Editing Paramedic (section)

===Pre-hospital emergency medical care===
By the early 1960s experiments in improving medical care had begun in some civilian centres. One early experiment involved the provision of pre-hospital [[cardiac]] care by physicians in [[Belfast]], Northern Ireland, in 1966.<ref>Br Heart J 1986;56:491-5</ref> This was repeated in [[Toronto]], Canada in 1968 using a single ambulance called ''Cardiac One'', which was staffed by a regular ambulance crew, along with a hospital [[intern]] to perform the advanced procedures. While both of these experiments had certain levels of success, the technology had not yet reached a sufficiently advanced level to be fully effective; for example, the Toronto portable [[defibrillator]] and [[heart monitor]] was powered by [[Lead–acid battery|lead-acid car batteries]], and weighed around {{convert|45|kg|lbs}}.

[[File:Woman collapses in the East Village of New York.jpg|right|thumb|EMTs caring for a collapsed woman in New York]]
In 1966, a report called ''Accidental Death and Disability: The Neglected Disease of Modern Society''—commonly known as ''[[Accidental Death and Disability: The Neglected Disease of Modern Society|The White Paper]]''—was published in the United States. This paper presented data showing that soldiers who were seriously wounded on the battlefields during the [[Vietnam War]] had a better survival rate than people who were seriously injured in motor vehicle accidents on [[California]]'s [[freeway]]s.<ref>{{citation |title=Accidental Death and Disability: The Neglected Disease of Modern Society |date=September 1966 |author=Division of Medical Sciences, Committee on Trauma and Committee on Shock |publisher=National Academy of Sciences-National Research Council |location=Washington, D.C.}}</ref> Key factors contributing to victim survival in transport to definitive care such as a hospital were identified as comprehensive trauma care, rapid transport to designated trauma facilities, and the presence of medical corpsmen who were trained to perform certain critical advanced medical procedures such as [[fluid replacement]] and [[airway management]].

As a result of ''The White Paper'', the US government moved to develop minimum standards for ambulance training, ambulance equipment and vehicle design. These new standards were incorporated into Federal Highway Safety legislation and the states were advised to either adopt these standards into state laws or risk a reduction in Federal highway safety funding. The "White Paper" also prompted the inception of a number of emergency medical service (EMS) [[pilot experiment|pilot unit]]s across the US including paramedic programs. The success of these units led to a rapid transition to make them fully operational.

Founded in 1967, [[Freedom House Ambulance Service]] was the first civilian emergency medical service in the United States to be staffed by [[paramedics]], most of whom were Black. 
New York City's Saint Vincent's Hospital developed the United States' first Mobile Coronary Care Unit (MCCU) under the medical direction of William Grace, MD, and based on Frank Pantridge's MCCU project in Belfast, Northern Ireland.{{when|date=December 2012}} In 1967, Eugene Nagle, MD and Jim Hirschmann, MD helped pioneer the United States' first EKG telemetry transmission to a hospital and then in 1968, a functional paramedic program in conjunction with the City of Miami Fire Department. In 1969, the City of Columbus Fire Department joined with the Ohio State University Medical Center to develop the "HEARTMOBILE" paramedic program under the medical direction of James Warren, MD and Richard Lewis, MD. In 1969, the Haywood County (NC) Volunteer Rescue Squad developed a paramedic program (then called Mobile Intensive Care Technicians) under the medical direction of Ralph Feichter, MD. In 1969, the initial Los Angeles paramedic training program was instituted in conjunction with Harbor General Hospital, now [[Harbor–UCLA Medical Center]], under the medical direction of [[J. Michael Criley]], MD and James Lewis, MD. In 1969, the Seattle "Medic 1" paramedic program was developed in conjunction with the [[Harborview Medical Center]] under the medical direction of Leonard Cobb, MD. The Marietta (GA) initial paramedic project was instituted in the Fall of 1970 in conjunction with Kennestone Hospital and Metro Ambulance Service, Inc. under the medical direction of Luther Fortson, MD.<ref>{{cite web |url=http://www.emsmuseum.org/virtual-museum/history/articles/399743/ |title=1967-Metro Ambulance Service (Atlanta, Georgia) |publisher=National EMS museum |access-date=9 October 2014 |url-status=dead |archive-url=https://archive.today/20130414165302/http://www.emsmuseum.org/virtual-museum/history/articles/399743/ |archive-date=14 April 2013 }}</ref> The Los Angeles County and City established paramedic programs following the passage of ''The Wedsworth-Townsend Act'' in 1970. Other cities and states passed their own paramedic bills, leading to the formation of services across the US. Many other countries also followed suit, and paramedic units formed around the world.

In the military, however, the required [[telemetry]] and [[miniaturization]] technologies were more advanced, particularly due to initiatives such as the [[space program]].  It would take several more years before these technologies drifted through to civilian applications. In North America, physicians were judged to be too expensive to be used in the pre-hospital setting, although such initiatives were implemented, and sometimes still operate, in [[Europe]]an countries and [[Latin America]].