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EMS Yesterday, Today and Tomorrow




How an industry…a profession... and our company… have evolved

Emergency medicine can be traced back as early as 1500 B.C. when “good Samaritans” treated the wounds of travelers. Today, EMS as we know it is completely different. As a company with a history that dates back nearly a century through its predecessors, AMR has seen the EMS industry grow and change. And we are proud of the fact that we have been a major contributor to many of those advancements.

As an industry initially focused primarily on the movement of sick and injured patients, the ambulances of yesteryear were much different than the state-of-the-art vehicles we use today. One of the first motorized ambulances to be used by our predecessor, Buck Ambulance in Portland, Ore., was a 1923 Dodge (see photo). Decades later, the vehicles used as ambulances were converted hearses. Today, AMR leads the industry with the fourth generation safety concept vehicle – a fully integrated, technologically advanced, mobile healthcare system specifically designed and built to dramatically enhance the safety of our caregivers.,.

“The concept ambulance continues to introduce technologies that can advance caregiver and patient safety, and, just as important, improve patient care,” said Ron Thackery, senior vice president of professional services.

AMR and manufacturer AEV were the pioneers of such advances in ambulance design. Much of that technology is now being adopted by other ambulance manufacturers across the country.

As the EMS industry continued to grow, the medical community began to evaluate the effects of medications, technology and clinical approaches in this unique setting. The paramedic drug box of the 1970s contained only epinephrine, atropine, bicarb, calcium, lidocaine, nitroglycerin, and D50W. There were no respiratory meds, no medication drips, no antiemetics, and no narcotics. The initial roles of the Medics were to be the “eyes & ears” of the physician, so Medics had to call a doctor for all orders and transmit ECG tracings for the physician to interpret. There were no KEDs, and back boards were made of 3/4 inch plywood. The original heart monitor/defibrillators were three-lead and weighed nearly 100 lbs. Today, not only do we have more sophisticated medical technology and therapeutics in the field, but the pre-hospital professionals-- Paramedics, EMTs, Nurses and Communications Specialists-- have grown professionally in both scope and ability. EMS became the perfect marriage of innovative, portable technology and skilled, capable practitioners.

Mark Bruning, AMR President, said, “For our company, AMR Medicine is the foundation for the care we provide for our patient, with our partners in our communities, as part of the entire healthcare system. AMR Medicine initiatives will further advance pre-hospital medicine and the ways we treat our patients.”

Ed Racht, MD, AMR Chief Medical Officer, added, “We truly believe AMR Medicine conveys a message of who we are and what we stand for. We participate in national organizations at the leadership level. We partner with academic institutions to participate in research and analysis of best practices. We work side by side with industry to brainstorm new ideas to improve the technology in the field.”

And now, EMS continues it’s growth by becoming a more integrated, evidence-based healthcare delivery system with significant opportunities to have an even greater impact on patient’s lives. AMR Medicine is the exciting next chapter in our evolution.

Out-of-hospital medicine is increasingly focused on evidence-based clinical interventions that improve patient outcomes. As a matter of fact, the American Board of Medical Specialties approved the designated subspecialty of EMS in 2010 – one more important indicator of the importance of EMS clinical care on patient outcome. The clinical metrics associated with AMR Medicine’s seven “Things That Matter” are at the forefront of the accountability and transparency movement in healthcare. As the largest provider of out-of-hospital care, we have the added advantage of partnering with numerous academic partners to identify best practices in EMS. “We believe that AMR Medicine provides a strong platform to differentiate AMR in the marketplace,” said Bruning.

Another avenue for improving patient care exists through innovative use of our proprietary data system (MEDS). Simplifying data entry for our crews, developing ongoing data solution technologies with our partners in industry, linking outcomes and exploring the development of decision support capabilities within MEDS are all high priorities at AMR.

What does the future hold for EMS? Fasten your seatbelts! AMR once again has an opportunity to have a significant effect on the future of our industry and our profession. Change is inevitable, predictable, and needed. With a footprint that includes EMS systems in 40 states, AMR has the potential to significantly participate in the evolution of the science of EMS.

We’re proud of where we’ve been and we’re proud of where we’re going. We will continue to make a difference for people in need.


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