EMS is a vital public service, as important to your community as the police or fire department. But surprisingly, few Americans understand how EMS works or what role it plays. A public opinion survey conducted for the American College of Emergency Medical Physicians (ACEP) in 1992 found that nearly half of adult Americans could not identify 9-1-1 as the emergency number, or confused it with 4-1-1, the directory assistance number. Fewer still--just one in five--had talked to their doctor about what to do in a medical emergency.

Emergency medical services is a system of care for victims of sudden and serious illness or injury. This system depends on the availability and coordination of many different elements, ranging from an informed public capable of recognizing medical emergencies to a network of trauma centers capable of providing highly specialized care to the most seriously ill or injured. The 9-1-1 emergency number, search and rescue teams, and prehospital and emergency department personnel are some of the critical elements necessary for the EMS system to work.

In 1966, a national Academy of Sciences report, Accidental Death and Disability: The Neglected Disease of Modern Society, documented widespread deficiencies in emergency care. At this time, it was common for emergency patients to be transported to the hospital in vehicles operated by mortuary services, and few hospitals had emergency wards staffed by doctors.

The NAS report, which revealed that the average American had a greater chance of survival in the combat zones of Korea or Vietnam than on the nation's highways, catalyzed public support for the creation of the EMS system as we know it today. Also in 1966, Congress passed legislation enabling the creation of the National Highway Traffic Safety Administration (NHTSA), setting the stage for the first federal standards in EMS.

In the 30 years since, the efforts of EMS providers at all levels have helped make our EMS system the most advanced in the world. But despite its remarkable progress, the EMS system still faces the challenge of declining support for state and federal EMS programs.