Bibliography
1 National Academy of Sciences, National Research Council, "Accidental Death and Disability: The Neglected Disease of Modern Society." Washington D.C.: National Academy Press, 1966.
2 ibid
3 Of note, the U.S. Fire Administration (USFA) was created as a result of the issues raised in the report "America Burning" (1973). The report highlighted the high numbers of fire deaths in the U.S. at the time and a subsequent report, America Burning, Revisited (1999), illustrated the results of fire prevention and education efforts. A similar follow-on report for EMS is desperately needed.
4 For simplicity, references to NHTSA (and its parent department, the U.S. Department of Transportation) are synonymously referred to as "DOT" in this document.
5 Dr. J.F. Pantridge introduced the concept of emergency cardiac care in the pre-hospital setting in Northern Ireland in 1966 (see: Pantridge JF, Geddes JS. A mobile intensive-care unit in the management of myocardial infarction. Lancet 1967; 2(7510):271-273.). The innovative work of Dr. Pantridge caught the attention of Leonard Cobb in Seattle and Eugene Nagel in Miami, who first brought emergency cardiac care to American homes (see: Nagel EL, Hirschman JC, Mayer PW, Dennis F. Telemetry of physiologic data: an aid to fire-rescue personnel in a metropolitan area. South Med J 1968; 61(6):598-601, and Baum RS, Alvarez H, III, Cobb LA. Survival after resuscitation from out-of-hospital ventricular fibrillation. Circulation 1974; 50(6):1231-1235.) The success of emergency medical services in saving lives in Vietnam (including helicopter evacuation), and the training of thousands of emergency medical technicians for the Army, further contributed to the development of modern EMS in America. The case for pre-hospital advanced-level care was brought to the nation's living rooms in 1971 with the hit television program "Emergency." Seeing paramedics Johnny Gage and Roy DeSoto saving lives every week with their high-tech equipment and advanced procedures, the public soon began to demand paramedic-level care in their hometowns.
6 HEW was the predecessor to the U.S. Department of Health and Human Services (HHS).
7 In most states, EMS competes for these dollars with the Women, Infants and Children (WIC) program and various other public health programs. In Maryland, the rat eradication program was one such public health program.
8 Kuehl AE. Prehospital Systems & Medical Oversight. 2nd ed. Missouri: Mosby Lifeline, 1994: 19.
9 Journal of Emergency Medical Services, Platinum Resource Guide, Key EMS Statistics http://www.jems.com/jems/2004resources/guide1.html
10 ibid
11 For further discussion on the role of EMS during mass casualty incidents see: Christen HT, Maniscalco PM. Mass Casualty and High-Impact Incidents: An Operations Guide. Prentice Hall, 2002; Maniscalco PM, Christen HT. Understanding Terrorism and Managing the Consequences. Prentice Hall, 2001; Christen HT, Maniscalco PM. The EMS Incident Management System: Operations for Mass Casualty and High-Impact Incidents. Pearson Education, 1998.
12 U.S. Department of Homeland Security. "Support for EMS Provided by the DHS Office of State and Local Government Coordination and Preparedness." A Report to the Committees on Appropriations of the United States Senate and House of Representatives. Washington, D.C., May 2004: 42.
13 The fire service has the Assistance to Firefighter Grant Program (http://www.firegrantsupport.com/) and law enforcement has the Community Oriented Policing Services (COPS) program (http://www.cops.usdoj.gov/).
14 U.S. Fire Administration, "fire statistics": http://www.usfa.fema.gov/statistics/quickstats/.
15 U.S. Department of Justice, Bureau of Justice Statistics, "Four measures of serious violent crime" http://www.ojp.usdoj.gov/bjs/glance/tables/4meastab.htm.
16 U.S. Fire Administration, "FEMA, USFA and NFPA national study identifies service gaps in America's fire departments," Release No.: 03-014, January 22, 2003: www.usfa.fema.gov/about/media/2003releases/03-014.shtm
17 Fewer than 10 federal courses specifically focus on EMS requirements and operations.
18 U.S. Department of Transportation, National Highway Traffic Safety Administration, EMS National Standard Curricula: http://www.nhtsa.dot.gov/people/injury/ems/nsc.htm; U.S. General Services Administration, Federal Specifications for the Star-of-Life Ambulance, KKK-A-1822E: http://www.gsa.gov/gsa/cm_attachments/GSA_DOCUMENT/ambulanc_1_R2FI5H_0Z5RDZ-i34K-pR.pdf.
19 EMS Agenda for the Future, National Highway Traffic Safety Administration, U.S. Department of Transportation, April 16, 1996: http://www.nhtsa.dot.gov/people/injury/ems/ems_agenda.html
20 EMS Agenda for the Future, National Highway Traffic Safety Administration, U.S. Department of Transportation, April 16, 1996: http://www.nhtsa.dot.gov/people/injury/ems/agenda/emsman.html#LEGISLATION
21 EMS Agenda for the Future Implementation Guide, National Highway Traffic Safety Administration, U.S. Department of Transportation, February, 1998: http://www.nhtsa.dot.gov/people/injury/ems/agenda/
22 Emergency Medical Services: The Forgotten First Responder" Center for Catastrophe Preparedness and Response, New York University, March 2005: http://www.nyu.edu/ccpr/pdf/NYUEMSreport.pdf
23 S.611, introduced by Senator Susan Collins and HR 1240, introduced by Congressman Hefley
24 National Highway Traffic Safety Administration, About NHTSA, "Who we are and what we do,": http://www.nhtsa.dot.gov/.
25 While EMS responses to traffic accidents continue, responses to other acute medical emergencies, notably cardiac emergencies, have increased dramatically, eclipsing the core discipline represented by NHTSA. Moreover, dramatic changes in the national security landscape require the creation and management of specialized competencies and disciplines that fall squarely within the Department of Homeland Security.
26 The Fifth Annual Report to the President and the Congress of the Advisory Panel to Assess the Domestic Response Capabilities for Terrorism Involving Weapons of Mass Destruction, December 15, 2003, 28: http://www.rand.org/nsrd/terrpanel/volume_v/volume_v_report_only.pdf.
27 Christen HT, Walsh DW. "The new normalcy." Journal of Emergency Medical Services, 2005, Vol 30, No. 4, pg 68.
28 U.S. Department of Homeland Security, Strategic Plan, February 23, 2004: http://www.dhs.gov/dhspublic/display?theme=10&content=3240.
29 Of particular note, the United States Coast Guard—with more than 50,000 members—was transferred from the Department of Transportation when DHS was created. With such a significant precedent, transferring the handful of employees from the DOT EMS office to DHS should be simple by comparison.
