In 1966, a report entitled “Accidental Death and Disability” was released by the National Academies of Sciences, bringing to light the “neglected epidemic” of accidental injury. This report, along with passage of the 1966 Highway Safety Act, provided impetus for increased national attention on the plight of victims of motor vehicle trauma. The Federal government was given a leadership role in reducing the number of injuries and deaths on America’s highways. As a result, the National Highway Safety Bureau (NHSB), which was the predecessor agency to National Highway Transportation Safety Administration (NHTSA), was created. A part of this new agency, the Division of Emergency Treatment and Transfer of the Injured, was dedicated to EMS.

In 1969, Dr. William Haddon, then Director of the NHSB, introduced the Haddon Matrix at the First DOT Inter-Departmental Safety Seminar. This simple, yet ground-breaking model defined EMS as a critical element of a comprehensive strategy to reduce traffic-related death and injury.  The Haddon Matrix applied a public health model to the “epidemic” of traffic-related injury. In this model, crashes can be prevented by changing human factors, vehicle factors, and environmental factors. Likewise, if a crash occurred, injuries can be prevented or minimized by changing the same three factors. Moreover, if these strategies fail, the matrix shows the importance of post-crash emergency care in reducing mortality and morbidity. In 1969, an organized system to provide emergency medical care did not yet exist.

Early on, Dr. Haddon recognized that the only sustainable “emergency medical services system” was one that responded to all types of illness and injury, not just car crashes. In fact, Dr. Haddon stated at the time that, “[Emergency Medical Services]“…are broader and relate to community response to a wide variety of social disruptions involving everything from riots to tornadoes to earthquakes to scattered emergencies such as acute childbirth problem[s], coronaries, and injuries in industry, and you don’t go at these any more if you think about this field in systems terms only in isolation, thinking only about the highway [crash patients] or only about the medical [patients].”

In 1970, the NHSB was reorganized as the National Highway Traffic Safety Administration (NHTSA). NHTSA, still under the leadership of Dr. Haddon, built upon the mission of the NHSB, including support for the development of emergency medical services.

In 1977, NHTSA created the Star of Life. Prior to its creation, there was no uniform symbol that represented EMS. Today, the Star of Life identifies emergency medical services not just in this country “” but across the globe. This symbol can be found on ambulances, emergency medical equipment, patches and apparel worn by EMS providers. It can also be found on road maps and highway signs indicating the location of or access to qualified emergency medical care.

In 1988, the NHTSA statewide EMS Technical Assessment Program is based on the 10 key components of EMS systems. NHTSA facilitates the process of gathering an independent team of EMS experts to identify EMS system strengths, needs, and strategies. Nearly all the States and U.S. territories have already taken advantage of this process and NHTSA is accepting requests for reassessment from States that have previously conducted an assessment and are interested in gauging subsequent progress.

For more information go to www.ems.gov