Editing Paramedic (section)

===Early ambulance services===
While civilian communities had organized ways to deal with prehospitalisation care and transportation of the sick and dying as far back as the [[bubonic plague]] in [[London]] between 1598 and 1665, such arrangements were typically ''ad hoc'' and temporary. In time, however, these arrangements began to formalize and become permanent. During the [[American Civil War]], [[Jonathan Letterman]] devised a system of mobile [[field hospital]]s employing the first uses of the principles of [[triage]]. After returning home, some veterans began to attempt to apply what had they had seen on the battlefield to their own communities, and commenced the creation of volunteer life-saving squads and ambulance corps.

[[File:Bundesarchiv Bild 102-11536, Sanitäter bei DRK-Übung.jpg|right|thumb|[[German Red Cross]] paramedics training in 1931]]
[[File:Magen David Adom1948.jpg|right|thumb|Ambulance of the [[Magen David Adom]] in Israel, [[1948 Palestine war|6 June 1948]]]]
These early developments in formalized ambulance services were decided at local levels, and this led to services being provided by diverse operators such as the local hospital, police, fire brigade, or even [[funeral director]]s who often possessed the only local transport allowing a passenger to lie down. In most cases these ambulances were operated by drivers and attendants with little or no medical training, and it was some time before formal training began to appear in some units. An early example was the members of the [[Toronto EMS|Toronto Police Ambulance Service]] receiving a mandatory five days of training from St. John as early as 1889.<ref>{{cite web|publisher=Toronto EMS|url=http://torontoems.ca/main-site/about/history.html|title=Toronto EMS: History|access-date=2011-01-03|archive-date=2010-12-26|archive-url=https://web.archive.org/web/20101226035841/http://www.torontoems.ca/main-site/about/history.html|url-status=dead}}</ref>

Prior to [[World War I]] motorized ambulances started to be developed, but once they proved their effectiveness on the battlefield during the war the concept spread rapidly to civilian systems. In terms of advanced skills, once again the military led the way. During [[World War II]] and the [[Korean War]] battlefield medics administered painkilling [[narcotic]]s by injection in emergency situations, and pharmacists' mates on warships were permitted to do even more without the guidance of a physician. The Korean War also marked the first widespread use of [[helicopter]]s to evacuate the wounded from forward positions to medical units, leading to the rise of the term "[[Medical evacuation|medevac]]". These innovations would not find their way into the civilian sphere for nearly twenty more years.