The celebration of EMS Week is a great opportunity to take a few moments and review one of the most historic documents in EMS history: “Death in a Ditch,” authored by J.D. Farrington, MD, FACS.
This short but powerful article, published in the May/June 1967 edition of the American College of Surgeons Bulletin, became the genesis for much of what would become modern EMS: training programs, ambulance standards, essential equipment, textbooks “¦
Why? Because Dr. Farrington took it upon himself, from his small area of the United States, to say enough was enough and point out the need for more training and improvements in EMS.
The article presented the concepts Dr. Farrington used to instruct rescue workers and townspeople on the safe extrication, emergency care and transport of patients involved in vehicle crashes. It outlines the steps he felt first responders should take in assessing patients’ level of injury and provide on-site care for those conditions. It also demonstrated extrication techniques and lists the equipment that should be carried in emergency vehicles.1
NOTE: This is one of the first places the backboard appeared as a way to slide a patient out of an automobile–not necessarily as a device that patients had to remain strapped to after extrication. You’ll see in this epic 1967 article how rescuers used a rope in a sling manner to pull victims onto the spineboard.
Farrington caught the attention of his ACS colleagues. More importantly, his colleagues agreed with him, joined his efforts and began to educate State and Federal legislators of the need for improvement — and more funding — to improve ambulance delivery and develop a systematic approach to care in America. In a sense, it is one of documents that awoke America’s physicians and politicians.
Farrington questioned why the lessons learned by the military medical corps during World War II and the Korean War couldn’t be brought into the civilian community to improve the standard of civilian care. Dr. Farrington and his colleague Dr. Sam Banks developed a trauma training school for the Chicago Fire Department that served as the prototype of what later became the first EMT-Ambulance (EMT-A) training program. Dr. Farrington was involved in the design of the program for the U.S. Department of Transportation (USDOT) along with Rocco Morando, Oscar Hampton, Walter Hoyt, Walter Hunt, Robert Oswald, Peter Safar, and Joseph Territo.2
In a time when EMS has no federal lead agency and little or no federal funding for improvements and essentially needed equipment to combat increasing call volumes, morbid obesity, an aging population and the real threat of terrorism on American soil, EMS agencies need to begin to educate and lobby their federal representatives for a lead agency in Washington, D.C. that is properly funded, and for an organized grant program that allows agencies big and small, paid and volunteer, urban and rural to improve care equally across the United States.
To download a copy of Death in a Ditch, go to:
http://em.pgpic.com/docs/Death%20in%20a%20Ditch.pdf
Resources
1 http://bulletin.facs.org/2013/06/death-in-a-ditch/
2 www.emsmuseum.org/virtual-museum/management/articles/398270-1951-J-D-Deke-Farrington-MD
