Before 1970, EMS in the United States, wasn't much to talk about. There was virtually no significant training of providers beyond basic first aid, ambulances were designed without standards—for speed, not patient care—and there were no real systems to coordinate the care and transport of the sick and injured. As a country, we were just functioning with a more contemporary model of what had been around since the Civil War. To use a computer software analogy, you might say we were operating Version 1.0 of EMS.
Modern EMS began in 1966 with the publication of the landmark white paper "Accidental Death and Disability: The neglected disease of modern society" from the National Research Council of the National Academy of Sciences. That same year, the Highway Safety Act (Public Law 89-564) was passed to reduce the number of fatalities and injuries that occur on U.S. roads and highways. This is when our current notion of EMS really began: we started to use the term "EMS," established standards of training for EMTs and paramedics, created design criteria for ambulances and talked about "systems" for delivering our service rapidly and ubiquitously.
In 1996, the National Highway Traffic Safety Administration (NHTSA) published the "EMS Agenda for the Future," which included guidance for EMS training, educational standards and the National Scope of Practice Model. These provided further enhancements to previous training curricula and standards, and described a more advanced world for EMS practitioners.
Over the last 50 years, this Version 2.0 of EMS saw us broadening the limits of what EMS could do and substantially refined the expectation of what an EMS system should be, boadened our scope of patient care, and laid down a path for the future we should strive to attain