Blast from the Past: Looking back gives us an idea of where we're going - Administration and Leadership - @

Blast from the Past: Looking back gives us an idea of where we're going



Gary Ludwig, MS, EMT-P | From the April 2009 Issue | Monday, March 30, 2009

My grandfather died in 1964. I was only six at the time and didn't fully understand what was happening, but I remember feeling a pit in the bottom of my stomach and knowing something was wrong the night he died.

Recently, while going through some photo albums, I came across a picture of him. I began to think about the era he grew up in and wondered how someone from his day would react if they were to see what the 21st century was like. Would they accept the ways in which our society has changed? What would seem most amazing?

Because our lives are so dependent on technology, I imagine I'd first tell them how much computers and the Internet have transformed the way we work and interact. Then I would explain the other significant inventions in the past 50 yearsƒmicrowaves, air conditioning, DVDs, cell phones, space exploration programs, digital cameras, satellite television, hybrid vehicles and video games. Some of these would really blow their minds. There have also been major cultural events, such as the election of the first African-American president.

EMS Revolutionized

If an EMS provider from the early 1900s were to get a glimpse of 2009, they would probably be most enchanted by modern medicine. EMS has changed a lot since the National Academy of Sciences published the white paper, "Accidental Death and Disability: The Neglected Disease of Modern Society," in 1966. In fact, the phrase "emergency medical services" didn't even exist yet. And neither did emergency medical technicians or paramedics.

I'd break the news to them that the name "ambulance driver" is no longer fashionable, and people in EMS actually get a little peeved when they're called that. After they calmed down, I'd recount all the advancements in prehospital care and medicine in general -- MRIs, cath labs, gene therapy, chemotherapy, and the vast array of medicines and vaccines available today. The best part would be watching their facial expression when I explained Viagra.

Transportation and equipment have come a long way as well. In the 1960s, they drove those old-style Cadillacs you see in pictures or sadly find sitting in junkyards these days. Those ambulances had limited head room for the attendant in the patient compartment and were usually equipped with just a stretcher, a kit and maybe an oxygen bottle. They would be amazed at how large the rear compartment of the ambulance has become, and how fully stocked the interior and exterior compartments are. They'd probably ask, wide-eyed, "What do you do with all this stuff?"

The monitor/defibrillator would immediately catch their eye, and after learning what it did, they would wonder how you could pump electricity through somebody and save their life. And even the stretcher would look different. It would be hard for them to believe it automatically moves the patient up and down.

Next, I'd try to explain protocols, standards, benchmarking and evidenced-based medicine. Certainly, things used to be simpler and easier. They'd probably lament the days when they loaded somebody on the stretcher and raced them to the hospital and didn't have to worry about all the other stuff.

I'd also tell them about how helicopters now take patients to hospitals, with nurses and paramedics in thehelicopters treating those patients. This would excite them but wouldn't be too surprising if they lived through the Korean War when helicopters transported wounded soldiers.

It would also be important to update them on how the educational requirements and training for a career in EMS has changed with the National Registry, National Scope of Practice, National EMS Core Content, National EMS Education Standards, National EMS Certification and National EMS Program Accreditation. A million acronyms would follow, such as ACLS, PALS, ITLS and PEPP. While I caught my breath, they'd probably tell me about the simple first aid class they took from the American Red Cross and how they learned to apply direct pressure on a wound to stop the bleeding. I'd tell them we still do that, but we also have specialized coagulants to help control bleeding now, too.

Back to Reality

Of course, this "blast from the past" is unrealistic, but it illustrates how far we've come as a profession. And there's still more to accomplish. I wonder what kind of world we'd find if we jumped ahead in time ourselves. Perhaps imagining all the possibilities shows us what we can work toward as today's leaders. JEMS

Gary Ludwig, MS, EMT-P, is a deputy fire chief with the Memphis (Tenn.) Fire Department. He has 30 years of fire and rescue experience. He's chair of the EMS Section for the International Association of Fire Chiefs.

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Related Topics: Administration and Leadership, Leadership and Professionalism, Jems Leadership Sector

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Gary Ludwig, MS, EMT-P

Gary Ludwig, MS, EMT-P, is a well-known author, lecturer and consultant who has successfully managed two large award-winning metropolitan fire-based EMS systems. He has 37 years of fire, rescue and EMS experience and has been a paramedic for over 35 years. He’s also past chair of the EMS section for the International Association of Fire Chiefs and has a master’s degree in management and business. He can be reached at


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