The History Of The Ambulance Service.
In many medical textbooks, credit for the modern ambulance is generally given to
Dr. Dominique Jean Larrey, a French surgeon in Napoleon Bonaparte’s Grande Armée.
In the late 1700’s during the Napoleonic Wars, Dr. Larrey, working close to the battlefields, saw first-hand the need for rapid application of medical care. Dr. Larrey saw the old heavy wagons used as field hospitals, stationed at the rear of the army, as woefully inadequate.
To address this Dr. Larrey set about developing a new lightweight wagon, which could move rapidly across the battlefield to quickly remove soldiers and deliver them to the field hospital, or bring the surgeons to the battlefield to provide immediate care for those with wounds too severe to move before receiving treatment. These wagons became known as “flying ambulances” and worked closely with Napoleon’s “flying artillery”, so named because of the speed at which they could move across the battlefield.
St John Ambulance Association, United Kingdom, introduced horse drawn ambulances free of charge to the poor in 1887.
A.F. Mulliners, cab manufacturer of Bridge Street, Northampton built first ambulance at a cost of £48.00, plus £6.10s for the rubber tyres. Charges for use of the Ambulance were 3 shillings per mile, which is an equivalent of USD19 or RUR1450 per 1.6kms today. It was not a cheap service!
In 1899 the first motorised ambulance came on the scene. It had advantages over the horse-drawn prototype. It was faster and smoother for the patients, who were now transported with greater ease and safety. It was able to move at 16 miles per hour. There was sometimes a doctor in the back of the vehicle who could communicate with the driver via a speaking tube. There were electric lights as well.
Following the First World War, horse-drawn ambulances fell out of favor due to the rise in popularity and practicality of the gas engine. Horse drawn ambulances replaced by motor vehicles by 1912-16.
It wasn’t long afterward that people started to take advantage of this new technolo-gy. By the late 1920s, it was common to see automobile ambulances as part of a hospital’s assets.
In 1937 the first ambulance with air-conditioning in the United States was built by a firm who specialized in building ambulances, Hess and Eisenhardt. And ambulance services spread slowly across the US and in Europe. 999 telephone number for the ambulance was introduced in England in 1937.
Following the World War II, there was a general decline in the number of doctors who participated in ambulance operations. For a time funeral homes, stepped in using a modified hearse equipped with flashing lights and a siren, to rapidly transport individuals to either the hospital or the funeral home.
The situation began to change when in 1947 legislation required ambulances to be equipped with basic medical supplies, as well as requiring the ambulance personnel to be trained in basic first aid. Before that patient care began only when the patient had arrived at the hospital.
In the 1950s and 1960s, medics became increasingly aware of the importance of early medical intervention and its impact on survivability rates.
Ambulances in USA and Canada: there are 3 Ambulance types: from the light medical vehicle to the heavy duty buses. Ambulances are mostly owned either by fire departments OR independent ambulance services (private businesses). Many firefighters are also trained paramedics. Quite often, a fire truck with additional personnel will accompany an ambulance on a medical call.
Ambulances in France: the most general term is "vehicle adapted to patient transport", the term "ambulance" only applies for some categories of patient transport vehicles. There are therefore 2 kinds of ambulance providers: hospitals and private companies.
Ambulances in the United Kingdom: in the UK, ambulance free services are provided under the National Health Service through local ambulance 'trusts'. Each trust is specific to a county or area, in a similar way to the British Police are.
Ambulances in Germany: originally, an ambulance that was sent to a potentially life-threatening situation (e.g. cardiac arrest), was usually staffed with two paramedics and one physician. If there is no physician needed, the doctor can leave and let the para-medics take care of the patient. Also, the driver of the emergency physician's car is usually a trained medic too.