicago Fire and Emergency! are actually technically accurate; they aren’t just medical gobbledygook). In many locales (it may differ in different jurisdictions — I’m mostly generalizing this description), fire department paramedics are themselves medical professionals; they no longer require instructions or authorization from doctors (again, to my knowledge, this depends on the jurisdiction). They themselves drive the ambulances, and the ambulances themselves are often emergency rooms on wheels, a far cry from the vehicles where their only function was to transport patients as fast as possible. And the roles of paramedic and search/rescue personnel are mostly different, not combined as in Emergency! (in Chicago Fire, these different roles are depicted by Ambulance 61 and Squad 3, respectively).

A couple of personal thoughts about the comparison between Emergency! and Chicago Fire: first, although I haven’t been able to find any citations to support this, I don’t think there’s any coincidence in that Chicago Firehouse 51 shares a unit number with LA County Fire Station 51 (which would support the influence that Emergency! had). Second, I would love to see an episode of Chicago Fire in which the characters of John Gage and Roy DeSoto make at least a cameo appearance. (Dick Wolf, if you’re reading this, can you make that happen???)

I hope you had as much fun reading this impromptu history of emergency services as much as I did writing about it (and I apologize for any inaccuracies I might have written — please feel free to correct them in the comments if I did). Funny what pops into your head while you’re watching TV…