Introduction

Transportation of injured and critically ill patients is a relatively new development in history. Apart from the Spartan mothers, who admonished their warrior sons to 'Come back home with your shield, or on it', the first organized transport of patients did not occur until the French Revolutionary War (1792-1802). Here, Doctor Baron Dominique Jean Larey, who was the surgeon to Napoleon himself, popularized the idea of using wheeled carts (which he called flying ambulances) to transport the wounded to hospitals. Of course, this was not done until the battle was decided; thus the wounded lay on the battlefield for days. The first air medical transport in the modern era was when the British Royal Air Force organized a Medical Branch and formulated an organized plan for casualty evacuation which was first implemented in 1920 in Somaliland. Helicopters came into use shortly after their development by Sikorsky (1945) and Young (1946) during the Korean War and have flourished since.

Ground ambulance development occurred later in the United States, and up until the mid-1970s the most common ground vehicle that could transport a patient in a stretcher was a mortician's hearse. The development of emergency medical service systems had to await the concepts of rapid evacuation, learned in Vietnam, coupled with the ground-breaking work of field defibrillation by Pantridge in Ireland ( Pantridge and Geddes 1967). The United States rapidly expanded the emergency medical service through government grants from the national Emergency Medical Services Act 1973 with the development of national emergency medical technician and paramedic curricula and the vehicles that we now recognize as the modern ground ambulance.

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